Montse Costa: «It is important to understand how the phobia has occurred»

Phobias are anxiety disorders that make us vulnerable to certain elements and situations that we may encounter on a day-to-day basis. For this reason, it is about psychological alterations capable of wearing down our quality of life a lot.

Fortunately, psychotherapy has techniques capable of helping people overcome these pathological fears. In this interview with the psychologist Montse Costa we will talk about phobias and how they are worked in therapy.

• Related article: "Types of Phobias: Exploring Fear Disorders"

Interview with Montse Costa: phobias

Montse Costa is a clinical psychologist and Director and founder of the Psicoavanza center, located in Barcelona. This professional has more than 20 years of experience offering therapy to psychological problems of all kinds, and in this interview he talks about the nature of phobias, and how they are addressed in therapy.

Could anyone develop a phobia under the right circumstances?

All people do not have the same chance of developing a phobia. You have to differentiate two main blocks by which you can acquire a phobia, you can develop a phobia or because a traumatic event happens to the person with a certain stimulus, or because the person lives with an excess of anxiety.

People who live with excess anxiety are much more likely to acquire phobias.

How do the first signs appear that a person is developing a phobic disorder?

The first signs that a person is developing a phobic disorder are that he begins to feel insecure or lack of control.

This has an explanation: living with anxiety implies living in a state of super alert, this means that our brain releases much more brain chemistry as cortisol, adrenaline and other hormones that in cases of danger help us to escape or defend ourselves from danger, but in situations that are not dangerous we feel the bodily sensations of this exaggerated release of brain chemistry and we may feel a feeling of dizziness or vertigo, blurred vision, imbalance when walk... All these sensations give us a feeling of insecurity or lack of control.

If every day we experience this type of sensation, at the end the feeling of fear of the stimulus that we have been experiencing with these sensations develops, such as when walking the street (agoraphobia develops) or driving (amaxophobia develops) which are the most common cases of phobia because they are the most common behaviors that we perform in our day to day.

From what you have seen as a professional, do you think that a phobia can have very serious consequences for those who suffer from it?

Phobias can be very limiting and have very serious consequences.

The most disabling phobia is agoraphobia; in it, the person who is afraid to go out, can go to extremes of not going out in years to the street and living secluded at home. There are other phobias that can be very limiting and serious such as phagophobia (fear of swallowing) the person who suffers from this phobia can reach very serious situations, endangering the well-being of the person with poor nutrition or weight problems insufficient.

Social phobia can also be very limiting and have serious consequences, since the person does not feel capable of be in social situations and may feel like not being able to study, work or any other situation Social.

The more time you spend in these circumstances, the worse the recovery, so it is very important to start working on them with psychotherapy as soon as we begin to feel the phobia.

What are some examples of avoidance behaviors that people who have developed a phobia adopt?

Avoidant behaviors depend on the phobia that is suffered, but in general the person always avoids everything that It has to do with the phobia you feel, that is, if you have agoraphobia, you will avoid going out alone, or going through squares or large avenues. If you have social fear, you will avoid looking people in the face, having conversations, drinking or eating in front of people and any situation that involves interaction with other people.

But there are examples of other simpler phobias such as the fear of vomiting that can make the person avoid eating certain things, eat a very restrictive diet, avoid going to places where you think you might see someone vomiting, and never leave home for it.

When treating a phobia in therapy, is it necessary to know if there is an event that gave rise to that problem? That is, if there was a specific situation that triggered the appearance of the disorder.

It is very important to understand how the phobia has occurred because psychotherapy has to be approached depending on how it occurred. If the person has caught the phobia due to a traumatic event, they have to work mainly on that traumatic event and subsequently the events that have occurred with fear after the trauma.

If the person has caught the phobia for having a lot of anxiety, the first thing we will have to work on is anxiety because we have to significantly lower the anxiety levels that are undoubtedly affecting having more phobia. Subsequently, the fear itself of the phobic stimulus is worked on with state-of-the-art deep therapies such as EMDR and Virtual Reality.

What is the process of psychotherapy applied to patients with phobias, in short?

First, an interview is conducted to understand the cause, development and maintenance of the phobia. The patient is trained in self-control techniques, so that he has tools to help him improve the phobia, such as relaxation, self-hypnosis, breathing techniques, visualizations, etc.

Then the fear of the phobic stimulus is worked on, using state-of-the-art therapies such as EMDR, Clinical Hypnosis and Virtual Reality. In this phase we lower the levels of fear and a positive pattern is incorporated regarding the phobic stimulus. The first exhibition is made virtually.

Finally, the live exposure is carried out in a very strategic way, to consolidate that the exposures are positive for the patient and free from anxiety.

Does it usually take a long time to overcome this type of problem, going to psychotherapy?

It depends a lot on the personal resources of the person and the time that the person has had the phobia, since the more negative experiences we have, the more we reinforce the phobia.

It also depends on the type of phobia we are talking about, since having an agoraphobia or social phobia is not the same as having a fear of spiders, there are phobias that are much more complex and that many more aspects of the person have to be worked on, such as social phobia, in which we will have to work on security and confidence in the person, their abilities social, etc.

But in general with the psychotherapy that we apply in our center, the results are very good and in a short time the person feels improvements, What is certain is that when you have a phobia you have to work on it every day to overcome the phobia in the shortest time possible. This does not imply that the person has to go to psychotherapy every day, but that we give the person exercises to perform each day, in this way the phobia is overcome before.