Aquaphobia - Paris Diderot University



Aquaphobia

From Wikipedia, the free encyclopedia

Aquaphobia is an abnormal and persistent fear of water.[1] Aquaphobia is a specific phobia that involves a level of fear that is beyond the patient's control or that may interfere with daily life.[2] People suffer aquaphobia in many ways and may experience it even though they realize the water in an ocean, a river, or even a bathtub poses no imminent threat. They may avoid such activities as boating and swimming, or they may avoid swimming in the deep ocean despite having mastered basic swimming skills.[3] This anxiety commonly extends to getting wet or splashed with water when it is unexpected, or being pushed or thrown into a body of water.

Prevalence

Phobias (in the clinical meaning of the term) are the most common form of anxiety disorders. A study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias.[4] Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25.

Of the simple phobias, aquaphobia is among the more common subtypes. In an article on anxiety disorders, Lindal and Stefansson suggest that aquaphobia may affect as many as 1.8% of the general Icelandic population, or roughly one in fifty people.[5]

Causes

Medical professionals indicate that aquaphobia may manifest itself in a person through their specific experiences or due to biological factors.[6] Some people may develop the phobia as a reaction to a traumatic water experience---a near drowning or other such event. Others may have simply failed to have acquired experience in the water through casual events like swimming or boating events due to cultural factors. Other individuals may suffer from an "instinctive reaction" to the water which arises separate from any observable factors. They have a gut reaction that limits their fundamental comfort level in any sort of casual water activities, such as swimming. Other sufferers may experience discomfort around the water without falling into any of the previous three categories.

• Traumatic water experience

• A family member may have suffered a traumatic water experience, and that may trigger it.

• Cultural limitations (such as those brought up in deserts)

• Instinctive fear

• Other

The correct Greek-derived term for ‘water-fear’ is hydrophobia. However, this word has long been used in English[7] to refer specifically to a symptom of later-stage rabies, which manifests itself in humans as difficulty in swallowing, fear when presented with liquids to drink and an inability to quench one's thirst.

In order to have an unambiguous term to refer to a general phobia about water or drowning, the term ‘aquaphobia’ has been coined, by jamming the Latin word aqua (which normally ought to have the form aqui- when used as a prefix) onto the front of the Greek word ‘phobia’.



Aqua-phobia, or Fear of the Water

What is Aqua-phobia? Why are Some People Afraid of Swimming?

From Coach Shev Gul, for

• Direct Learning Experience - A kinesthetic origin and personally experienced through once body, doing it, feeling it, physically experiencing it.

• Indirect Learning Experiences - Visual modality origin, through witnessing an incident, seeing a film (Titanic, Crocs and Sharks Piranhas Wild Life Documentaries!), dreams...

• Auditory Modality Origin - through reading, talking about it, hearing (The film music-Jaws,) story telling.

• Subconscious Learning - Learning to fear water environment has manifested itself subconsciously through negative early childhood experiences, our dreams, secondary gains, positive intentions (protective) - the needs of the part responsible for our negative feelings and behaviour in the presence of larger mass-volume of water (pools, lakes, seas, oceans).

Effective Treatment and Interventions:

Fear of water can be of mild intensity (lacking confidence),or it could manifest itself as a crippling and very intense negative state and condition (Chronic Water Phobia). After establishing the possible origins of a person's aqua-phobia, and modelling and constructing the structure - components - of their fearful behaviour (the internal representation), a trained Neuro Linguistic Programming (NLP) practitioner can facilitate for the aqua phobia to be permanently dissolved quickly.

Through the Neuro Linguistic Programming (NLP: Brain and Mind Technologies Study), behavior change facilitating techniques such as Sub Modality Change, Swish Pattern, Fast Phobia Cure, Hypnotherapy and Time Line Therapy, are the most successfully and effectively employed techniques (Ref: The Magic in Action; NLP Change Technologies; Richard Bandler, John Grinder, Milton H Erickson M.D, Robert Dilts - USA).

Pacing: Acknowledging that the expressed fear is true, and that it is our mind-body's natural defensive mechanism, whose positive intentions are to protect ourselves against; experiencing and reliving again the unwanted past negative events (phobia experience) which created the fear of water - aqua phobia condition.

Jun 19 2009

A fear of water. A non resourceful state, negative feeling, an unwanted reaction, a pattern of behaviour experienced by an individual, which prevents the swimmer from learning a water skill or freely entering a mass-volume water environment such as a swimming pool, sea, lake, ocean, or river.

