Online Therapy for phobias and anxiety

I found it extremely interesting to discover that the first International E-Health Summit 2009 is due to be held in Amsterdam on 16-18 October 2009. When I look at the sponsors and those who are attending from the academic world, this gives great credibility to the possibilities of on-line therapy for mental disorder.
I also found it interesting to note that there will be a symposium on social phobias and anxiety: "Online treatment for anxiety and social phobia,  presenter T. Berger, PhD" on the first day of the conference. There is a great deal of research going on presently on the topic of on-line therapy and it will be extremely interesting to follow the results of this conference. The web address for the  International E- Mental Health Summit is here. Although there have been reservations expressed abou the the potential risks of on-line therapy, the topic is still very much debated.
Craig Childress has written an excellent article on the topic of  "Potential Risks and Benefits of Online Psychotherapeutic Interventions". In his view the main potential drawbacks ca be summed up as follows:
1. A loss of visual and auditory cues,
2. Confidentiality,
3. Competence,
4. Crisis management,
5. Legal and juridicial issues.
On the other hand  Craig Childress sees the following potential:
1. Screening,
2. Treatment of non-clinical problems,
3. Unique advantages of on-line communication,
4. Support groups,
5. Adjunctive Internet use.

Next month I shall be updating you on some of the conclusions of this world summit.

Stuttering and social anxiety. Chicken or egg?

I have spent most of the week-end reading about stuttering and stammering a it is seemingly in some way related to social anxiety. To me it would seem perfectly obvious that anyone with a (severe) speech impediment would be extremely prone to avoid embarrassement, social situations etc. Inititally this could seem to be a clear cause and effect situation. But then I thought back when my social phobia was at its worst and remembered that, although I did not stutter, I had a severe fear that I would do so in a social situation.
What I find of particular interest now is that some of the drugs used to help those of us suffering from phobic disorders are alse being used  today in the treatment of stuttering.

There has been a magnifient amount of research done into the disorder known as stuttering and a great deal of empirical research. Although there is no scientific or medical consensus on the actual causes of stuttering or on a definitive cure, it is interesting to note that this disorder, like phobias, is the subject of exploitation by those who will stop at nothing to earn their living. I am referring to scam websites such as this one  which promise the earth for $97.
For those of you looking for a really great website on the topic of stutteirng this one I cam highly recommend.

Comment by Ysabeth which is really worth thinking about on phobias

Ysabeth, a frequent visitor and contributor to this blog wrote the following comment:
"
Most phobias are based on a rational concern, which has overgrown into an irrational fear that interferes with ordinary activities. For instance, a fear of snakes is based on the fact that some snakes are dangerous and most will nip if they feel threatened, which makes it prudent to be careful about them. But a phobia can be triggered by a *photo* of a snake, even though the photo cannot cause direct harm. The challenge is to bring the phobia back into the rational and managable range, without denying whatever factual basis it might have."
I find this an extremely interesting comment. Even a pictorial representation of the dreaded object can trigger fear, even though the individual knows that he/she cannot be harmed by a picture. In my view this would seem to strenghten the case for behavourial desensitization. By that I mean in this example gradual exposure to anything related to the presence of a snake - perhaps starting with a picture, then a model, then a video then actually visiting a zoo etc etc.

A fear of accidents?

Dystychiphobia - This is the word which a reader my blog is looking for and it means fear of accidents. I consider it to be quit natural to have a fear of accidents as no one wishes to have an accident. I think the important thing to recognise is the degree to which you fear such accidents. If it is excessive then yes I would imagine it could be called a phobia. Looking up the list of known phobias I find the length of the list of phobias quite incredible.

Who can answer the following. What are the following four phobias? (It helps if you speak Greek!)

