RELIEF OF PARTICULAR SYMPTOMS SELF-MANAGEMENT OF ANXIETY: PHOBIAS
Phobias arise through the individual’s anxiety becoming attached to the phobic situation. This is rather similar to the way in which anxiety may become focused on some particular organ of the body and produce symptoms in it. Thus anxiety focused on the heart produces palpitation; on the stomach, dyspepsia; or on the lungs, asthma. In the case of the phobias we can often see quite clearly how the anxiety became associated with the particular situation. A child, punished by being locked in the broom closet, may develop a phobia of being confined in a small space. In other cases the anxiety becomes attached to the phobic situation through the mechanism of symbolism. Thus snakes and, to a lesser extent, mice, may represent important sexual symbols to some people, and a phobia of these animals may be a symbolic expression of anxiety which is in fact sexual in origin. However, bringing the patient to understand the cause of his phobia does not in itself relieve the patient’s fear.
For instance, during the war in some bombers the rear gunners were locked into the tail gun turret by themselves. Many of these men subsequently developed a phobia of confined spaces. They would prefer to keep the door of the toilet slightly ajar. Of course, they knew the cause of their condition, but this did not stop the phobia.
We can use our relaxing mental exercises in three ways in the self-management of phobias. In the first place we practise our exercises when we are not in the phobic situation. Let us suppose that we have a phobia about going outside. We practise at home when there is no particular occasion for us to go outside. We do the exercises—very relaxed and letting ourselves
regress—and as we do so we think:
Relaxed.
Whole body relaxed.
Relaxed and calm and easy in myself.
Easy in myself.
Easy in myself wherever I go.
The exercise is repeated quietly and easily several times a day.
The second way of using the exercises is slightly different. As we relax we visualize ourselves at ease in the phobic situation. In our present example it means seeing ourselves in the street quite relaxed and comfortable. We do it very completely. As we relax we see ourselves; then as we relax more thoroughly, we see ourselves with greater and greater vividness. We are aware that we are calm and comfortable, and all the time that we visualize ourselves in this way, we are relaxed and at ease in ourselves.
Relaxed.
Utterly calm and easy.
See myself go out the door,
I am calm and easy.
I can see myself.
Calm and easy.
Nothing disturbs me.
In the third method we bring ourselves closer and closer to the centre of the phobic situation. We go to the door. As we do so, we pause and capture again the relaxed feeling in our mind which we experience during the exercises. We go outside, relaxed and easy, and then we return. We repeatedly venture to the edge of the phobic situation. If we experience the slightest feeling of anxiety, we consciously recapture the relaxed feeling of the exercises. We do it easily. There is no panic. We do it little by little, more and more each day. The secret is that we do not allow anxiety to develop. Because of this, the conditioning process allows us to go further each day. Soon we are rewarded by finding that we are at ease in the phobic situation. But remember that this takes time, and requires a good deal of self-discipline.
On the one hand, we must make ourselves do it; on the other hand, we must not push ourselves so far that we become anxious.
As you read this, you probably think, “I have done all this before and it has not helped me. In the past I have tried like mad, and disciplined myself, but I am still the same.” I must remind you again that the success of this approach depends entirely upon using the regression which comes with our relaxation. I believe that to overcome a phobia by self-discipline in cold blood is almost impossible. On the other hand, I do know for a fact that many people have overcome phobias when they have used the regressed state of mind to help them.
Mild phobias about moths are very common. They are usually not very severe, and are often regarded rather in the light of a slight idiosyncrasy and a matter for jest. However, an
eighteen-year-old girl was brought to me with a severe moth phobia. She was in fact terrified of moths. The phobia was so bad that it was ruining her life. She was refusing to go out at night for fear there might be a moth in one of the street lights or in any place of entertainment.
While I was talking to her, she suddenly thought that I might have a moth in the cigarette box on my desk. She screamed in real terror, sprang from her chair, and rushed to the far side of the room.
Because of her anxiety I had difficulty in showing her how to relax properly. However, she eventually mastered it. Then, when she was very relaxed I was able to show her a moth without it disturbing her. Soon she was able to take a moth in her hand. I don’t think she ever really lost her dislike of moths, but her phobia was relieved of all its previous intensity and she was able to resume a normal way of life.
A young professional man had a severe phobia about leaving his home. As long as he was at home and his wife was there with him, he was relatively free from anxiety. But each morning when leaving home and going to work he would be stricken with apprehension and panic. He would sweat, and would be nearly overcome by the pounding of his heart and the feeling of his stomach turning over. Once he reached his place of work, the acuteness of his anxiety would pass until it was time to return home. He had had a great deal of psychiatric treatment without help.
When I last saw him, he still had not gained complete peace of mind, but he had learned to manage the worst of his anxiety on his travels to and from his place of work.
A middle-aged housewife had become tense. As long as she remained at home she was relatively comfortable, and she had come to make excuses for not going out. The short trip to the shops to buy her household goods was becoming increasingly difficult. Sometimes she would stand petrified before bringing herself to enter a shop.
She learned to relax. Her general tension subsided, and she returned to doing her shopping without anxiety.
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