Water Phobia Origins:

Fear of water can be acquired as a result of any of the following direct or indirect learning experiences, as well as through the medium of subconscious learning process.

n the Light Aqua Phobia (lacking water confidence) cases, by just empowering the client with the necessary knowledge and scientific information and the facts, through explanations and active demonstrations, is sufficient to facilitate a positive behavioural change to take place.

It is true - "Lack of relevant knowledge and the necessary information and facts on a subject, will always breed in; the unknown, uncertainty, fear, anxiety, and phobia to manifest itself into us " -SG. Can you imagine what our reaction would be if we were asked to enter and find an object and explore the contents of a pitch-dark basement storage room or a deserted century old barn, for the first time?

Empowering Through Knowledge and Information - Eureka!, Eureka!

• Inform client that the human beings are naturally born floaters; our natural buoyancy, our density approx with the water and, the presence of cavities in our bones, the air sacks in our lungs, the sinuses, the fat tissues throughout our body etc.

• Demonstrate how, when we relax, and go completely still for a few seconds, holding our breath, slumped face down and with arms hanging by side, feet/legs dangling down, one will always end up in a floating and suspended position, near the water surface (buoyancy law-Eureka!).

• Archimedes Principle - Eureka!, Eureka! For an object to float in a liquid medium (water), the weight of the displaced volume of the water must be equal to the weight of the object.

• Reinforce and demonstrate again, when we jump in, or drop ourselves into the water (intentionally or accidentally), water will always push and lift us upward toward the surface, provided we stay relaxed and perform lazy and gentle limb movements.

• Explain and demonstrate that it is impossible for us to remain under the water (buoyancy law). Unless we have tied ourselves-feet to a concrete block!

• Explain and comfort the learner about the fact that, human beings; when they are in a totally relaxed state, can stay underwater without taking any breath for approx 160 to 180 + sec. So, holding their breath while face down or head under the water for 5-10 sec; will be a 'child's play-fun and a 'cool ' thing to do!

Deep-End (plenty water!) Practices!:

After empowering the learner with the necessary info, facts and the specific knowledge; about the governing natural - physical buoyancy laws, relating to objects immersed in the water environment, and going through the above summarised demonstrations with the learner; now it is time to take the aqua-phobic person, for some deep-end (plenty water!) fun practices.

Starting with relaxed, lazy and gentle movements, while the learner is holding on with one hand/finger only, very lightly, onto the rail or the pool edge. Until the learner is ready to take his hand/finger off the rail, and starts experiencing and tasting the 'magic in action ' and the Eureka! i.e., Floating freely and confidently and gently moving around in the water, for the first time in their lives- without any fear! "Forever goodbye to water blues, which was all the time 'in the mind' to start with!"

People suffering from a Chronic Aqua Phobia will require cognitive interventions prior to putting them through the method on page 2. One of the quickest and most effective way to facilitate a permanent change is the method and techniques offered by the Neuro Linguistic Programming (NLP) interventions. Pioneered by two M.D.'s, Richard Bandler and John Grinder 30-40 years ago in California, USA.

There are several very effective and well tried and tested NLP techniques at hand, depending on the severity of the aqua-phobia condition. Among the most effective and widely used interventions-behaviour change facilitating techniques are:

• Fast Phobia Cure

• Sub Modality Restructuring

• Swish Pattern

• Hypnotherapy

• Time Line Therapy

With these very powerful NLP behaviour change techniques, one can be cured permanently of this dilapidating condition as short as in, 30-60 minutes. And how does it work?

All our past resourceful, non resourceful learning and experiences and memories, are internally stored and encoded through our internal sensory representational systems-modalities (or encoding), known as:

• V - Visual

• Ad/t - Auditory

• K - Kinesthetic

• O - Smell and Taste

A trained and qualified NLP practitioner has the ability to decode, detect and construct a model - the structure of that past learning, experience and the memory. In this case the structure-model of the aqua-phobia condition itself. Once the client's 'model-structure' of his/her aqua phobia is known, then the practitioner helps the client to acquire, to access-add, and to utilize the client's own limitless existing resources from within (via the above mentioned NLP techniques), which directs the patient toward a permanent and more resourceful change process to take place by the client himself, with his own already available and existing inexhaustibly rich inner resources.

