February 28, 2005
iranian.com

About Shokooh

QUESTION
Why is she so afraid?

Dear Shokooh,

Can phobias be treated? My sister is deathly afraid of snakes. We live in a big city and there's no snake problem, so I don't understand why she's so afraid. It started off a simple fear, but has gotten a lot worse. Actually, things are so bad that she stayed home for Norooz last year because she was afraid there would be snakes at the park. I want our family to be together for Norooz celebrations this year. Can a psychologist help her get over this?

A.D.

REPLY

Dear A.D.,

Absolutely! In fact, research has shown that psychological treatment of such fears has a very high success rate. It is an issue that can be addressed and treated.

The essential component of a specific phobia is a marked and persistent fear. A person who has a phobic fear of snakes will react with an anxiety response. Sometimes this anxiety response will be so serious that it will look and feel like a full panic attack -- complete with symptoms such as a pounding heart, difficulty breathing, or dizziness. Keep in mind that some degree of fear is normal -- many of us have fears of certain objects or situations. The most prevalent fears involve public speaking, flying, heights, certain animals, or seeing blood.

A person with a phobia is different in the degree of fear and reaction. This is someone whose avoidance, fear, or anxious anticipation of encountering the phobic object (such as snakes) is truly interfering significantly with his/her life.

It sounds like you have a good idea of your sister's situation, but keep in mind that only a medical professional can diagnose phobia. Psychiatrists and psychologists assessing an adult patient for phobia will look for the following symptoms and signs:

* Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation.

* Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of panic attack.

* The person recognizes that the fear is excessive or unreasonable.

* The phobic object or situation is avoided or else is endured with intense anxiety or distress.

* The avoidance, anxious anticipation or distress in the fear situation interferes significantly with the person's normal routine, occupational or academic functioning, social activities or relations, or there is marked distress about having the phobia.

You specifically asked if psychologists can help your sister "get over" this fear -- the answer is a resounding yes! Cognitive Behavioral Therapy (CBT) is a widely accepted therapy for phobias and usually involves exposure to the thing that is feared. Thus, for your sister to address this issue, she may need to consider experiencing a certain degree of discomfort as her psychologist guides her past her fear of snakes. A trained and experienced psychologist can truly make a difference in the life of someone with a phobia.

If and when you do talk to your sister about this issue, remember that a bit of sensitivity can go a long way. It will most likely be easier for her to listen to you and remain open to therapy if you try to understand her fears. Consider taking some time to think about things from her perspective. How do you think she feels about her fear? What does it feel like to have such an intense fear? What would it be like to feel like you have to miss out on important family and community events because of this fear? How does this fear impact her life? How have others reacted to her fear? Take some time to consider these questions -- I believe it will make your conversation with more positive.

You sound like a supportive and caring sister. I wish your family all the best.

Shokooh

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This column is for general educational purposes only-- it is not a substitute for medical attention, counseling, or therapy of any kind. The Couch and the staff of this website urge you to seek immediate medical attention if you are in an urgent, harmful, or potentially dangerous situation. Psychiatric emergencies or urgent matters should be handled by calling 9-1-1 or going to the nearest emergency room.   Please note that your emails will not be answered on an individual basis and your confidentiality cannot be guaranteed. Top

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