Treatment of a Specific Phobia - The Case of Karen

Gerald Tarlow, Ph.D. Health Guide
  •      I thought it might be interesting for my readers to follow the treatment of a patient from the initial evaluation through the end of treatment.  Karen is a 45-year-old married female who found my name on the internet in searching for help with a severe fear of flying.  After taking the Fear of Flying Test on the website she determined that she had a severe phobia.  During the initial session it was important for me to make sure that the diagnosis was correct.  Many patients who believe they are suffering from a specific phobia may be experiencing panic attacks and agoraphobia.  In Karen's case it was clear that she had a specific phobia.  Karen had flown all of her life until about ten years ago.  She first experienced severe anxiety symptoms on a flight from New York to Los Angeles.  There was a lot of turbulence on the flight and Karen started to notice that her heart was beating rapidly, she was perspiring and she was having difficulty breathing.  She started thinking that the plane would crash and she would die and never see her children again.  Ever since that initial bad flight she has not been able to fly comfortably.  In the last eight years she has stopped flying completely.  Karen reports that she does not experience the anxiety in any other situations. She reports that the fear has led to some feelings of depression, because she is unable to take vacations with her family and she is unable to visit her parents back east.  Karen has had some general talk therapy, which she reports has not helped her to get back on a plane.  She has also been prescribed medications, which have not helped.  At one point she was drinking excessively when she flew in an attempt to self-medicate. 

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         Karen's diagnosis was a specific phobia.  Fear of flying is the most common phobia I have treated in my 34 years of practice.  Karen was presented with two treatment options.  The first, systematic desensitization, involves learning to relax and then gradually facing your fears.  The second, flooding, involves facing your most difficult fear immediately for a prolonged period of time.  Karen chose systematic desensitization and agreed to start the treatment during her next session.  Karen agreed to come in for weekly sessions and was told that the treatment would last 3-4 months.  In my next SharePost I will talk about the techniques that Karen was taught to help her eliminate the physical symptoms of anxiety.

Published On: August 27, 2008