"All the resources that we need to make behavioral changes are already there-inside us"

"Our conscious resources are limited. Where as, our subconscious resources are limitless-infinite"

- Milton. H. Erickson, M.D. - USA



How to Recognize Aquaphobia

Contributor

By Jaceson Maughan

eHow Contributing Writer

When a fear becomes irrational and debilitating, it is known as a phobia. As one of the most common types of anxiety disorders[pic], phobias bring about a level of fear that is outside of what is considered normal. While the sufferer may know logically that his fear is unfounded, it doesn't stop the phobia from severely impacting his life. Aquaphobia, or a fear of water, is a common phobia that ranges from a fear of open water to avoiding bathtubs.

Instructions

1. Step 1

Understand the condition. Aquaphobia can range from a fear of a large body of water, such as an ocean or lake, to anxiety about being splashed or rained on. Even though the sufferer knows that water is not a threat to them, they still have an abnormal fear of it. Most aquaphobes avoid swimming, boating or even standing near a pool, lake or stream.

2. Step 2

Analyze your past. Many psychologists believe that phobias are caused by a deeply traumatic event in early childhood. Many aquaphobes recall a near drowning, traumatic event on or near water, experienced a family member's traumatic water event or simply have an instinctive fear of water from a young age. Often, inexperience around large bodies of water can trigger aquaphobia.

3. Step 3

See how you react. Sufferers of aquaphobia usually experience panic attacks[pic] when exposed to water. Rapid heartbeat, sweating, labored breathing, intense anxiety and an overwhelming urge to avoid water are typical responses. Sufferers may avoid standing next to people also near water for fear of being pushed or dragged into the water.

4. Step 4

Know your limits. Some aquaphobes are fine with water on a small scale, such as in a bathroom or even a fountain, but panic around anything larger. Other aquaphobia victims recoil at even the smallest water amounts and avoid scenarios where they have to deal with water at all. Don't be surprised if you experience all or few of these wide ranging symptoms as you attempt to diagnose aquaphobia.



Aquaphobia: The Fear of Water

Many people are afraid of the water, however, aquaphobia is "an abnormal and persistent fear of water. Suffers of aquaphobia experience anxiety even through they realize the water in an ocean, lake, creek, or even a bathtub may pose no imminent threat. They generally avoid such activities as boating and swimming. Around the house, they may fear the water in a shower or tub and even desist from bathing." [1]

 

Aquaphobia is considered to be a specific phobia. According to the National Institute of Mental Health, specific phobias normally develop in childhood. Approximately 19.2 million American adults suffer from some type of specific phobia. The fear of water is a common specific phobia.

 

Dr. Jane Katz, a professor of health and physical education at Bronx Community College of the City University and author of "Swimming for Total Fitness", believes that the majority of people suffering from aquaphobia have had a bad experience in the past. It may have been they almost drowned, someone they know drowned, they were pushed into the water or in a boat that over turned or the fear may have developed based on parental attitudes. Somewhere in their past, a scary experience with water has made them afraid. [2]

 

The fear of water is very real and can be quite debilitating and embarrassing. Imagine the teenager invited to a friend's home to swim. The fear of water may cause them to avoid the situation all together, foregoing the invitation to sit home, alone and lonely, or to go and sit on the sidelines, missing out on the fun his or her friends are having. Or imagine the parent, sitting at the side of the pool, feeling helpless to help if their child needs help in the water.

 

The fear of water, or aquaphobia, can be as simple as being afraid to put your head in the water, or avoiding water altogether. Some people may experience panic attacks when near water or even at the thought of being near water. Some may be able to be in shallow water but may have a fear of being in water that is above their neck.

 

Tips to overcoming Fear of Water

 

Work with an experienced and knowledgeable lifeguard and swim instruction. Talk to the instructor before your, or your child's lesson about the fear of water and ask what strategies he or she employs to help someone overcome the fear of water.

 

Begin slowly and have patience with yourself in our attempts. You may want to begin by just being near a pool, working up to sitting on the side of the pool with your feet in the water. Allow yourself time to become accustomed and feel comfortable each step of the way.

 

Understand the buoyancy factor. Human beings will always float on or near the top of the water. This is based on bone and body density. Understanding that you will not sink and your body will naturally rise to the top of the water can help you in overcoming your fear of drowning or sinking to the bottom of the pool and not being able to get to the surface.

Practice deep breathing and relaxation exercises to help keep your body relaxed while in the water. Take some time to walk around in the water feeling the relaxation and soothing effects of the water.

