- The Washington Times - Saturday, October 30, 2004

Creepy crawlers — particularly spiders — so often spoofed at Halloween are no laughing matter to people like Denise Montgomery of Northeast Washington, who starts shaking and sweating whenever she sees insects.

“I saw some crickets in the park recently, and I just took off running,” Mrs. Montgomery says.

When her son Adrian Jordan, now 20, was a young boy, Mrs. Montgomery was afraid she would transfer her irrational fears — also known as phobias — to him. She did, at least for a while.

“I think I’ve outgrown it now, but I used to freak out about insects,” says Mr. Jordan, now a student of finance at Florida A&M; University in Tallahassee. “I didn’t want to see them, touch them or get near them.”

Mrs. Montgomery is not alone in having phobias or being worried about transferring them to her child. The National Institute of Mental Health reports that about 11.5 million Americans have phobias.



“Parents model behavior. Children learn by observing that behavior,” says Ada Kahn, co-author of “Facing Fears: The Sourcebook for Phobias, Fears and Anxieties.”

For example, if parents cross the street each time they see a big dog, children will learn to be fearful of dogs, Ms. Kahn says.

Mr. Jordan agrees.

“I saw my mother’s reactions to things and figured that if my mother is afraid, I should be afraid, too,” he says.

There is also a hereditary component to phobias, says Jerilyn Ross, president and CEO of the Silver Spring-based Anxiety Disorders Association of America.

This national, nonprofit group educates the public about anxiety disorders and provides self-help tools and lists of support groups and psychologists.

“Research shows people have a genetic predisposition to develop phobias,” says Mrs. Ross, who is also the director of the Ross Center for Anxiety and Related Disorders Inc. in Northwest.

For example, she says she has seen cases where twins — who have no contact with each other — develop the same kind of phobias.

The type of phobia that Mrs. Montgomery and earlier her son had are called specific phobias. This means the irrational fear, sometimes accompanied by physical symptoms such as nausea and heart palpitations, is triggered by something very specific, whether it’s an animal or an event, says Dr. David Charney, an Alexandria psychiatrist.

“Specific phobias don’t necessarily spill into other areas of life,” says Dr. Charney, who is also the founder and director of Roundhouse Square Psychiatric Center in Alexandria. “It’s possible to avoid whatever the trigger is — tall buildings or dogs.”

There are two other types of phobias — social phobia and agoraphobia — which are more likely to affect every minute of every day, he says.

Social phobia is a fear of being humiliated in front of other people and agoraphobia is a fear of being in places from which it’s difficult to escape, such as a room full of people or an elevator. Agoraphobia is often associated with anxiety and panic attacks, Dr. Charney says.

“Agoraphobia can cause people to shut down their lives, and in the most extreme cases they won’t leave their house,” he says.

Living with phobias

Some people live for years with phobias without seeking professional help. They find ways of coping, sometime by avoidance, Ms. Kahn says.

The avoidance can work well because the phobia trigger does not play a role in the person’s everyday life, she says.

“If you live on a farm, it doesn’t matter if you’re afraid of elevators,” Ms. Kahn says.

This can get a little tricky, however, if the phobic person is also a parent who has an irrational fear of, for example, dogs, Dr. Charney says.

“If you have a parent who is extremely afraid of dogs, it may be difficult to conceal that from your child,” he says, “but maybe you can recruit the other parent to be the one dealing with the situation.”

If the parent is really concerned that their own fears are something the child will develop because of the parent’s behavior, then that might be a motivating factor for them to seek help, Dr. Charney says. However, he says he hasn’t seen any cases like that.

Children, however, are likely to have phobias of their own, without any help from their parents, Dr. Charney says.

Animal phobias in children are very common, and that’s not necessarily a bad thing, he says.

“Maybe it’s nature’s way of giving children a leg up, and it may be just as well that they have that fear until they can exercise a more adult judgment,” Dr. Charney says.

A fear of heights is also common — and probably a good thing — in infants, he says.

Some phobias just disappear over time, which is what happened with Mr. Jordan.

“When I was 11 or 12 and spent a lot of time with my peers, I realized there was no reason to be afraid,” he says. “They weren’t afraid, so why should I be afraid?”

But phobias can also manifest themselves later in life, Dr. Charney says.

People in their late teens and early 20s can develop phobias as life gets more complicated, with increased independence and responsibility, he says.

“The phobia is collecting tension from some other areas of life,” he says, “but when that tension quiets down, so does the phobia.”

Sometimes, however, the tension doesn’t quiet down and the avoidance stops working because the person who is afraid of flying suddenly has to fly to attend a funeral or a person who is afraid of elevators gets a job in a high-rise.

“If the phobia is interfering with your life, it’s time to seek help,” Mrs. Ross says.

The good news for those seeking help is that in the past 25 years the medical community’s understanding of phobias has improved greatly, she says.

“We’ve come a long way in identifying anxiety disorders. Now, when a patient comes into a primary care doctor with nausea and heart palpitations, the doctor knows those symptoms can be signs of a panic attack,” Mrs. Ross says.

“These patients used to be told, ‘It’s nothing. It’s just in your head.’”

Treating phobias

There are several strategies in treating phobias, Mrs. Ross says. The most common one is cognitive behavioral therapy, during which the patient learns to overcome the fear by confronting it, she says.

Mrs. Ross, who works as a therapist, typically devotes eight to 15 sessions to helping the patient overcome the phobia through gradual desensitization, which, she says, can go something like this:

A patient who is afraid of riding the elevator will first just watch people getting in and out of the elevator. The next step can be just to stand in the elevator, but not ride it. When the patient feels fairly comfortable with that, the next step can be to ride the elevator one floor.

