Re: PHOBIAS

From: Lawrence H. de Bivort (debivort@umd5.umd.edu)
Date: Thu May 18 2000 - 17:58:05 BST

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    From: "Lawrence H. de Bivort" <debivort@umd5.umd.edu>
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    On Thu, 18 May 2000, Bill Spight wrote:

    LdB: >> The structure of the phobia can be fully undone, leaving the
    person totally free of the phobia:

    >I do not wish to underestimate the importance of phobia relief,
    >nor the fact that it is possible, as Lawrence indicates. The
    >method presented is a kind of desensitization. If it takes only
    >30 min., it is a very efficient variety. :-)

    Yes, a kind of sensitization -- but the critical difference between this
    kind and what is often meant by the term is that the actual structure
    underlying the phobia is dismantled. The patient is not simply desentized
    to the thing or situation that creates the fear. They do not end up with a
    lesser or more manageable fear: the structures that create the fear or
    removed entirely. The initial approach that I described -- dissociation --
    is a form of desentization, but the overall result of the intervention is
    removing the phobic structure itself.

    I said 30 minutes -- but should have indicated that the basic process is
    0ne that takes about 30 minutes, but that there can be side-paths that
    need to be taken which can add to the time. I would estimate that such
    side-paths (to deal with affiliated issues) occur in about one third of
    the instances of a phobia intervention, and that the amount of time needed
    to deal with them ranges from 5 to 30 minutes for 90% of the
    instances. Occassionally a 'side-path' turns out the be the main thing
    (and was mis-diagnosed as a simple phobia) and this can ended up requiring
    significantly more time. Also: the real world testing of the change is
    not included in the 30 minutes. (For example, last year, I took a person
    cliff-climbing & rapelling to test for a fear-of-heights phobia and that
    took about 3 hours because I also had to teach climbing and rapelling
    techniques.)

    >Three points, however. 1) Most phobias have an innate component.
    >While a bunny rabbit phobia is possible, for instance, a snake
    >phobia is more common and harder to extinguish. This makes
    >evolutionary sense. Chicks run from a silhouette of a hawk, even
    >if they have never seen one.

    This makes sense. Phobia types do cluster thematically around survival
    issues, but I have run into a few that seem to have no objective
    relationship to survival, e.g. phobia of classical music (now, if it had
    been rap....)

     2) There is fairly recent evidence
    >that the neurological phobic structures persist, even after
    >successful desensitization (emotional memory). While normally the
    >phobia remains dormant, it can occasionally resurface.

    Now this is not something I have run into. I wonder whether latent
    persistence of the phobic structure (and its later resurgence) might not
    simply be a matter of poor technique in removing the phobia. We have been
    tracking some of our phobia people for nearly two decades now and none
    have experienced _any_ resurgence, or required any reinfrcement sessions
    (unlike our results on addictive habits, where we do sometimes have to
    have reinforcement sessions, or where the change ultimately fails.)

    Can you say a bit more about the characteristics of techniques where
    resurgence occurs?

     3)
    >Self-desensitization is possible (just as self-hypnosis is),
    >although difficult. Better to get help. :-)

    Yes. Generally, it is possible to do self-interventions (though doing so
    for phobias I consider near-impossible for technical reasons) but the
    general problem that has to be overcome is that in a self-intervention the
    person has to play two roles at once that are seemingly
    contradictory: that of a subject of the process, and that of a technical
    leader of the process. We can talk more about why these are contradictory,
    if anyone is interested. On a personal note, I had occassion in the last
    three years to have to put myself through a major self-intervention, and I
    had to invent particular modifications to the technqiues to be able to do
    so. I think it would have been difficult to do had I not known the
    essential techniques pretty well to begin with.

    >And I should add, a competent cognitive or behavioral therapist,
    >or even a good hypnotherapist, can provide rapid and reliable
    >phobic relief. :-)

    _Especially_ if they can do so without leaving dormant structures and
    potential resurgency in place <grin>

    - Lawrence

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