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Clowns and spiders and planes, oh my! Do you have a phobia?

Monday,October 21, 2013

Joe Thompson on ITV's Daybreak this week discussed how he was eventually helped to overcome his fear of flying or aerophobia. Previously, this 12 yr. old schoolboy from Somerset, UK had been stranded in Abu Dhabi for more than a year, unable to board a flight home. He was belatedly helped by both hypnotherapy and cognitive behavioural therapy (CBT). Via conditioning techniques, CBT alters thought patterns and actions in order to understand and cope with fears. Also many with phobias go through a process of 'graded exposure' to overcome them. Although many different phobias were noted, ranging from "simple"(snakes, animals, etc,), "complex"(traveling from home or agoraphobia and being enclosed or trapped or claustrophobia) and "social"(public speaking), there lacked any real explanation as to causation. And a classification based on phobic origins and specific treatment choices/causation was nowhere to be found. Lists of intriguing and exotic phobias with complex Greek and Latin names were noted instead of meaningful insights. According to Dr Levinson's extensive research summarized in his groundbreaking book Phobia Free, phobias were classified into 4-Types based on specific origins. And each origin or causation had a specific treatment of choice. Moreover, most all the diverse phobias were included within these 4 Types, and their specific neurophysiological and/or psychological phobic mechanisms were clarified and explained. Not infrequently, phobias had multiple Type1-4 mechanisms. And similar named phobias had different Type 1-4 origins Thus for example:

Type-1 Phobias were conditioned or learned following a realistic trauma, eg. car, train or plane accidents, etc. And conditioning techniques were most beneficial. Anticipation anxiety triggers can be learned from all anxiety Types.

Type-2 Phobias were of a neurotic origin resulting from unconscious conflicts dating back to childhood events. Most often, psychotherapy is best, although hypnotherapy may be combined with conditioning depending on circumstances. The Type-2 phobic triggers might vary from planes, being alone, flying, etc. This demonstrates yet again the futility of classification by name rather than determining mechanisms.

Type-3 Phobias were discovered to be of an inner-ear origin and responded best to inner-ear-enhancing medications. This insight explained motion and traveling phobias, eg. fears of moving elevators, escalators, trains, planes, buses, walking. Imbalance and fears of falling triggered fears of heights, bridges, walking unassisted across open spaces, etc.

Type-4 Phobias were due primarily to overreactive anxiety brain centers releasing maladaptive, exaggerated responses to varied triggers. Included are the universal or simple phobias, eg. snakes, pets, rodents, etc. Importantly, exaggerated responses might accrue to Types 1-3, thus also explaining the differences between fears and phobias. SSRI-related medications are the treatment of choice, although best results are often obtained by combined therapies.

About Harold Levinson, M.D.

Formerly Clinical Associate Professor of Psychiatry at New York University Medical Center, Dr. Harold Levinson is currently Director of the Levinson Medical Center for Learning Disabilities in Great Neck, New York. He is a well known neuropsychiatrist, clinical researcher and author. His "highly original" research into the cerebellar-vestibular (inner-ear) origins and treatment of dyslexia and related learning, attention-deficit/hyperactivity and anxiety or phobic disorders has evolved over the past four decades. Levinson's concepts encompass the collective insights derived from the examinations, follow-up and successful treatment of over 35,000 children, adults and even seniors and have led to new methods of screening, diagnosis, treatment and prevention. His expanded theories appear capable of encompassing and/or explaining all reported symptoms as well as most other concepts and experimental data, thus resulting in a truly holistic perspective.

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