Getting Rid of Phobias Without Drugs

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Sam Jackson and Co-starLast summer, there was a movie, called Snakes on a Plane which I think my husband wanted to see.  The “plot” (which obviously fell a little short of classic Shakespearean construction) has something to do with a witness transported on a plane and somebody tries to “whack” him with a bunch of snakes.  I absolutely did not want to see it. (To my husband’s credit, we still have not.  Yes, there are men who love their wives THAT much.) I don’t much like snakes.  I tend to avoid them.  I do not run screaming if I see a garter snake.

Incidentally, they say the film initially did quite well, probably because of a lot of internet hype.  It went on to do less well than expected.  I cannot help but wonder if that had something to do with the way a lot of people feel about snakes.

In college when I took comparative vertebrate zoology, they called it “herpetophobia,” which literally means fear of reptiles.  The more correct term is ophidiophobia,” more specifically meaning fear of snakes.

Every single person I knew at that time who was so impassioned of reptiles that they actually wanted to get a graduate degree in herpetology (reptile study) had been following a passion and fascination with snakes.

Recently, a charming female patient I was seeing for unrelated things asked me if I wanted to cure her fear of snakes. I informed her first, that even though it would be easy to cure, I did not know if it was worth the trouble. Since she lived in downtown of the delightful urban area of San Diego, her chance of meeting a snake was pretty small.  If, however, there was something else going on.  If she were a camper, or went to a place that had snakes, or someone in her family had a pet snake, we could take care of this quickly.  She had none of the above.  She simply was called to avoid the reptile house at the zoo, and sat outside quietly while her family went in.  They never even bothered her about it.

The easiest cure for this sort of thing is some variant of Emotional Freedom Technique (EFT), something I love and use and I had used on this very patient in other situations.  Suddenly, she realized, just like Dorothy in the Wizard of Oz realized she had been wearing the ruby slippers all along, that she had the method and I told her how.  She felt empowered and happy.

That’s an example of a “simple phobia,” when someone is afraid of something, one thing or group of things.  They have no symptoms as long as that thing is not in their lives, and may have some symptoms (usually the desire to buck and run) when it is in their lives.  So you can either keep it out of your life, or treat it.

There is an anecdote I cherish about “my first patient,” a frail and high-strung 22 year old student who had a phobia of buses.  He was, he told me, an outstanding student at Beauty School, but could not attend class because he needed to take the bus.  This was long before I discovered the wonders of EFT.  I learned about something I knew nothing about before then: Behavioral desensitization, as developed by Joseph Wolpe, a South African psychiatrist.

Here is the technique.  Curiously enough, the example they give is how to use it on a fear of snakes.  I taught “my first patient” how to do deep relaxation with deep breathing.  We had him couple this with various images.  I remember combing the local children’s section of the library to find a cartoon-like picture of a bus, and photos of buses, and we taught him, slowly, to relax with successively more stressful bus related stimuli.

We went outside and stood at a bus stop while the bus stopped without getting on.  After a few more trips to observe the buses and to calm his fears about them, he agreed that he was ready to board a bus. We took a small tour along a local route, and I literally held his hand as we rode the bus together.  Last I heard from him, it was a triumph.  He sent me a postcard from Miami, where he had enrolled in what he told me was one of the great glamour beauty-schools of the United States and the world.

Although I currently prefer EFT, I have used Behavioral Desensitization with a bunch of patients for a bunch of things.  Some patients will go with EFT even though it seems “funky” and strange at first.  Others (most often academic types or even military types) would rather approach things like a class, like learning, so that I “teach” them to relax.

No matter which approach people want, I have been doing this for years and cannot think of a single patient whose simple phobia I have not helped significantly, one way or another.

There is NO REASON to give medication for this.  Most of the people I have seen have who have had this kind of problem have been hooked on Xanax (alprazolam) by well-meaning (but misinformed) doctors. The drug is neither necessary or helpful.  It is nearly always detrimental and most people who have been there seek me out to get them “un-hooked” and undergo something like EFT.

Once (and I mean one time only) I got “stuck” giving one or two Xanax to a patient who came to me (for example) the night before a cross country flight and she had a fear of flying and refused both of my methods.  She flew as part of her employment, and the problem was expected to present itself more often.

I saw the “problem presenting more often” as opening the window for a possibility of habitual use.  I was not going to that place.  Two Xanax tablets (one to fly each way) is no big deal, and I was pretty convinced I was not treating or creating an addict, still I told her it was a dumb idea to take medicine for something that could be treated without it, and if she continued to see me when she came back, she could be “fixed” from her problem with no Xanax.  I even told her, after the measly two Xanax pills, that if she wanted any more for this condition and declined to work with me, she might as well find another psychiatrist.

I never saw her again.  It is not hard to find doctors who give out Xanax.

Phobias may have, on some level, a reason for existing.  Fear of snakes is one of the most common.  I (and others) have long suspected the obvious.  Since people can die from snakebite, being afraid of snakes in Fred Flintstone’s day could have done a good job of keeping people alive.  In other words, it could have been an evolutionary adaptation.

Freud and even some folks schooled in the contemporary analytic methods have told me (usually at cocktail parties or the equivalent) that snakes are obviously shaped like a penis and that has something to do with why some people may be scared of them.  No wonder people always accuse us shrinks of having dirty minds!

Well, according to Freud’s theories, explaining these analogies should help people get rid of the fears.  However, I studied Freud and I am not exactly running to frolic in the snake house at the world-famous San Diego Zoo.

I remember an old friend, a psychiatrist, who played the violin, and who told me if you listen to the Freudians, they will tell you that everything that is longer than it is wide is a phallic symbol, and he quoted to me Freud’s famous quote that “Sometimes a cigar is just a cigar.”

This same psychiatrist had been informed by a colleague that his love of the violin had something to do with it having a shape like a phallus. Whereupon my psychiatrist friend replied that he would clobber the analyst with the violin, if it were not for the fact that the violin were rather expensive.  In other words, although analysis can be fascinating, it is not usually, in my estimation, the quickest way to getting rid of symptoms.

As for snakes and me, it is not a real “phobia,” although I prefer to have a piece of glass between the nearest snake and me.  Once, long before I met my beloved husband, I actually treated one poisonous snakebite in an emergency room in the Midwest.  (I called a supervisor; this was neither my expertise nor my passion.)

I certainly understand why some are fascinated by snakes.  This goes back to Biblical times. Every herpetologist I have ever known can quote, The way of a serpent on a rock.”

One person’s poetry may be another person’s terror.  With phobias, as with other psychiatric symptoms, the questions are: Is the symptom messing up your life enough that you want to actually do something about it? How much are you willing to do to get rid of your symptoms?

And please don’t ask for a prescription of Xanax — because I might clobber you with a violin.

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