 

Start floating in shallow water. It may be easier when you know that you can put your feet down and stand up.

 

Celebrate your achievements, no matter how small and accept that overcoming your fear is a process and a journey, rather than expecting to overcome your fear in one trip to the pool.

 

Take swimming lessons to learn the basics of swimming, floating and attention to safety in the water.

 

Start children in swimming lessons early.

 

Remember to never swim alone. Swimming alone is never a safe idea. Even if you are embarrassed about your fears and believe it would be easier to overcome your anxiety without anyone else present, it is important to have someone qualified and able to react in an emergency situation with you as you discover the joys of swimming and relaxing in the water.

 

 

Sources:

 

[1] "Definition of Fear of Water", Reviewed 2004, Oct 19,

 

[2] "Relationships; Mastering the Fear of Water, 1987, Aug 31, Olive Evans, The New York Times

 

"The Numbers Count: Mental Disorders in America", 2008, Author Unknown, National Institute of Mental Health



Fear of the water and how to overcome it

|Presented in ASCTA Convention, Broadbeach, Australia, May 2000 |

|Lecturer Ilkka Keskinen |

|Department of Sport Sciences, Jyväskylä University, Finland |

|Email: ilkka.keskinen@sport.jyu.fi |

|WWW-homepage: |

|In the course of writing my Master´s thesis in 1982 on swimming I noticed that after a 12-lesson teaching period everyone did not learn to swim.|

|When I was investigating why, I noticed that the biggest (80%) reason was fear of water, 10 % lacked muscular endurance, 7% had an illness and |

|only 3% had motor learning problems. When I compared two groups: those who couldput their face in the water at the beginning of the teaching |

|period and those who could not, the difference in learning was huge. Nearly all (95%) of the kids who were able to wet their face at the |

|beginning of the twelve-hour teaching period learned to swim. Only 35% of those from the group who were too afraid to put their face in the |

|water learned. It is a dramatic difference, but what does it tell us? It tells that some kids have problems in being in water and that it has a |

|negative effect on learning to swim. |

|In this presentation I would like to examine some of the reasons for the fear of water or the phenomenon which is usually given this name. I |

|shall also offer some possible ways of overcoming those so called "fears". |

|It is good to be afraid of the water: fear saves lives |

|If we were asked to jump from an aeroplane with a parachute most of us would say no. We would think of it very dangerous. Those who do it all |

|the time would say that it is safer than walking on the streets. You have to know an environment before it feels safe. Of course it is the same |

|with water. The best way to get to know water is a warm and shallow pool where you can safely play and test your skills with a trusted teacher |

|or parent. |

|It is said that we have a self preservation instinct which is genetically programmed. You could say that it is a kind of guardian angel which |

|protects us from dangers. You could also suggest that the diving reflex in babies belongs to this same instinct. It prevents the baby from |

|breathing underwater. |

|Have you also noticed that many kids can swim in waist deep water but not in the deep end of the pool? Technically there are no differences. It |

|is naturally a wise decision if you are not yet certain about your skills. So being careful is a good thing. It would be fair to say that |

|Finnish men should be more afraid of water. It would save many lives. Nearly 200 men drown in Finland every year. |

|"There are monsters under the water surface and they will grab you" |

|When you talk with small kids you may find that they have a very vivid imagination. When this is combined with inadequate knowledge they may end|

|up as strange ideas. There are underwater monsters or other aliens and fish that can bite even in swimming pools. One-five-year old child said |

|that the reason why he does not open his eyes underwater is that he will go blind if he did. His friend´s older sister had told him this fact. |

|The strangest thing is that it is also parents who tell these weird lies to their own children. At least in Finland this happens. Parents of |

|course have a good reason for this: they want to keep their precious child far from the danger of water. It is easier to tell lies than to go |

|and teach their child to swim. |

|Adults too can have misconceptions about water. Probably the most common misconception is the idea that in water you sink. However in water you |

|float rather than sink which is why it is very hard to stay under the surface. |

|What is the cure against such misconceptions? |

|Truthful information is, of course, a good cure. Before you can give it is advisable that you talk with those who are afraid of water so that |

|you can acquire a good understanding of the kind of information they need. Another good remedy against uncertainty is the use of goggles because|

|with goggles you can monitor the situation and find out the real truth. Do you see evil fish in the swimming pool? I don´t think so. What about |

|sinking? Floating is perhaps the easiest thing to teach and certainly cures any ideas about sinking. |