Didaskaleinophobia

Elurophobia

Genuphobia

Heliophobia 



 

The scams for phobias which I hate

Dear Readers, 

Apologies but scams sich as the one you see below get me very upset. I received this just this morning and when I read the nonsense it is really not worth even reading, much less purchasing. The reason I object to this Clickbank products is that it is exploiting an illness and offering immediate cure with 10 minutes a day. Just take a second and read it through and you will see what I mean



            Secret Of Meditation:

	Instantly Relax and Meditate anywhere, anytime you wish. There is no ritual or certain rules you have to follow . (Editor: well that sounds very handy, indeed, I really can do what I want when I want to?)
	Improve your health dramatically - physically, emotionally, and mentally. (Editor: This sentence says absolutely nothing about the product at all. It is a complete and utter generalisation which could apply to anything.)
	Empower yourself for Greater Success, Better Health, Relationship and Financially. (Editor; Equally meaningless sentence which says absolutely nothing, all it is doing is filling the page but not giving you any information.)
	Get rid of limiting belief, never let fear control your life (Editor; So I can jump of a ten storey building without fear.)
	Ability to Heal Yourself and become a facilitator to heal others instantly (Editor: wow, that is not. Not only does it heal me instantly, I can start healing others immediately!)
	Increase vitality and feelings of rejuvenation, face your life with positive attitude. (Editor: Better than any vitamins you will ever buy.)
	Decrease symptoms of Panic and Anxiety , start and end your day with Pure Unconditional Love
	Create emotional stability, stop suffering from mood swings.
	Increase your intuitions and boost your sixth sense (Editor: Boost my what?)
	Activate 7 major Chakras and preparing youself for KUNDALINI Awakening (Editor: I bet, just can't wait!)
	Naturally Cure Insomnia, Stress and Depression

Well as you see I could continue, this text says nothing, it promises the earth. You have to do nothing to get rid of your phobias or panic and anxity attack - just pay $67 dollars and everthing will be fine! Problem is there are so many desperate phobics out there, I wondered how much he sold?

Learn about your phobias!!

This may seem a strange thing to say but many people who suffer from phobias are totally at their mercy partly because they feel totally exposed and at the mercy of phobias. Learning about phobias, in general, is a good idea because it does help you understand what is happening to you and it demystifies the whole thing. One always has a greater fear of the unknown, this is common knowledge.
So, my advice is read literature on the matter, look for and join Internet forums and discuss your phobia(s) with others. You will very soon discover that these terrifying situations you are experiencing are being experienced by thousands of people just like you every day.

In fact, phobias and panic attacks are extremely common and seemingly all the more so in today's stressful and hectic way of life. You would be surprised about the number of people who takes the stairs at work and not the elevator becuase they panic at the mere thought. You would be surprised about the number of people you know who prefer to eat alone and deliberately go to eat earlier or later than the rest - simply because they have a phobia of eaiting in company. You would be equally surprised at the number of people who do not go on that training course they woudl love to go on just in case during the class they might be but in a position of having to answer a question or get up and say something in front of others. So do me and do yourself a favour - read up a little on panic attacks and phobias and come back and tell me how this has affected you.

On a lighter note - it' s a dog's life

Folks, we are not alone with our phobias, our canine friends also have this complaint and there has been quite a lot of research into what causes it. The most common phobia for dogs is thunderstorms and - wait for it - "It's becoming increasingly common for veterinarians to prescribe the generic version of drugs such as Xanax or Prozac for anxious dogs." As yet there is no clear answer as to why dogs develop phobias but they do and many are not detected until their phobic behaviour becomes visible at the age of four or five. Some believe it is through watching humans reaction to storms which cause them to react in this way, Some believe that dogs are much more aware of static electricity and this built up in their body is what makes them feel uncomfortable.

Social phobia - it's all about negative emotions about yourself

The one great thing about the Internet, I find, is that it gives me access to the experience and opinios of thousands of people like myself who suffer from social phobia. What I try to do is look at other people's opinion and feelings about their condition and then try and work out what they all have in common. Only the Internet gives me the opportunity to gather such useful information. It is a magnificent tool for empirical research. Well, havng done so now for some time - and it is something I will continue to do on a regular basis - I have come accross certain common denominators concerning the condition of panic attacks and social phobias. There are some valid points which I think shows what we all need to work on to improve our mental condition.
Nine times out of ten individuals suffering from social phobias are intensely worried about how other people perceive them. Work on yourself. Keep telling yourself you are OK as you are and it really does not matter how other people see you. That is a vital step in the process.
Continue such positive thoughts with your self-esteem and encourage and reward yourself on a daily basis for everything you discover positive about yourself.
Positive thoughts EMPOWER you and really effect your future. Try and fall asleep at night with postive thoughts about yourself. Try and have positive thoughts about yourself when you wake up in the morning. You will be AMAZED how this unconsciously influences you. Give it a try.