This gradual approach is used until the patient is comfortable riding the elevator up and down and many floors at a time, Mrs. Ross says.

Dr. Charney says the therapy should be followed up by a continued vigilance against recurrence of the phobia. This means the patient should continue facing the fear — whether it’s flying or riding an elevator — because continued exposure is key, he says.

It can also help patients if they can find a way to distract their minds from the action or item that triggers their phobia, Dr. Charney says.

“We sometimes do counting exercises or listen to a certain kind of music,” he says.

In some cases, however, he prescribes medication, such as antidepressants and beta-blockers, to help reduce anxiety levels and hinder panic attacks.

For people who try to cope with specific phobias on their own, breathing exercises and other ways of relaxing can be helpful, Ms. Kahn says.

“Breathing is an important part of any therapy,” she says. “Try to take deep breaths as soon as you become aware of your trigger of fear.”

She says controlling the breathing encourages relaxation and can help prevent the bodily sensations, such as nausea and heart palpitations, that sometimes accompany the fear.

In trying to control her fear, Mrs. Montgomery says she uses breathing exercises and talks to herself aloud, trying to assure herself that the critters, while nasty, are not dangerous.

“I’ve gotten a little bit better over the years,” she says. “I even killed a roach recently, and I swept it up and threw it out,” she says, smiling proudly.

PHOBIA FACTS —

Millions of Americans suffer from anxiety disorders. Phobias are the most common group.

It includes agoraphobia, a fear of being in places (such as a room full of people) from which it’s difficult to escape, social phobia, a fear of being humiliated in front of other people, and specific phobia, often the least severe phobia.

Listed below are some examples specific phobias — the irrational fear of an event, situation, object or animal:

• Acarophobia or entomophobia — a fear of insects. Some individuals are so afraid of insects that they seal off their windows and doors.

• Arachnophobia — a fear of spiders. Individuals who have severe spider phobia must regularly fumigate their homes.

• Ophidiophobia — a fear of snakes.

• Suriphobia or musophobia — a fear of mice.

• Laliophobia — a fear of speaking, includes public speaking, which is one of the most common fears among adults.

• Claustrophobia — an exaggerated fear of closed spaces, such as closets, subways and telephone booths.

• Acrophobia — a fear heights. Acrophobics fear being on high floors of buildings or on the tops of mountains. Fear of elevators, escalators and stairways are all related to a fear of heights.

• Aeroacrophobia — a fear of flying. This is one of the most common phobias among adults.

• Aquaphobia or hydrophobia — a fear of water. Fear of water is related to a fear of drowning and a fear of death.

mScolionophobia — a fear of going to school, or more rather, a fear of leaving home or parents.

• Noctiphobia or nyctophobia — a fear of the night. This phobia is related to fear of the dark and is common in young children.

• Phasmophobia or daemonophobia — a fear of ghosts.

Sources: “Facing Fears: The Sourcebook for Phobias, Fears and Anxieties,” by Ada P. Kahn and Ronald M. Doctor, Facts for Life, 2000; and an interview with Dr. David Charney by reporter Gabriella Boston.

More info:

Books —

• “Facing Fears: The Sourcebook of Phobias, Fears and Anxieties,” by Ada P. Kahn and Ronald M. Doctor, Facts for Life, Facts on File Inc., 2000. This book provides basic information about the most common fears and phobias. An A-to-Z reference section provides information on specific phobias, disorders and treatments. The authors have also written “Phobias,” (Scholastic Library Publishing, 2003) which is written for children and teenagers.

• “The Anxiety Book: Developing Strength in the Face of Fear,” by Jonathan Davidson and Henry Dreher, Penguin Group Inc., 2004. One in five Americans suffers from an anxiety disorder that can lead to such symptoms as sleeplessness, irritability, muscle tension, thoughts you can’t escape, trembling, racing heart, cold sweats and numbing emotion. This book offers advice on how to get back to peace and serenity.

• “Beyond Anxiety and Phobia,” by Edmund Bourne, New Harbinger Publications, 2001. This book offers a holistic approach to treating phobias. It describes alternative therapies, such as herbs, yoga, massage, acupuncture and homeopathy. Also available is a workbook on the topic, “Anxiety and Phobia Workbook,” by Edmund J. Bourne, New Harbinger Publications, 2001.

Associations —

• Anxiety Disorders Association of America, 8730 Georgia Ave., Suite 600, Silver Spring, MD 20910. Phone: 240/485-1001. Web site: www.adaa.org. This national, nonprofit group is dedicated to informing the public about anxiety disorders. It offers support groups, self-help tools and presents facts about anxiety disorders, including phobias.

• American Psychiatric Association, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209. Phone: 703/907-7300. Web site: www.psych.org. The American Psychiatric Association, which has more than 35,000 member physicians, offers information about phobias on its Web site. It also provides general information on mental illness for families with children and tips on how to choose a psychiatrist.

• American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove, Ill. 60007. Phone: 847/434-4000. Web site: www.aap.org. This professional organization for pediatricians nationwide offers information on childhood phobias.

Online —

• Medline Plus (www.medlineplus.com), sponsored by the National Institutes of Health and the U.S. National Library of Medicine, has several articles on phobias and other anxiety disorders.

• BabyCenter (www.babycenter.com), sponsored by the Johnson & Johnson pharmaceutical company, offers information on its Web site about childhood fears and phobias.

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