Dealing with Phobic Reactions

                  

                  

A phobia is defined as an extreme or irrational fear of or aversion to something.  The key word here is irrational.  Fears such as trying to escape from a fire or flood are not irrational.   However, when fear becomes irrational where there is no imminent danger, we can relabel the fear as anxiety, the origin of which is psychological.  These anxieties can weigh heavily on the human mind often with the effect of hindering an individual’s growth and development.

Years ago, while swimming laps in a pool, I suddenly had the sensation of being unable to breathe properly and found myself gasping for air.   I had been swimming all my life without ever experiencing such a weird bodily impression.  Suddenly, I could not swim the length of the pool without stopping and standing motionless in the pool to catch my breath.  Oddly enough, I had no fear of drowning inasmuch as there was no place in the lap pool where the water was above my head.  The depth of the water in the deepest part of the pool was about 5 feet, well below my physical size.

From where this phobic response emerged, I had little idea.  Was my body telling me something about my present state?  Recently, I had read that a very athletic man had died from a heart attack at the age of 88 while swimming in a community pool.  Although I was not that close to his age, perhaps I was feeling more vulnerable with my own advancing years.  I remember the first time being greeted by this frightening sensation upon swimming a few crawl strokes.  I stopped and walked a distance and then proceeded to swim.  When I reached the end of the pool length, I found myself out of breath and unable to continue swimming.  Holding onto the rail, I worked on slowing my breathing, a technique I have used in assisting my patients that have experienced panic attacks.  Then I proceeded.  With some concerted effort, I was able to swim back to the other end of the pool, but once again feeling the need to stop, hold on to the surface outside of the pool, and take some very slow and deep breaths.

I managed to swim two or three laps stopping at each end of the pool to regain my breath and composure.  I knew that if I gave in to this sudden phobic reaction, by getting out of the pool, it would become that much harder to overcome it as I would be reinforcing the anxiety.  In forcing myself to continue swimming, after perhaps three laps (i.e. back and forth three times), surprisingly, I no longer experienced difficulty in breathing  

The next time I entered the pool the tightness in my breathing overwhelmed me with each stroke I took.  This time I decided I would not stop until reaching the other end of the pool.  Once there, however, I felt compelled to stop, catch my breath, breath slowly and deeply before continuing to swim.  The same pattern as before resulted where by the third lap I no longer felt the need to stop and regain my breath.  This same sequence repeated itself for about one month:  Upon entering the pool and swimming, a sudden shortness of breath seized me causing me to stop at the other end of the pool.  Finally, after about one month this very strange and disconcerting sensation ceased, almost as suddenly, as it had started.  I congratulated myself for not giving in to the completely irrational fear that was affecting my ability to swim.

Similarly, recently, a patient of mine told me that he had suddenly developed an anxiety on driving on a certain exit of a California freeway that merges with another freeway.  He began to experience a palpitating anxiety as he was changing freeways, a route that he had been driving on for years.  In the past, we had talked about the importance of facing his irrational anxieties so rather than avoid this section of his route, he challenged himself by following the exit ramp that was the source of his anxiety.  Moreover, he repeated the exact same route noticing that each time he confronted his anxiety, it became a little less bothersome.  After the third or fourth repetition of this same procedure, his anxiety had diminished to where he was no longer troubled by it.

What my patient and I had done, has been called exposure treatment.  Rather than avoiding our anxieties, the origin of which neither of us fully understood, we faced our anxieties directly as a means of mastering them.  We both realized that if we let our anxieties control us, it would impede our lives in some very unpleasant way.  We chose the initial lack of comfort, that is exposing ourselves to the irrational fear, to reduce or extinguish these anxieties.  In general, I have found that individuals suffering from some stressful situation or event reduce their anxiety by facing it rather than by avoiding it.

A phobia is defined as an extreme or irrational fear of or aversion to something.  The key word here is irrational.  Fears such as trying to escape from a fire or flood are not irrational.   However, when fear becomes irrational where there is no imminent danger, we can relabel the fear as anxiety, the origin of which is psychological.  These anxieties can weigh heavily on the human mind often with the effect of hindering an individual’s growth and development.

Years ago, while swimming laps in a pool, I suddenly had the sensation of being unable to breathe properly and found myself gasping for air.   I had been swimming all my life without ever experiencing such a weird bodily impression.  Suddenly, I could not swim the length of the pool without stopping and standing motionless in the pool to catch my breath.  Oddly enough, I had no fear of drowning inasmuch as there was no place in the lap pool where the water was above my head.  The depth of the water in the deepest part of the pool was about 5 feet, well below my physical size.

From where this phobic response emerged, I had little idea.  Was my body telling me something about my present state?  Recently, I had read that a very athletic man had died from a heart attack at the age of 88 while swimming in a community pool.  Although I was not that close to his age, perhaps I was feeling more vulnerable with my own advancing years.  I remember the first time being greeted by this frightening sensation upon swimming a few crawl strokes.  I stopped and walked a distance and then proceeded to swim.  When I reached the end of the pool length, I found myself out of breath and unable to continue swimming.  Holding onto the rail, I worked on slowing my breathing, a technique I have used in assisting my patients that have experienced panic attacks.  Then I proceeded.  With some concerted effort, I was able to swim back to the other end of the pool, but once again feeling the need to stop, hold on to the surface outside of the pool, and take some very slow and deep breaths.

I managed to swim two or three laps stopping at each end of the pool to regain my breath and composure.  I knew that if I gave in to this sudden phobic reaction, by getting out of the pool, it would become that much harder to overcome it as I would be reinforcing the anxiety.  In forcing myself to continue swimming, after perhaps three laps (i.e. back and forth three times), surprisingly, I no longer experienced difficulty in breathing  

The next time I entered the pool the tightness in my breathing overwhelmed me with each stroke I took.  This time I decided I would not stop until reaching the other end of the pool.  Once there, however, I felt compelled to stop, catch my breath, breath slowly and deeply before continuing to swim.  The same pattern as before resulted where by the third lap I no longer felt the need to stop and regain my breath.  This same sequence repeated itself for about one month:  Upon entering the pool and swimming, a sudden shortness of breath seized me causing me to stop at the other end of the pool.  Finally, after about one month this very strange and disconcerting sensation ceased, almost as suddenly, as it had started.  I congratulated myself for not giving in to the completely irrational fear that was affecting my ability to swim.

Similarly, recently, a patient of mine told me that he had suddenly developed an anxiety on driving on a certain exit of a California freeway that merges with another freeway.  He began to experience a palpitating anxiety as he was changing freeways, a route that he had been driving on for years.  In the past, we had talked about the importance of facing his irrational anxieties so rather than avoid this section of his route, he challenged himself by following the exit ramp that was the source of his anxiety.  Moreover, he repeated the exact same route noticing that each time he confronted his anxiety, it became a little less bothersome.  After the third or fourth repetition of this same procedure, his anxiety had diminished to where he was no longer troubled by it.

What my patient and I had done, has been called exposure treatment.  Rather than avoiding our anxieties, the origin of which neither of us fully understood, we faced our anxieties directly as a means of mastering them.  We both realized that if we let our anxieties control us, it would impede our lives in some very unpleasant way.  We chose the initial lack of comfort, that is exposing ourselves to the irrational fear, to reduce or extinguish these anxieties.  In general, I have found that individuals suffering from some stressful situation or event reduce their anxiety by facing it rather than by avoiding it.