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overcoming phobias

In the terrific book, "Prozac Backlash" (which, unlike "Hormone Heresy" is well-documented and written by a doctor who practices what he preaches) Dr. Glenmuller tells of "exposure therapy" for persons with phobias. He tells how the patient is gradually exposed to the object of fear, learns at each step that it will not harm him, and, ideally, also undergoes psychotherapy intended to root out the original cause of the phobia. I suspect that this digging into the past helps the patient realize that the fear is irrational.

I did none of this in conquering my own fear of height. My approach was simpler and every bit as effective, and I never found out the actual cause of the fear. I suspect I gained it by suggestion from my mother, who also had this phobia (along with many others that I did not gain). But I don't know. It's as good an explanation as any, yet I did not even look into that part of it. I just set out to attack the fear from a rational point of view and succeeded.

I grew up believing that deep psychotherapy was the only way to get to the root of my problems, that I would never solve any of them without that. I do believe that therapy has helped me tremendously over the years. However, I also believe that I am fully capable of doing the work myself, at least at this stage of my life. I go to my therapist once a month these days, and mostly spill what I have worked out about myself. She does not direct, although sometimes she asks questions that get me thinking. I would get nowhere if I were not intensely committed to working out what about me gets in my own way.

As long as I was convinced that there was no way I could help myself on my own, there simply was no way. As long as alcoholics are convinced that they cannot make it on their own they won't. As long as depressed patients are convinced that they cannot make it without drugs they won't. It's necessary at times to look at these beliefs. They have us tied up, trussed, unable to move on our own. This is a form of "learned helplessness". I apologize to those I may have offended here but I don't take it back. I have come full circle from believing that we are victims of our own histories, unable to break out, to believing we have far more power than we let ourselves use. Incidentally, this is not a sermon to "snap out of it," to those who are in pain. I know pain, mental, emotional pain, as well as anyone else, and I know that the last thing we seem capable of doing when we feel badly are those things that will help us. It is perverse and I understand it. We can forgive ourselves for not acting. We can forgive ourselves for relying on drugs long enough to get back on some sort of track. I don't advocate the "buck up!" school. I don't suggest that this pain is not real and is not debilitating. I do suggest that we can take one tiny step at a time, even if that step is to lie down and accept being a rug for a day or a week or whatever, and know that we have it in us to get past it.

Speaking of suggestibility! My mother mentioned, when I was in seventh grade, that she had had laryngitis when she was my age and it kept her out of school for six weeks. I developed laryngitis and I malingered for eight weeks! I do not think I was conscious of what I was doing but I was certainly highly suggestible to have done this. Funny thing about that period is that it took me about two days to get back on track at school when I returned. I felt disappointed by this, that the rest of the class had not really been learning anything anyway.


( 5 comments — Leave a comment )
Oct. 13th, 2002 04:30 am (UTC)
Interesting about the absence from school. In his book Memories, Dreams, Reflections, Jung recounts how he had a fall as a child and the thought flashed through his mind, 'Now I won't have to go to school'. Whenever his parents sent him after that he had fainting fits. This went on for over 6 months until he heard his father say he was in despair of ever finding a cure. Jung was horrified, returned to his lesson books, fainted several times but persisted then was soon able to return to school proper. He comments: that was when I learnt what a neurosis is.
Oct. 13th, 2002 08:17 am (UTC)
That's interesting. Early insight, rather confirming my sense. I think, too, that I knew I was following my mother's experience, thinking, "If she could be out for six weeks so can I" and extending it even longer.

It seems that some of us are given the ability to see more clearly into ourselves, even though some of our sight is distorted. THat is, for some reason we know the window is there and we use it. While others think it's a wall (to continue a silly analogy).

I have never read anything by Jung, have heard some things that make me think I won't entirely agree with him, but he's another one that I feel I should at least investigate further.
Oct. 13th, 2002 08:30 am (UTC)
I think Jung would acquiese in your observation that some of us are given the ability to see more clearly into ourselves; it seemed to be both his gift and his burden.
He is someone I admire tremendously though find most of his works obscure. The autobiography I mention, published in about 1960, is the most accessible of his writings.I was thrilled to see a 1965 TV interview with him that was shown again earlier this year. It was strange seeing such a giant from the past on the small screen.
Oct. 24th, 2002 04:09 pm (UTC)
Drugs and helplessness
Using medications for depression is not an "either/or": "As long as depressed patients are convinced that they cannot make it without drugs they won't. It's necessary at times to look at these beliefs."

It's also necessary to understand how medications should be used with a depressed person. They should be used in conjunction with therapy, and in the care of a medical doctor or pschiatrist who is monitoring the patient's progress. The point of the monitoring, and of the therapy, is to determine, with the patient, when and if to get off medications. It is very rare that a person is told that he or she must be on drugs for life. I don't get where the dependency statement comes in. Medications are not "happy pills" a person gets addicted to. There are some medications, of course, that are addictive and must be closely monitored (Xanax, for example). But used correctly, they have a tremondous benefit. So I would not put a patient relying on meds in the same boat as an alcoholic. It is not the same thing.I don't think using anti depressants is learned helplessness. I am completely in the other camp: medications used for depressant are helpful in getting people out of helplessness.
Oct. 24th, 2002 05:46 pm (UTC)
Re: Drugs and helplessness
I disagree on a couple of points.

First, the majority of antidepressants are prescribed by general practitioners, who routinely prescribe for months at a time, and do not monitor at all. Do not recommend any talk therapy in conjunction. So to say this is rare is simply wrong. This is the majority. In my own life I have met many persons who are on antidepressants who are not seeing a psychiatrist or any kind of mental health practitioner. ANd they are told that they have a "chemical imbalance" (not true; never proven; these drugs actually cause imbalances, do not correct them) and that they may need to be on them for life.

I agree that if drugs are to be used they must be used along with talk therapy. Sometimes there are physical causes for depression - hormonal imbalance, for example - which can be caused by diet, stress, or use of HRT, for example - and in these cases the cure is to find out the actual culprit, not to put one on antidepressants. The rest of the time, the great majority of the time, there is an actual life cause that can be helped with talk therapy.

In cases of extreme depression, when the person is so far down it looks like up and is stuck there, unable to move - drugs might help, for a very short period of time. They should get off them as quickly as possible. And that can only happen if the drugs are used along with intelligent emotional help.

Zoloft and other newer drugs have the same - in some cases worse - side effects as Prozac. These drugs are not benign. Most doctors, unfortunately, are not aware of the relationships between the drug companies and the testing laboratories and many writers of medical journal articles. Most people are not aware that the FDA does not require long-term studies of any drug, and that typical large-scale studies on which FDA approval is based last no longer than eight weeks. Few people know that FDA approval only requires that the drug be shown to be slightly better than a placebo. In other words, it is only after ten or twenty years that the real info starts to get out.

I stay by my comment on "learned helplessness". If you feel you have a chemical imbalance, similar to diabetes, then you will feel you cannot help yourself without drugs. And this is simply not true.
( 5 comments — Leave a comment )


Judith Lautner
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