Be Not Afraid: Hope and Help for Your Phobias
If you are tired of being held back by your phobias, here are some suggestions to overcome them
It's 9:30 p.m. and I check my phone for the last time. Sandwiched between two emails of no consequence is one from the minister of the local Unitarian Universalist Church. He's just read my latest column for The Chattanooga Times Free Press, about how invasive and disheartening it feels when your Christian neighbor knocks on your door to inquire whether you, the resident Jew, know Jesus.
"I think our congregation would be interested to hear you speak on this topic," his email says. Would I be willing to do it one day very soon?
I gasp and read the email aloud to my husband.
"So you're going to do it, right?" he says.
He's joking. No one is more intimately acquainted with my lifetime public speaking phobia than he is. "I turn pale at the outset of a speech and quake in every limb and in all my soul," said the Roman emperor Cicero, about his public speaking anxiety. I could not have put it better myself.
And I discover something about myself I never knew: I love the public spotlight. It's the anxiety I hate.
At 13, I refused to become a bat mitzvah because of my public speaking phobia. At 24, I changed my mind about pursuing a Ph.D. because of it. At 26, I couldn't eulogize my father because of it.
But I'm older now, and sick of being held back by fear.
Once again, there is opportunity, this time to speak out about the importance and the privacy of religious freedom. I accept the invitation to speak, and the next day I book an appointment with a psychiatrist who prescribes propranolol, a common blood pressure medication that blocks the more egregious symptoms of anxiety, such as a racing heart and shaking hands.
The morning of my talk, I 'm a wreck. But I take the pill and hope for the best. The results are no less than dramatic. I am completely comfortable at the podium. I'm clear-headed and energized. And I discover something about myself I never knew: I love the public spotlight. It's the anxiety I hate.
The Difference Between Fears and Phobias
Fear is a natural emotion that arises when we are faced with real (as opposed to imagined) danger, while "specific phobias," according to the National Institute of Mental Health, are "the intense, irrational fear of something that poses little or no actual danger."
When confronted with a phobic object or situation, people may experience a range of symptoms, including dizziness, heart palpitations or racing heart, chest pain, sweating, shortness of breath, a choking sensation, nausea, gastrointestinal distress and panic attacks. And it's pointless to try to reason with a phobia; they do not abate in the face of evidence that the fear is unfounded.
But take heart. If you are one of the nation's 19 million adults suffering with a phobia (approximately 9% of the U.S. population), you've got company.
Actress Jennifer Aniston has a fear of being underwater. Actress Nicole Kidman has a fear of butterflies. At the height of her career, Barbra Streisand famously developed performance anxiety, and for 27 years would only appear in small venues. Just before a concert in 1981, an anxious Carly Simon collapsed, after which she abandoned the stage for seven years. Abraham Lincoln, Winston Churchill and Gandhi all had glossophobia (fear of public speaking).
According to the Anxiety and Depression Association of America (for which singer Donny Osmond became a spokesman after he suffered panic attacks), women are more than twice as likely as men to develop a specific phobia, with most sufferers between the ages of 45 and 59.
Phobias are believed to begin in childhood, around age seven; at any given time, over 32% percent of Americans are receiving treatment for one or more.
Some Common Threads About Fear
Well known phobias include fear of heights, flying, public speaking, leaving the home (agoraphobia) and germs. But there are many less common phobias as well, including fears of hands, beards, names and arithmetic—it appears that our phobias are only as limited as our imaginations.
There is even something called "voracious victimization," which is a phobic reaction to a negative situation or event someone close to us has suffered — a kind of sympathetic terror.
Maximilian Fuhrmann, an author and clinical psychologist with a specialty in geropsychology (which addresses issues facing older adults) who practices in Thousand Oaks and Beverly Hills, Calif., says that while phobias differ in scope and focus, they have a common thread.
"Phobias come from feeling of incompetence or loss of control." he says, "The fear that you won't be able to handle what's going to happen to you when you come face to face with the feared object or event."
Some examples of phobias: That if you are on a high cliff, you might lose your balance and fall; that the airplane could lose power and crash; that an audience might mock and laugh at your presentation. At the heart of the terror is the belief that you are not in control of the situation and will not be able to handle the consequences.
