Coping with Anxiety vii: Phobias and Phobic responses (cont”d).

(Following on from my most recent blog).
At first we got nowhere: then, just when it seemed pointless to continue, I became aware – from the very apparent and spontaneous change in my patient’s pattern of breathing, taken together with her more “at ease” demeanour – that she now was indeed, relaxing deeply. What followed surprised me even more. After a few moments – during which time she was becoming progressively more relaxed and at ease – I very gently probed in the direction of, “Anything else that might be troubling you…” (as I believe I put it). The change in her was nothing short of dramatic: she tensed visibly and then screamed, “Get me away from here”.

Let me curtail somewhat, what has already become a lengthy account. Just after the time of this lady’s husband’s referral to me, both he and his wife had, to my knowledge, been involved in a minor road accident; although fortunately no one had been seriously hurt. Their car (which the husband had been driving at the time and which thankfully, had only been moving slowly) had collided with another vehicle at a minor crossroads. Consequently, my patient had been thrown forward with some force onto the steering wheel. The impact had caused severe bruising around his ribs, although happily, there had been no evidence of fracture.

What I didn’t know and what had been completely forgotten by the lady concerned (until, that is, she had momentarily, but vividly, re-lived this event in my clinic room) was that on that particular occasion, she had got out of the car and rushed round to her husband on the driver’s side: and it was there that she had – although only momentarily – espied a dead crow lying by the roadside. It had played absolutely no part in the accident and – in her state of alarm and concern for her husband’s welfare – she had instantly put the matter, not so much “out of” as to the “back of” her mind and promptly forgotten it. For some reason – possibly in response to my reference, in the relaxation session, to “Anything else that might be troubling you”, she had once more and again quite spontaneously, focused momentarily upon the memory of that day: hence her cry, “Get me away from here”!

You will recall we said that phobias are irrational fears that have become imprinted on the memory. Where the true cause of their existence can be brought to the ‘light-of-day’ and where pent up, misplaced and frustrated emotion released, they not infrequently reduce significantly and can even ‘melt away’ altogether. However, where they remain, they may continue to exist as a stimulus to neurotic anxiety, in that the perceived source of danger is internal rather than external and its precise stressor, left unidentified. Moreover, it can continue to possess the capacity to induce intense irrational fear – irrational that is – in that the stressor is in reality, entirely harmless.

What we have just accounted for then, amounts to nothing more – or less than a classic case of “phobia”. (Incidentally, such anxiety can nowadays be successfully treated, most commonly with the help of a relatively modern treatment strategy known as Cognitive Behaviour Therapy (CBT) and I hope to focus more sharply on this and other therapeutic approaches at some future date. Incidentally, I am glad to be able to report that the above story had a brighter ending. After a few weeks, Tommy was back on the perch of his old cage, wild birds were being fed and the little cairn terrier had no further cause to adjust to canine vagrancy: happy days! Incidentally – and although I have not mentioned them thus far; it is important to mention that I intend, in next week’s blog, to write briefly about anxiety problems of an obsessive-compulsive nature; and with that I shall bring to a conclusion my blogs describing and otherwise dealing with anxiety; anxiety state and its likely further effects on the mind and behaviour.

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