The unstable ground of psychiatry as a science

It is reasonable to believe in scientific terms that there is a reason for everything. I just was reading recently on a web site devoted to social phobia amd I came across the following:
Associated Laboratory Findings:

No laboratory test has been found to be diagnostic of this disorder.
I believe it is exactly this which puts psychiatry on very shakey ground at times. If you have no way of diagnosing something, how then can you assert that it even exists in scientific terms? Basically the academic and scientific answer is a simple own - you cannot. But does that mean it does not exist as an illness. Of course it doesn't, there are thousands even millions of individuals who suffer from phobic disorders regardless of the inability of science to find a way of diagnosing it in the laboratory.
I thnk this again ties in with the discussion which we have ongoing about the stigma of social phobias and anxiety disorders. It is hidden, it cannot be diagnosed like a physical illness and as such is always treated with suspicion in the eyes of the sceptics.

Does physical exercise reduce phobias?

I have reviewed many stories relatibg to the effect physical exercise on a regular basis has on individuals who suffer form phobias. In general my research would seem to show that yes indeed regular even daily physical exercise does have an overall beneficial effect. Here is what one sufferer writes:

"I found that as the more intense demands I could put on my body, that a chemical release of maybe endorphenes and dopamine, would give me a high that would last about 1 hr.! It was like floating to the music and everything was wonderful! After the high wore off, there still was a good feeling lasting all day which helped me face my fears much better.".

While in the vast majority of cases, individuals recognise that psychical exercises is not actually a cure for phobic disorders, it does place one in a better physcial and mental position to deal with them.

Excellent thoughts on t he stigma of mental illness

Glitteringlynx has responded with such excellent thoughts to my post on the stigma of mentla illness that I feel compelled to post the comment in full:
"What you don't realise is that much of what we know of mental illness has only been acquired in the last 20 years. Mental illness was something you didn't want people to know about your family. A friend of mine has a great uncle who no one ever talks about. When his father developed schizophrenia, they came to recognise that the uncle was probably schizophrenic as well. Even his father was mostly exiled from his own family, though his mother and a couple siblings still keep in touch. Once upon a time we'd just lock up anyone whose illness was bad enough that people noticed. So is it really any wonder that people would try to hide their unusual aspects of themselves and even today refuse to seek treatment or assistance from a physician? Or is it really a shock that so many try to self-medicate through substances such as alcohol or illegal drugs just in order to deal with daily life?

It's also a problem when the symptoms of an illness show up differently in the different genders. For example, women with depression will tell their doctor of emotional complaints, whereas men with depression will tell their doctor of physical complaints. As a result, men will often be inspected for heart disease or other physical ailments, when depression is the actual problem.

Furthermore, it is incredibly difficult to understand why they are "illnesses" when these experiences and behaviours are otherwise normal elements of human existence. Depression can occur during or after a woman's pregnancy or after the loss of a loved one. Mania can seem like someone who just has a lot of energy. ADHD can look only like normal hyperactivity or, at older ages, a lack of mental discipline. Schizophrenia (as in the spectrum) is easily concealed within the scope of religion where hearing the voice of God or seeing visions of angels or spirits would not be considered abnormal. Of course schizophrenia has the additional problem of being confused with Multiple-Personality Disorder (MPD), which is evident in the colloquial use of the word "schizophrenic." Social phobia can be labelled as "shyness" or "introverted" and not seen as problematic. Obsessive Compulsive Disorder can be viewed only as worrying too much. Et cetera.

The ONLY difference between when these experiences are normal and when they are not, are when they negatively impact ones ability to function normally in society. With the "disorders" themselves being so complex, and our enlightenment so recent, it is far from surprising that these continue to be so misunderstood.