The Good News About Fear
As distressing as phobias can be, there is good news when it comes to prevailing over them. There are a variety of treatments, some of which require a trained therapist and some of which you can practice on your own or with the assistance of professionals via YouTube videos.
"Part of being older is that you've been there and done that," he says — "and here you still are."
Perhaps the best piece of news for those of us over 50 is that phobias (and their little sister, fears) typically begin to diminish as we get older. Fuhrmann chalks this up to the fact that, the older we are, the more life experience we've had, and therefore the more opportunities to see that very little of what we feared actually came to pass.
"Part of being older is you've been there and done that," he says — "and here you still are." It's just one of the many gifts of aging, that we have years of experiences to guide and comfort us.
Kate Chapman, a certified life coach in New Jersey who also happens to be a longtime Broadway performer, agrees that "phobias are manageable." And, she says: "Some definitely go away. How curable they are depends on their scope, how deep they run, how long they've been nurtured and what the person gains from indulging in one."
How to Treat Fears and Phobias
The literature on the treatment of phobias is fairly consistent when it comes to what helps — and what doesn't.
Talk therapy — simply discussing the fear and delving into its origin — may make us feel better in the moment, but it doesn't address the behavioral component to phobias (avoidance), which must be addressed in order to break the stranglehold they have over us, says Brandon Santan, of Thrivepoint Counseling in Chattanooga, Tenn.
And the old technique of flooding — exposing a client to the feared event or object in great quantities or repeatedly in a short time frame — can actually make things worse or be harmful to more emotionally fragile clients.
According to almost everyone I interviewed for this article, systematic desensitization is the treatment of choice. This method asks clients to construct a detailed hierarchy of steps involved in (for example) giving a talk, from the least scary step to the scariest.
My hierarchy would be writing the talk, thinking about giving the talk, eating breakfast before the talk, driving to the auditorium, walking in, waiting to speak, walking to the podium and delivering the speech.
The therapist then pairs a series of relaxation exercises (or other mindfulness activity) as you mentally go through the steps, until you're able to mentally perform each one, including the final, most feared one, without anxiety. The process can take several months depending on a client's motivation, the frequency of sessions and the depth and duration of the phobia.
Fortunately for older adults, says Fuhrmann, they often get better more quickly than younger adults because they tend to be more committed to the process (perhaps because they've suffered with the phobia for longer).
I was overjoyed to be able to join in these larger conversations, and sad about all the opportunities I missed to speak my mind and my heart because of my phobia.
Hypnosis, meditation, breathing exercises and guided visualization may also be helpful in the treatment of phobias. And, of course, there are medications, such as the beta-blockers I take to speak, as well as a number of anti-anxiety medications.
As for non-traditional approaches to dealing with phobias, well, there are some of those as well: When Carly Simon returned to performing after her hiatus, she discovered that having members of her band spank her before she went onstage distracted her from her anxiety.
Sex and aerobics? Both useful distraction techniques that can have the added benefit of exhaustion, which can help cancel out anxiety.
You may need to try a variety of options before you find what works best for you.
Lastly, while phobias can be successfully treated, it's not unusual to have a resurgence of symptoms down the road or when the former phobia is encountered in a new or stressful context, says Nikki Press, clinical psychologist at the New York-Presbyterian Hospital-Columbia University Medical Center.
"It's called spontaneous recovery, it's nothing to worry about, and it's something that a few booster therapy sessions can help," she notes.
Case in point: Fuhrmann says that the COVID-19 pandemic has caused some with successfully treated germ phobias to regress. (Interestingly, he adds that the pandemic has actually comforted others with germ phobias, because they feel that their fears are no longer unfounded.)
There Is Hope for Overcoming Phobias
As you can see, there is hope for those of us who suffer, whether in the glare of the spotlight, like Cicero and Gandhi, or in a field of flitting butterflies, like Nicole Kidman.
After my successful talk at the Unitarian Universalist Church, I was called on to speak on various topics at other venues, as well as to give workshops, lectures, readings and talks at literature conferences, book clubs and on the radio. I was overjoyed to be able to join in these larger conversations, and sad about all the opportunities I missed to speak my mind and my heart because of my phobia.
Whatever it is you fear, however big or small or irrational, it may very well be disrupting your life. Know that there is hope and help. Don't be afraid to reach out.
And forgive yourself your fears, for as history shows us, you're in the company of greatness.