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For most people, the treatment of phobias has been a cope-as-you-go business: preflight cocktails for the fearful flyer, stairways instead of elevators for the claustrophobe. But such home-brew tactics are usually only stopgaps at best. Happily, safe and lasting phobia treatments are now at hand. In an era in which more and more emotional disorders are falling before the scythe of science, phobias are among the disorders falling fastest.
Researchers are making enormous progress in determining what phobias are, what kinds of neurochemical storms they trigger in the brain and for what evolutionary purpose the potential for such psychic squalls was encoded into us in the first place. With this understanding has come a magic bag of treatments: exposure therapy that can stomp out a lifetime phobia in a single six-hour session; virtual-reality programs that can safely simulate the thing the phobic most fears, slowly stripping it of its power to terrorize; new medications that can snuff the brain's phobic spark before it can catch. In the past year, the U.S. Food and Drug Administration approved the first drug--an existing antidepressant called Paxil--specifically for the treatment of social phobias. And just last week the Anxiety Disorders Association of America held a four-day seminar in Atlanta on a wide range of topics, including how to recognize and overcome social phobias, how to spot phobia and anxiety disorders in children and how to help patients maintain gains achieved in treatment.
"There's been nothing like this in the field of mental health," says psychologist David H. Barlow, director of the Center for Anxiety and Related Disorders at Boston University. "In the past few years, we've had a complete turnaround in the treatment of phobic disorders."
For something that can cause as much suffering as a phobia, it's remarkable how many people lay claim to having one--and how many of them are wrong. Self-described computer phobics are probably nothing of the kind. They may not care for the infernal machines and may occasionally want to throw one out the window, but that's not the same as a full-fledged phobia. Self-described claustrophobics often misdiagnose as well. The middle seat on a transatlantic flight may be something you approach with dismay, but unless you also experience a racing heart and ragged breath, you are probably not phobic. Drawing the distinction between distaste and the singular terror of a phobia is not always easy--and it's made all the harder by the fact that fear in some circumstances is perfectly appropriate. If flying into a storm or easing into weaving traffic isn't the right time to go a little white knuckled, what is?