The stigma of mental illness

Sincere thanks again to Ysabeth Wordsmith for her extensive comments on he stigma of mental illness. At the end of her comments Ysabeth writes:
"Because ... when your mind is bleeding to death, most people can't see that kind of blood."
She explains as follows:
"...not everyone has the experience of mental complaints. That makes it harder to understand and sympathize what someone else is going through. It is *easier and simpler* to assume the person is just undisciplined and should pull themselves together. They don't recognize the severity of the problem.
I think this is a very obvious point which I simply missed. In stark terms, physical illness is much easier recognised, it is also something most of us can empathise with - unlike mental illness which for many is unknown territory and full of the old cliches. Yes, it is much "easier and simpler" to make false assumptions a bit like all the misinformed though well-intentioned advise, for example, for someone who is suffering from severe depression. "Shake it off, think positively, stop moaning". This entirely misses the point that the actual inability to do such things is, de facto, a part of the illness. Why in society today is this so difficult for most people to understand?

Great comment from Ysabeth Wordsmith on mental illness

Ysabeth writes in a comment to my last post:
"We have some drugs that work great for some people, sort-of for most people, and not at all for many. Mental health care just lags way behind physical care. People are trying, but they don't really have the equipment to do a great job yet, and the social background doesn't help.
I agree with a lot of what is contained in this statement from Ysabeth. I believe there is no "one size fits all" cure for individuals and that the danger with psychiatry is that it tends to generalise and put lots of us under the same diagnosis.
And yes, I agree that mental health is lagging behind physical care why? Less than 50 years ago psychiatry was still sending electric shocks through people's heads to cure there depression. 100 years ago we were being put in baths full of freezing water to stop our seizures. Why does mental care lag so far behind physical care? How does this relate to the whole stigma of mental illness?

Phobia - nothing wrong with you?

Particularly in the 1960's and onwards there has been a growing movement against the omnipotence of psychiatry. Psychriatists such as R.D. Laing were the leaders of such a movement which could be described as antipsychiatry. One of the main critisicms of modern psychiatry is the fact of comorbidity which means the presence of more than one psychiatric disorder at the same time. For exmaple, is an individual with depression and phobias suffering from depression, phobias or both. Accusations were made that pschiatry was simply making up different illnesses as it went along and that these suited the drug companies just fine in their quest for billions of dollars. In other words the traditional psychiatry was justifying their existence through legitimization of new mental disorders.
As a more generalised statement one could say that psychiatry was nothing more than an advocate of social compliance - if you did not fit into the social behaviour society invented for you or if you questioned this you were mentally ill.
Personally I find the body of evidence for this perspective weak. The development of psycho-parmaceuticals since the 1960's has proven beyond doubt that illnesses under which the individual suffers, i e. social phobia can be countered with the proper medication.

Phobias, social anxiety - fear of fear

Many in their comments write to me that they get very upset and frustrated with themselves about having panic attacks. While this is a natural reaction I think we have to look a little deeper at this frustration.
I believe the real frustration and self-anger experienced by many of us who suffer from social phobias or social anxiety stems from the fact that we recognise the illogical nature of the fear and that what we are really confronted with is the fear of the fear of a particular social situation. I am not really worried about giving a speech before 200 people tomorrow, I fear the fear of such an action. It is this gradual build up over time which is so unnerving and energy sapping that all we feel is frustration.
This is the tricky thing, I feel, about phobias and anxiety in general, we fear the fear of the situation and not the actual situation. Perhaps I am not making myself very clear?

Social phobia and panic attacks - 1 step at a time

In my view there is no short term cure for the problem of phobias and social anxiety. My advice:
- Seek medical help, you are far from alone,
- Confide in a friend or family member and stop the secrecy,
- no matter what you do take one step at a time,
- stop critcising yourself and lowering your self-esteem,
- find others on the Internet who have the same problems and talk about it.
Always bear in mind that Social anxiety is one of the main psychological problems currently in the US affecting about 15 million US citizens in any given year.
Yet the illness is not commonly understood among the population, leading to people withdrawing from social contacts in case....., even stopping work in case ......, avoiding friends, in case ........., stop eating in company, in case...... Interesting piece from a psychologist on social anxiety disorder.