dyslimbic
05-19-2007, 07:21 PM
FEARS AND PHOBIAS
http://www.lcmedia.com/mind479.htm
Broadcast beginning week of May 15, 2007
The show begins with Anica, a 40-year-old New Yorker with a bug phobia. She is terrified that they will crawl on her, touch her, even enter her ear or crawl up her nose. When she sees a bug, she experiences the anxiety, panic and sweating typical of a phobic reaction. Anica describes seeing and feeling three large waterbugs crawling on her as a child, and her mother's attempt at dispelling her fear through showing her the live bugs.
Next, host, Dr. Fred Goodwin talks with Jerilyn Ross, a psychotherapist in Washington, DC, president of the Anxiety Disorders Association of America, and the author of Triumph Over Fear. Ross points out that we all have fears, and if we didn't, we wouldn't survive as a species. A phobia differs from a fear in that it's and irrational fear reaction to an everyday object of activity. She says that people with phobias often modify their lives to avoid what they fear. Phobias often develop when a person has a panic attack in a given situation, in a tightly enclosed space for example. The person then becomes afraid to be in an enclosed place for fear of having another panic attack. The phobia becomes more of a fear of fear, of losing control, than a fear of enclosed places. The fear of the fear takes on a life of its own. Ross herself has a phobia of heights. She developed the phobia at the age of 25, when she had a panic attack in a tall building. She felt like she was losing control., like she was going to jump off the edge of the building. As a result, she became a master of avoidance, and by the time she was 30, hadn't been above the 10th floor of a building for 3 or 4 years, which is difficult in Manhattan, where she lived at the time. She said nobody knew about her avoidance Ross is still dealing with her phobia, but practices what she preaches and no longer avoids heights. Ross has had patients with common phobias, like fear of bridges or tunnels, and some with more uncommon phobias, like a fear of statues. She treats her patients with cognitive behavioral therapy. She asks her patients what would happen if they put themselves into the situation they fear, and then talks to them about some of their misconceptions. For example, one patient feared subways, and thought that if she panicked, her blood pressure would rise all the way up and she would pass out. Ross often accompanies her patients on their fearful journeys, perhaps over a bridge, or on a subway and tries to get them out of the "what-if" mode by employing techniques like deep-breathing. Ross also works with a doctor to use medication in some instances, including anti-depressants for people with multiple phobias or a phobia and depression. She notes there is a high overlap of depression and phobias, of one phobia with another, and of phobias with substance abuse. She recommends information and experience as therapy for phobias. For example, she says, if you fear flying, go to an airport armed with questions for pilots, flight attendants, and mechanics and don't worry about questions being too simplistic. For a free anxiety disorder screening, call 1-888-442-2022. More information about Ross' work is available on her Website at http://www.RossCenter.com. For information on the Anxiety Disorders Association of America, click here (www.ADAA.org). You can learn more about or order Ross' book, Triumph Over Fear.
Next comes a report on a virtual reality program that simulates airplane flight to help patients overcome fear of flying. Therapists at Hillside Hospital on Long Island, and at five other sites around the country, are using the program, called Virtually Better, to expose patients to a simulation of flying, to evoke their feelings of anxiety, and to give them methods to help reduce their anxiety. One patient, Steve, who is in his late thirties, describes his feelings when he flies, saying he loses limb function, and feels hot, then cold, then numb. He isn't afraid of crashing, he says, but of losing control, being in a place he can't escape from. With help from his psychologist, Joyce Tanzer, Steve has just taken his first flight in two years. He says he felt relaxed during the flight, and will take another, longer trip next month. Dr. Michael Kahan, who is the director of the phobia clinic at Hillside, describes how he treats people with phobias. He says he tries to replace inaccurate thoughts with accurate information, and teaches techniques such as deep-breathing to help calm patients. He uses the virtual reality program, a type of "exposure therapy," to work with patients while they are experiencing the flight simulation and the accompanying anxiety. The computer program was developed by Dr. Larry Hodges of Georgia Tech and Dr. Barbara Rothbaum of Emory University. The way it works is that the patient sits in an airline seat with a headset covering their eyes and ears. They experiences the sights and sounds one would on a plane, they can turn their head to look at the scene out the window, which moves and changes according to the stage of flight, and can hear the sounds of takeoff, turbulence, landing and details like the voice of a flight attendant. The seat even vibrates along with the engine. For more information about Hillside Hospital and the phobia clinic, call 718-470-8554 or click here. For more information on the Virtually Better program, and to find out where the program is being used, click here or call 1-404-873-4404.
