Fear of the plane, of dogs, of heights, of being locked up ... In the face of certain situations considered dangerous, fear can be life-saving, but what to do when it becomes phobic and prevents life? Is it really impossible to overcome your phobia as it is often considered? Overview of the different methods to get rid of a pervasive fear.
"There is no age at which to become phobic, but treatment is quite possible as long as you look for the causes, always multiple, at the origin of this disorder. "Says Christine Mirabel-Sarron, psychiatrist in charge of the university psychotherapy center at Saint-Anne hospital in Paris and author of Understanding and treating phobias (ed. Dunod 2012). If today the phobic disorder is no longer perceived by the medical field as a simple "intrapsychic conflict" since it always results from multiple causes, various methods can cure the phobia depending on its origins.
The essential defining element of a phobic disorder is avoidance. When we have fear, we feel it, and we face the situation that generates that fear, even reluctantly. The phobic cannot go there. When it is no longer possible to face reality, we go beyond the realm of fear to enter that of phobia.
A dozen different origins can explain the acquisition of one or more phobic disorders. Depending on the types of phobia, there can be traumatic, genetic, biological, psychological aspects ... But we can also "learn phobias", especially through parental speech, as is often the case with water phobia. Repeating over and over: "Watch out for the sea, the waves" will construct a representation of water as dangerous even without any real experience of this nature. It should also be remembered that there is no age at all to become phobic.
It all depends on the type of phobia we are talking about. While between 400 and 500 phobias are listed by the medical field, most of them can be categorized into three groups with their own prevalence. Specific or simple phobias (fear of animals, insects, etc.) probably affect more than half of French people. But in its most severe forms with total avoidance and anticipatory anxiety, the figure stands at 6%. Regarding the family of agoraphobias (phobias of the great outdoors, outdoors) the prevalence rate varies between 5 and 10% maximum. Then come social phobias (anxiety, fear of relationships with another human being.) Which would affect between 2 and 3% of the population. Phobic disorders, especially simple ones, are very common because they protect the species and allow humans to survive in the face of the great dangers that threaten them.
A phobia can be treated and cured. However, it should be remembered that simple or specific phobias should not lead to drug treatment except in cases of depression "by exhaustion". This is the case, for example, of the person phobic of spiders who goes to settle in the countryside and finds himself confronted daily with his phobia and will gradually slide into depression. On the other hand, an agoraphobic disorder cannot be cured without medication to regulate the serotonergic system. This treatment usually cures half of the patients. For the remaining 50%, this will not be enough, it will require additional follow-up, such as a psychologist, which must adapt to the phobic origins and its factors: is it a learned family discourse, a trauma ...? Depending on this, it is necessary to choose the psychological help modality closest to the patient's problem.
"To treat phobias, behavioral and cognitive therapy (CBT) deconditions fear" explains Stephany Pelissolo, psychotherapist and CBT practitioner.
“Phobias are the heavy legacy of learning, of real conditioning. To be cured, it is then necessary to decondition fear by a progressive exposure to its phobia. For example, with a cat phobia, we ask the person to look at the written word to start. Then we show him pictures, then films and finally we confront him with reality. The key to healing is to accustom the patient to what he fears in order to extinguish his fear with support from the therapist at every step. "
Duration of therapy: For a simple phobia, about 3 months at the rate of one 45-minute session per week.
For a social phobia, between 3 months to 2 years depending on the intensity of the phobia. 2-hour group psychotherapy sessions so that the patient learns to expose himself to the gaze and judgment of others without being afraid.
For agoraphobia, the psychotherapist accompanies the patient in anxiety-provoking situations for 1 hour 30 minutes. The number of sessions depends on the intensity of the agoraphobia and the number of situations to be desensitized. For an agoraphobia which concerns only the situation of the metro for example, 5 to 6 sessions of 1h30 with an exhibition work between each session are sufficient.
"Hypnotherapy can go back to the origin of the phobia and treat the cause of the problem in depth" for Djayabala Varma, doctor of psychology and hypnotherapist.
"The interest of hypnosis in the treatment of phobias is to offer a multidisciplinary approach that integrates four techniques. Self-hypnosis, taught at the start of therapy, allows the patient to remain calm in general. The techniques known as "age regression" and "affect bridge in hypno-analysis" then help to trace the origin of the phobia and treat the cause of the fear. The alternative hypnotic stimuli ultimately suppress the unpleasant emotions associated with the phobia. For more efficiency, techniques from energy psychology can be used. They involve tapping acupuncture points and facilitate the elimination of harmful emotions. "
Duration of therapy: Between one and 10 one-hour sessions, depending on the extent of the phobia.