|Water is unpleasant |

|Every swimming teacher is eager to claim that water and swimming are great fun. I think they are lying. Water is an unpleasant element. All your|

|senses tell you this. First of all it feels cold and turns you blue. Secondly chlorine and salt irritate your eyes and in some cases you are |

|practically blind underwater, especially if we usually wear glasses. The water gets into your ears and your hearing is disturbed. It also tastes|

|bad and often it even smells bad and feels very uncomfortable when it goes up your nose. And finally when it goes into your mouth and you |

|breathe it you probably think that you are going to die. |

|According to Huhtala´s Master´s (1999) thesis half of the 12-year-old children investigated found it disturbing to open their eyes underwater, a|

|third found it disturbing when water splashed onto their face and another third foundit disturbing when water went into their ears. Similar |

|results were also found in Pellinen´s (1992) and Virtanen´s (1998)Master´s theses. |

|When I made my Master´s thesis in 1982 I thought that if a child does not want to put his face in the water he has a fear of water. Now I know |

|better. They simply do not like the water: it is unpleasant and it does not have to do anything with fear. |

|The strangest thing in our system of teaching swimming is the starting point. At least in Finland swimming teaching starts with a most |

|unpleasant exercise: putting the face in the water with the eyes open. Usually teaching begins with an easy exercise and the hard ones come |

|later. I would claim that we do not have do the hard and unpleasant exercises in order to learn to swim. |

|What is the cure against unpleasant experiences in water? |

|This is very easy. Let us provide children with swimming goggles or a mask. Did you know that swimming pros also use these? After this their |

|eyes are no longer irritated by chlorine or salt and they are no longer blind because they can see underwater. Are you afraid of the dark? |

|Putting goggles on is about the same as switching on the lights. The good thing about a diving mask is that it also locks the nose so that water|

|can no longer get up it. Look at their happy faces when it feels good and they can easily explore the underwater world. But can you do this or |

|are you using the "natural method" where all artificial aids (masks, goggles, floating aids, flippers) are forbidden? I know that some teachers |

|believe in this natural method: to learn swimming the hard way or not at all. |

|A very important thing would be warming the pool up to 27-30 degrees Celsius. You would also see the faces of small skinny and blue kids looking|

|happy. I think that this is only fair or do you think that swimming is only for obese and tough kids. |

|"True fear of the water" |

|Twenty years ago I really thought that all kids who act anxiously in water had a fear of water. I do not think so anymore. My guess is that only|

|ten to twenty per cent of anxious children really have a fear of the water. Of course it depends on how you define fear. My definition of fear |

|is that it is a learned state of mind. Something traumatic has once happened to them in water and they usually remember it. Often they would say|

|that they have drowned or nearly drowned. The have fallen into a swimming pool or from a boat or a pier. Someone has pushed them underwater or |

|some other accident has happened. The worst reason is when a swimming teacher has forced a child to do too difficult a task and something |

|unpleasant has happened. |

|I think that these kids are in trouble because they know that water is bad and therefore talking does not help. They do not believe you. This |

|group is the hardest to teach to swim but this is also the most grateful group if they learn to swim.One adult group of fearful swimmers even |

|bought me a bottle of whisky when I taught them to swim. They must indeed have been very grateful. |

|How to cure the fear of water? |

|Basically the formula is very easy: the learners have to learn that water is not dangerous and that it can be a lot of fun. They also have to |

|learn skills by which they can conquer the water. |

|First of all it means that the environment must be pleasant: warm water, a shallow pool and a teacher the learner can trust. Then the child |

|should be allowed to use goggles or a mask and floating device if he wants to. If these conditions are met the real work can start. It is called|

|desensitization. It usually takes time: perhaps ten to twenty lessons or even more. Desensitization in practice means starting with easy and |

|non-frightening exercises in which the child can succeed. After the first exercises we choose tasks which need a little bit more courage but |

|still keeping in mind that the child has to have a good chance of success. It is usually also a good idea to have other kids around so that the |

|fearful child can observe the enjoyment of the skilful ones and play with them and so fears will be washed away with victories and happy |

|moments. If we can not offer these opportunities we will not succeed. |

|If the child gets too old, let us say over 13 years of age, we may be facing a new problem. Fear of the water will also turn to shame about that|

|fear and it usually means that the child will no longer participate in swimming classes and we will have lost the battle. Fortunately some may |

|come back twenty years later and join a swimming school for adults and we will have a second chance. |