Dr. Goodwin then interviews Lilyan Wilder, the author of 7 Steps to Fearless Speaking and a communications consultant who has coached Oprah Winfrey, Charlie Rose, George Bush, and Dr. Goodwin himself, among others. Dr. Goodwin points out that surveys have shown that people are less afraid of dying than of public speaking, and Ms. Wilder agrees that almost everyone has a fear of speaking in public. She says that most important step in public speaking is connecting to a person in the audience and getting a response from them. She believes that a speaker needs to lose their isolation, and should engage in a dialogue, rather than be beholden to words on a page. She recommends a good outline. In addition to getting a response from a member of the audience, be it as subtle as a nod, she recommends being clear in your message and identifying your audience, and speaking from the heart. She says to make what you say worthwhile by believing in it. You can find more information about and order Lilyan Wilder's best-selling book 7 Steps to Fearless Speaking. Dr. Goodwin then speaks with Dr. Dennis Charney, about what goes on in the brain during anxiety or panic. Dr. Charney first describes a typical panic attack: a severe and frightening attack of anxiety that occurs often right out of the blue and includes a variety of physical symptoms, including a racing heart and a shortness of breath. The attack usually lasts between 10 and 20 minutes. In many cases, he says, the patient thinks they are having a heart attack. Dr. Charney theorizes that panic attacks occur when the alarm system in the brain turns on when it's not needed. He believes that our alarm system may have an evolutionary origin, and developed to keep us attuned to our natural predators. Using sensitive brain imaging devices, doctors have identified parts of the brain involved in panic and anxiety. One of these is the amygdala, an almond-shaped structure in the temporal lobe. Another is the locus coeruleus, a very small structure in the brain stem that contains adrenaline and sends it around to other parts of the brain. Dr. Charney says that anxiety disorders run in families, and that there are probably several genes responsible for the development of these disorders. Sufferers may have an overly sensitive alarm system that turns on without reason. Dr. Goodwin wonders if there are signs of anxiety disorders in children, if there is a strong genetic component. Dr. Charney explains that children have trouble articulating their feelings, but that kids who have trouble separating from their parents or going to school may be feeling panic. He points out that even infants have been shown to react differently to their environments, suggesting some may feel more fear than others. Anxiety disorders, however, are not full-blown until adolescence. There are certain chemicals mediating our feelings of anxiety, Dr. Charney says. They include adrenaline, serotonin, Gamma amino butyric acid, or GABA, and neuropeptides. There are drugs that can regulate some of the these chemicals that are used to treat anxiety, including Prozac and Zoloft. There are others in the works, including one that focuses on Substance P, a peptide involved in regulation of mood and anxiety. By targeting something this specific, researchers hope to avoid some of the side effects found with other anti-anxiety drugs, says Dr. Goodwin.
http://www.lcmedia.com/mind479.htm
Broadcast beginning week of May 15, 2007
The show begins with Anica, a 40-year-old New Yorker with a bug phobia. She is terrified that they will crawl on her, touch her, even enter her ear or crawl up her nose. When she sees a bug, she experiences the anxiety, panic and sweating typical of a phobic reaction. Anica describes seeing and feeling three large waterbugs crawling on her as a child, and her mother's attempt at dispelling her fear through showing her the live bugs.
Next, host, Dr. Fred Goodwin talks with Jerilyn Ross, a psychotherapist in Washington, DC, president of the Anxiety Disorders Association of America, and the author of Triumph Over Fear. Ross points out that we all have fears, and if we didn't, we wouldn't survive as a species. A phobia differs from a fear in that it's and irrational fear reaction to an everyday object of activity. She says that people with phobias often modify their lives to avoid what they fear. Phobias often develop when a person has a panic attack in a given situation, in a tightly enclosed space for example. The person then becomes afraid to be in an enclosed place for fear of having another panic attack. The phobia becomes more of a fear of fear, of losing control, than a fear of enclosed places. The fear of the fear takes on a life of its own. Ross herself has a phobia of heights. She developed the phobia at the age of 25, when she had a panic attack in a tall building. She felt like she was losing control., like she was going to jump off the edge of the building. As a result, she became a master of avoidance, and by the time she was 30, hadn't been above the 10th floor of a building for 3 or 4 years, which is difficult in Manhattan, where she lived at the time. She said nobody knew about her avoidance Ross is still dealing with her phobia, but practices what she preaches and no longer avoids heights. Ross has had patients with common phobias, like fear of bridges or tunnels, and some with more uncommon phobias, like a fear of statues. She treats her patients with cognitive behavioral therapy. She asks her patients what would happen if they put themselves into the situation they fear, and then talks to them about some of their misconceptions. For example, one patient feared subways, and thought that if she panicked, her blood pressure would rise all the way up and she would pass out. Ross often accompanies her patients on their fearful journeys, perhaps over a bridge, or on a subway and tries to get them out of the "what-if" mode by employing techniques like deep-breathing. Ross also works with a doctor to use medication in some instances, including anti-depressants for people with multiple phobias or a phobia and depression. She notes there is a high overlap of depression and phobias, of one phobia with another, and of phobias with substance abuse. She recommends information and experience as therapy for phobias. For example, she says, if you fear flying, go to an airport armed with questions for pilots, flight attendants, and mechanics and don't worry about questions being too simplistic. For a free anxiety disorder screening, call 1-888-442-2022. More information about Ross' work is available on her Website at http://www.RossCenter.com. For information on the Anxiety Disorders Association of America, click here (www.ADAA.org). You can learn more about or order Ross' book, Triumph Over Fear.
