Monday, February 16, 2009

Phobias

Wilma and Thelma are in a conflict of some kind. As far as Wilma can see, Thelma's behaviour/fears/views are completely irrational. In fact, as far as anyone except Thelma can see, Thelma's response is irrational. As in, the moon is made of blue cheese or the earth is flat. But Thelma is not to be reasoned with about the make-up of the moon.

What is the right response to what I suppose could be called a phobia?

--Anonymous

Does the phobia have any impact on anyone other than Thelma? Is the phobia relatively benign? For instance, someone living in North America with a phobia of kangaroos isn’t going to be negatively impacted by that phobia very easily. Zoo trips might need creative planning. Some nature programs will be avoided. But such a phobia will be primarily irrelevant – a personality quirk that can be worked on if Thelma ever decides to do so.

Of course, if the phobia negatively impacts Thelma and those around her on a regular basis, it’s a different story. Moon made of blue cheese? No big deal. Water will melt all people like the wicked witch in the Wizard of Oz? Massive problems.

I’ll assume the phobia is the latter variety – one that causes constant and severe problems for Thelma, her family, and her friends. The right response to such a phobia? Patience, I’m thinking, and a willingness to creatively confront the phobia. It seems likely to me that there will be a balancing act between creating safety for Thelma and creating opportunities for her to revise her ideas.

Another very obvious and very important piece to pay attention to is Thelma’s view of the world. There is a good chance that there is some small nugget of truth in her phobia. Maybe she’s terrified of ants because once she stood on an anthill without realizing it and suddenly discovered the little critters climbing all over her legs and into her pants. This isn’t irrational. Maybe the scene from the Wizard of Oz, with the melting witch, reminded her of the shock and fear she felt when splashed in the face at the local swimming pool. This isn’t irrational.

Whatever the phobia, whatever the story, there is real fear there, and she needs to be able to safely address and dismantle that fear. I definitely don’t think that has to mean deep, probing questions about the nature of her fear. (In fact, I think too much conversation can sometimes reinforce the bigness and badness of the phobia – which is absolutely not helpful.) I do think it is crucial to cultivate a real awareness about what, precisely, the fear is rooted in. The idea that Thelma is irrational to be afraid sets the rest of us up to dismiss her real fear – I think that’s a mistake. Dismissing the fear entirely leads us away from the careful exploration that can get us to the root of the problem. If water in the sink is okay, but water coming out of the faucet is terrifying, start there. Play with water in the sink. Notice when and where the fear isn’t an issue, and build on those experiences. Create opportunities for success.

As always, optimism, playful exploration, and remaining present in the moment are your best tools. And as always, I hope something here helps!

1 comment:

larsy said...

There are medications that can help, though the decision to take/not take is Thelma's to make. Exploring that option is important, though, imo. Thelma ought to be aware that if she is having, say, obsessive thoughts that she wishes she could stop, medication might help. And that there is a down side to medication as well.

Also, a sympathetic therapist might be a good person to help Thelma and her family to understand the thinking habits that might have been put in place mistakenly (or that helped at some time but now have become burdensome and even harmful). A parent in this position might be very glad to have someone to talk to about it, brainstorm strategies, increase understanding of both about phobia and about the parent's reactions to the situation that might get in the way of helping hir child (if the child is the phobic).

I suspect that sometimes more existential fears, like fear of death, can be expressed through obsessions and phobias in children and adults, combined with the genetic tendency towards such things.

We grapple with all kinds of irrationalities in life, much of which we are not consciously aware, imo. If it was a simple matter of reasoning, irrationality would be so easy to dispel! if only... no, each person must work through to refutation for their own self, in their own way. A parent's place in helping hir child explore ideas- or not, as the child is or is not ready- and figuring out ways to cope as they learn, and to research for more ways to help which might include confronting the parent's own prejudices about, say, medication vs nonmedication (or whatever).