From a 2007 article in the Vancouver Sun,
Friday, April 13, 2007
It's a word we in the media like to trot out today: paraskevidekatriaphobia [pronounced pair-uh-skee-vee-dek-uh-tree-uh-FOH-bee-uh] -- the excessive, and sometimes morbid fear of Friday the 13th.
We like it, first, because it's such an impressive-sounding word -- it takes some doing to make all those syllables trip elegantly off the tongue -- and second, because irrational though the fear of a calendar date might sound, it is a bona fide phobia nonetheless, just like ablutophobia, the fear of washing or bathing, lachanophobia, the fear of vegetables, and soceraphobia, the fear of one's parents-in-law.
However, because "irrational" is a word that implies judgment, it's not a word used by professionals who treat phobias. (Especially, they add, given that some phobias can make sense. Think, for example, how valuable a fear of snakes and scorpions was in hunter/gatherer times when one misplaced step could mean death.) What matters to them is whether the phobia, rational or not, impedes the sufferer's ability to live normally.
"If someone is afraid of snakes, and he lives in Ireland where there are no snakes, it's not very serious," says Dr. Mark Watling, a psychiatrist and author, with psychologist Martin Antony, of the book, Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors and Dentists. But if you're a diabetic with a debilitating fear of needles, you're in trouble. You're not alone.
Watling, who practises out of the Anxiety Treatment and Research Centre in Hamilton, estimates as many as 13 per cent of people have, to some extent, a fear of things medical.
Sometimes that fear will be so pronounced it will result in panic attacks, and for people with a serious medical condition, that, literally, could be a matter of life and death.
"Certainly there are people who are so afraid of needles that they will put off getting blood work that needs to be done," Watling said in an interview. "But it's when they reach a point like that in their lives that they come to our clinic."
Why such phobias develop is a matter of debate. Genetics is sometimes thought to be partly responsible -- think of those atavistic fears of snakes and spiders -- though it's not clear how much of a fear is inherited and how much is learned. More likely most phobias are born of accidentally associating something otherwise benign with something unpleasant.
Maybe, says Watling, a person's first immunization was terribly painful. Or maybe a person's parents are afraid of needles, so the fear will be exaggerated in the child. It's really hard to say, he adds. No one can draw a definitive conclusion.
Certainly Julianne Lee, a kindergarten teacher in south Surrey, has no explanation for her fear of rats and mice; she just knows she's terrified of them.
"It started when I was 12," she says. "I went blackberry picking in Steveston in Richmond and I stepped on a piece of wood and out came this rodent. I think it was a rat or a mouse. And as soon as I saw it, I remember not being able to breathe, and screaming and screaming like the world was closing in."
And she still feels that way to this day.
If one of her three children ever were to bring home a rat or mouse, she doesn't know what she'd do.
"If they ever touched a mouse or a rat, I think I would be hysterical," she says.
If she were invited to dinner at the home of someone who kept a mouse as a pet, she wouldn't go. She'd never stay in a youth hostel because in her mind they're breeding grounds for mice, and she won't ever set foot in Stanley Park's petting zoo. Never.
"I'd rather be in a room with 10 snakes than one mouse," is how she puts it.
Curiously, when Jerilyn Ross, now a clinical social worker in Washington, D.C. and the CEO of the Anxiety Disorders Association of America, developed her fear of heights, it was on one of the most magical nights of her life.
She was in her 20s, in Salzburg during the Mozart Festival, and she was dancing "with a Prince Charming" on a verandah overlooking the city, which that night was bathed in a kind of fairytale glow.
"I remember dancing and thinking 'what an extraordinary night'," she recalls 30 years later. "And then all of a sudden out of the blue I had this sensation that something would happen to me -- that I was going to be pulled over the edge or pushed over or something."
Perhaps, she now says with the cool clarity of someone who's studied phobias, it was the extreme emotional intensity of the experience -- the twinkling lights, the glorious music, the handsome partner -- that triggered what would become an affliction lasting years. She can't honestly say.
What she can say is that for almost four years, before she finally sought help for it, it affected every aspect of her life. It prevented her from seeking a better job -- she was afraid the interviews might take place in a skyscraper (a good bet since she lived in New York) -- and accepting all kinds of invitations for the same reason.
"My fear was that I was going to lose control -- to run to a window and do something crazy. Since then I've learned it was a misfiring of my body's fight-or-flight response."
What saved her -- indeed what saves most people affected by a phobia, regardless of its genesis -- is something called exposure therapy, a kind of psychological immunization that, like using allergens to treat allergies, uses the very thing the person is afraid of to help him or her get over it. In other words, to face one's fear head-on, but in a gradual, controlled and above all, safe environment.
For Ross, that meant going with her therapist to the sixth floor of a building one week, to the seventh the next, and to the eighth the week after that. Each time she would be afraid, she recalls, but each time -- with time -- she would learn to manage and control that fear and move on it from it.
It took months of practice, but she finally beat the phobia altogether. Recently, she and her husband bought a condo in Florida with floor-to-ceiling windows on the 16th floor.
What's important, says Steve Taylor, a psychologist practising out of the University of B.C.'s psychiatry department, is that the therapy be done slowly, methodically and preferably under the care of someone who really knows what he's doing.
"You can try it to do it on your own," he says, "but it's best to do it gradually. Too often people with phobias will try and push themselves too hard."
No matter the source of the phobia -- rats, cats, dinner conversation (deipnophobia), music (melophobia), or the colour purple (porphyrophobia) -- the idea is to expose the sufferer to it steadily and gradually to the point that eventually the phobia is all but wiped out or at least endurable.
For example, while he was still practising in Australia, Taylor once had a patient so afraid of spiders that simply seeing a picture of a dot with eight radiating strokes around it caused her panic. But at the end of a course of exposure therapy, she was a different woman -- "going out and catching them in a jar and then having them run across the floor in front of her," Taylor recalls.
For cases of certain kinds of social phobias -- that is, the fear of being in situations where one is under the scrutiny of others -- dating, job interviews and suchlike -- sometimes the same kinds of drugs used to treat depression will be used to treat the phobia, he says.
"Nobody knows for sure why they work," he adds, "but serotonin is thought to play a role in regulating emotions, and it's thought that somehow this neurotransmitter is de-regulated in people who develop a social phobia."
Sometimes, says Watling, something called "flooding" is tried as well. "This is exposing you to your worst-case scenario right off the bat," he explains.
In other words, this would involve, say, placing someone with a fear of cats in a crowded cat shelter. Needless to say, it's a drastic measure that is never prescribed lightly.
"It can be effective sometimes," Watling says, "but it's not effective if you scare the person out of ever having treatment again."
That's why for most people, he, Taylor and Ross concur, a gradual introduction to whatever it is that's prompting the fear is the best way.
In fact, for about 95 per cent of people who seek relief from their phobias, that kind of easy-as-you-go approach will do the trick."The exposures are designed to induce a manageable amount of anxiety -- nothing is supposed to be a surprise," Watling said.