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Psychology Presentation on Phobias
Transcript of Psychology Presentation on Phobias
One of the most important steps in diagnosing a phobia is deciding whether the symptoms are better explained by another disorder. Phobias can be traced to specific, concrete fears that adult sufferers recognize as irrational.
The fact that the fear is concrete separates phobias from disorders such as generalized anxiety disorder, in which the anxiety is more broad-based. Phobia sufferers are able to pinpoint an exact object or situation that they fear.
Being able to recognize the fear as irrational separates anxiety disorders from the psychotic disorders such as schizophrenia. People who suffer from psychotic disorders genuinely believe that the fear is based on a real danger, though the nature of the danger appears illogical to others. Common Criteria
Each type of phobia has its own unique set of diagnostic criteria. However, there are some overlaps. Diagnostic criteria that are similar to all phobias include:
Life-Limiting: A phobia is not diagnosed unless it significantly impacts the sufferer’s life in some way.
Avoidance: Some people with clinically diagnosable phobias are able to endure the feared situation. However, attempts to avoid the feared situation are an important criterion for diagnosing a phobia.
Anticipatory Anxiety: People with phobias tend to dwell on upcoming events that may feature the feared object or situation. Phobias, or irrational fears, and Obsessive Compulsive Disorder, a tendency towards repetitive or uncontrollable behavior, are also classed with anxiety disorders. These may co-exist, as many individuals with obsessive compulsive disorders have phobias about germs or un cleanliness and may wash their hands or bathe excessively. DSM-IV (TR) Diagnosing Phobia Psychoanalytic theory: phobias result from anxiety produced by repressed id impulses; content is symbol of psychosexual stage of fixation (e.g., snake = phallic symbol and Oedipal stage)
Behavioral theories: focus on learning as the etiological basis of phobias
Phobias are learned avoidance responses (classical and operant conditioning)
Phobias may be acquired through modeling
We are biologically prepared to learn certain fears (e.g. taste with nausea)
Cognitive theory: Thought processes result in high levels of anxiety
Biological theory: genes and autonomic nervous system labilitiy
Humanistic/existential: self-actualization impeded Treating Phobias
Psychoanalytic therapy attempts to uncover repressed conflicts using free association & dream analysis
Behavioral approaches use systematic desensitization, social skills training, & modeling to reduce anxiety responses to phobic stimuli and situations
Flooding: exposure to a phobic stimulus at full intensity
Cognitive approaches focus on altering irrational beliefs via cognitive restructuring & exposure to phobic stimulus; changing cognitions alone is not sufficient
- also social skills training for social phobias
Biological approach uses drugs to eliminate anxiety symptoms
Anxiolytic drugs such as the benzodiazepines (Valium) can reduce anxiety but are also addictive and give rise to withdrawal symptoms upon termination (Soravia et. al, 2006)
Glucocorticoids have recently been found to reduce phobic fear
MAO inhibitors such as phenelzine reduce the degradation of norepinephrine and serotonin
MAO inhibitors can have adverse side effects
Selective serotonin reuptake inhibitors (SSRI’s) (fluoxetine) increase brain serotonin
Humanistic/existential approaches use empathy, unconditional positive regard, and interpretation for all disorders Female, Age 39 years, Anxiety, Phobia
“Phobias can be debilitating and mine was no exception. I have emtophobia, an irrational fear of me or someone else getting sick and vomiting, and my entire life has been riddled with fear. Reactions characterizing my typical nervousness include increased heart rate, shakiness, a hollow feeling in the pit of my stomach, and clammy hands.
Case Studies These symptoms were manageable for me until a decade ago. I was involved in a car accident at that time, which, according to Dr. Elster’s description of possible catalysts, most likely intensified my condition. I began to notice more pronounced symptoms – an overwhelming desire to isolate myself, feelings of hopelessness, inability to breathe calmly, and inability to focus my thoughts. Whenever I was in what I perceived to be a threatening situation, the panic would almost overwhelm me. The most pronounced physical symptom was repeated “waves” of nervousness permeating my entire body. Sleeping was also a challenge, as I would wake up with those waves coursing through me. I lived without a good night’s rest for several years. As would be expected, daily life was becoming intolerable.
A friend recommended Dr. Elster and gave me a brochure outlining some of the physical ailments that had been relieved by her method of upper spine care. One of them was phobias. I must admit I was skeptical but I was also desperate.
The first visit revealed my head was indeed sitting atop my spine lopsided, which was preventing panic-relieving chemicals from passing from my head to the rest of my body.
Within a month after my first treatment, I was sleeping uninterrupted. I continued with the treatments and although I cannot pinpoint the exact moment my panic attacks subsided, I can relate with certainty that within 9 months, the intense symptoms of my phobia were gone!
After 3 years now, I continue to sleep deeply and thoroughly and when I find myself in situations that may involve illness, I am able to function without panic.
I am confident, and frankly thrilled, that Dr. Elster’s re-positioning my upper spine has contributed to my recovery.”
-Jenn Z., Longmont, CO This specific phobia is a form of generalized anxiety disorder in which there is a fear of social contact. Speaking on the phone, working with others, fulfilling social obligations becomes difficult. Since the people with social phobia generally know enough to realize that they are different, they beat themselves up over their fears, which leads to a vicious circle. As of 2002, there is evidence of a genetic factor, though there are many psychosocial factors, such as the fear of public speaking. SSRIs, MAOIs, Beta Blockers have been used as treatment since 2002. Social Phobia Case study:
Jim, an American in his 30s, presented with a case of social phobia. He had been shy since his adolescence, had little to no dating history. Under the impression that he was constantly the center of attention, though he did not want to be, he had learned to fear all social contact in case he embarrassed himself. When he first started working, he owned a small record store, and had little customer interaction. However, the company was sold and Jim’s position in the new company forced him to call clients on a regular basis. While on the phone, he would constantly choke and freeze, unable to clearly complete sentences. Feeling humiliated, he would constantly berate himself, creating a vicious cycle. After cognitive therapy, in which he completed social exercises that proved he could make small mistakes without fear of repercussion, and little need of medication, he was able to move past his fear and find a new job in which he was able to be a much more dynamic presence. Articles from 2002 or later
http://www.anxietynetwork.com/spcase.html Ricky Williams, Social Phobia:
Won Heisman Trophy at Texas
NFL running back drafted in 1999 as the 5th overall pick
Always viewed as strange or odd in the eyes of the media for his constant lack of eye contact as well as extremely shy nature
In february of 2001 Ricky williams was diagnosed with social anxiety disorder, better known as social phobia
Started therapy along with taking medication called Paxil, the only federally approved social anxiety disorder drug
After starting treatment he can now interact with fans without having an intense fear of being scrutinized and avoid conversation
Behind depression and alcoholism, social phobia is the third most common psychiatric condition
He 'Looked in the mirror and saw pure pain'
"I played by myself. Ans I grew into the type of person who felt like he was missing something if he wasn't at home."
"Here I am a young man, a millionaire, sitting at home, not wanting to leave"
The difference between shyness and social phobia is like the difference between having a chest pain and suffering a heart attack says Jerilyn Ross a chief executive of the Anxiety Disorders Association of America