Next comes a report on a virtual reality program that simulates airplane flight to help patients overcome fear of flying. Therapists at Hillside Hospital on Long Island, and at five other sites around the country, are using the program, called Virtually Better, to expose patients to a simulation of flying, to evoke their feelings of anxiety, and to give them methods to help reduce their anxiety. One patient, Steve, who is in his late thirties, describes his feelings when he flies, saying he loses limb function, and feels hot, then cold, then numb. He isn't afraid of crashing, he says, but of losing control, being in a place he can't escape from. With help from his psychologist, Joyce Tanzer, Steve has just taken his first flight in two years. He says he felt relaxed during the flight, and will take another, longer trip next month. Dr. Michael Kahan, who is the director of the phobia clinic at Hillside, describes how he treats people with phobias. He says he tries to replace inaccurate thoughts with accurate information, and teaches techniques such as deep-breathing to help calm patients. He uses the virtual reality program, a type of "exposure therapy," to work with patients while they are experiencing the flight simulation and the accompanying anxiety. The computer program was developed by Dr. Larry Hodges of Georgia Tech and Dr. Barbara Rothbaum of Emory University. The way it works is that the patient sits in an airline seat with a headset covering their eyes and ears. They experiences the sights and sounds one would on a plane, they can turn their head to look at the scene out the window, which moves and changes according to the stage of flight, and can hear the sounds of takeoff, turbulence, landing and details like the voice of a flight attendant. The seat even vibrates along with the engine. For more information about Hillside Hospital and the phobia clinic, call 718-470-8554 or click here. For more information on the Virtually Better program, and to find out where the program is being used, click here or call 1-404-873-4404.
Dr. Goodwin then interviews Lilyan Wilder, the author of 7 Steps to Fearless Speaking and a communications consultant who has coached Oprah Winfrey, Charlie Rose, George Bush, and Dr. Goodwin himself, among others. Dr. Goodwin points out that surveys have shown that people are less afraid of dying than of public speaking, and Ms. Wilder agrees that almost everyone has a fear of speaking in public. She says that most important step in public speaking is connecting to a person in the audience and getting a response from them. She believes that a speaker needs to lose their isolation, and should engage in a dialogue, rather than be beholden to words on a page. She recommends a good outline. In addition to getting a response from a member of the audience, be it as subtle as a nod, she recommends being clear in your message and identifying your audience, and speaking from the heart. She says to make what you say worthwhile by believing in it. You can find more information about and order Lilyan Wilder's best-selling book 7 Steps to Fearless Speaking. Dr. Goodwin then speaks with Dr. Dennis Charney, about what goes on in the brain during anxiety or panic. Dr. Charney first describes a typical panic attack: a severe and frightening attack of anxiety that occurs often right out of the blue and includes a variety of physical symptoms, including a racing heart and a shortness of breath. The attack usually lasts between 10 and 20 minutes. In many cases, he says, the patient thinks they are having a heart attack. Dr. Charney theorizes that panic attacks occur when the alarm system in the brain turns on when it's not needed. He believes that our alarm system may have an evolutionary origin, and developed to keep us attuned to our natural predators. Using sensitive brain imaging devices, doctors have identified parts of the brain involved in panic and anxiety. One of these is the amygdala, an almond-shaped structure in the temporal lobe. Another is the locus coeruleus, a very small structure in the brain stem that contains adrenaline and sends it around to other parts of the brain. Dr. Charney says that anxiety disorders run in families, and that there are probably several genes responsible for the development of these disorders. Sufferers may have an overly sensitive alarm system that turns on without reason. Dr. Goodwin wonders if there are signs of anxiety disorders in children, if there is a strong genetic component. Dr. Charney explains that children have trouble articulating their feelings, but that kids who have trouble separating from their parents or going to school may be feeling panic. He points out that even infants have been shown to react differently to their environments, suggesting some may feel more fear than others. Anxiety disorders, however, are not full-blown until adolescence. There are certain chemicals mediating our feelings of anxiety, Dr. Charney says. They include adrenaline, serotonin, Gamma amino butyric acid, or GABA, and neuropeptides. There are drugs that can regulate some of the these chemicals that are used to treat anxiety, including Prozac and Zoloft. There are others in the works, including one that focuses on Substance P, a peptide involved in regulation of mood and anxiety. By targeting something this specific, researchers hope to avoid some of the side effects found with other anti-anxiety drugs, says Dr. Goodwin.