|Bathing suit may feel too revealing |

|When 13-year-old children were asked if showing up wearing bathing suit was disturbing 10% answered yes. I do not know what to do about this. |

|Perhaps a discussion would help or taking girls and boys to swimming pool separately. In any case we have to be aware of this problem. |

|Conclusion |

|Teaching swimming is not always easy. Sometimes it may almost seem impossible. Fortunately experienced swimming teachers have found good and |

|also easy cures for most of swimming related "fears". |

|So let´s not be afraid. We can help them. |



THE ULTIMATE PHOBIA CURE IN 2 EASY STEPS

• Step one of this guide will help you completely free yourself from any fear or anxiety about water and swimming.

• The second part of the guide will then help you to feel calm and composed whenever you are near water or you are swimming.

• Just as you learnt to fear water you can easily unlearn the fear and feel positive about water.

Aquaphobia definition (a fear of water)

Aquaphobia is an abnormal and persistent fear of water often caused by a negative past experience. Sufferers from aquaphobia experience undue anxiety about encountering water. This phobia can become quite irrational if left untreated.

How to cure aquaphobia (a fear of water)

Most phobias are simply learned patterns of behaviour that become anchored in the unconscious mind. The most effective way to completely free yourself of the fear of water or being in water is to re-programme your mind by using effective self-hypnosis methods. It is said that the conscious part of our brain accounts for about ten percent, which is why if you try to make changes purely on a conscious level you are likely to fail. By using this comprehensive self-hypnosis guide to break free of the negative pattern of behaviour and accept positive new conditioning in its place you will be using the larger part of your unconscious mind. This is why self-hypnosis is so effective in curing phobias and creating permanent positive changes. Follow the instructions in the guide and listen to the hypnosis MP3 download and you will free yourself from aquaphobia forever.

Professional help for the treatment of aquaphobia (a fear of water)

The author of the self-hypnosis guide and the MP3 download Glenn Harrold, is a highly experienced professional hypnotherapist and best-selling author. His hypnosis CDs have sold over 600,000 worldwide and are the UK’s best selling self-help CDs of all time. He also writes self-books for Orion in the UK and McGraw Hill in the USA and produces hypnosis CDs for BBC audiobooks and Diviniti Publishing. Glenn has drawn from his past experiences and his expertise as a hypnotherapist to give you the solution you need to permanently overcome the fear of water.

Download the instant solution to aquaphobia

Download the 6,200 word guide and use Glenn’s proven techniques to help you feel positive about water and swimming. This guide offers a permanent and lasting solution to all types of water phobia by first releasing destructive conditioning and then programming your mind to feel positive about water.



How to deal with Aquaphobia

Aquaphobia is an abnormal and persistent fear of water. Get to know how you can treat this disorder

Dr Kanan Khatau Chikhal

Posted On Wednesday, January 21, 2009    [pic][pic][pic][pic][pic][pic]

Do you get palpitations when you have to go on a boat ride? Does your heart beat in dread when you have to take a swim in the ocean? Does a picnic under a waterfall feel like a nightmare? Do you fear closing your eyes whilst under a shower? If you feel the above, then you are a victim of Aquaphobia, which is an abnormal and persistent fear of water. It involves a level of fear that is beyond control or that may interfere with daily life.

 

Causes

 

Aquaphobia may manifest itself through direct experiences, which may be a reaction to a traumatic water experience – like a near drowning event, unknowingly pushed into a pool or falling out of a boat. Sometimes even a scary movie like Jaws or even a documentary on dangerous creatures of the ocean can trigger off a reaction. Even the loss of a loved one in a tragedy involving water may trigger off a panic reaction that stays for life!

 

Aqua phobia is different from Hydrophobia

 

Hydrophobia is a symptom of later stages of rabies and manifests in humans as difficulty in swallowing. When a patient sees a glass of water he shudders and is not able to quench his thirst. This is Hydrophobia.

 

Some individuals simply have an instinctive hyper reaction to water which limits their comfort level to any sort of casual water activity like swimming.

 

You know you have got it when

 

You have an irrational fear of water, and there is a generalised state of anxiety and palpitations. Furthermore, this state leads to sweating. trembling, dizziness and shortness of breath (which may or may not accompany tears).

 

Treatment

 

Fear not. Help is always at hand. A phobia can be as life crippling; it affects all aspects of your life and hinders you from enjoying the joys of being in water.

Get swimming lessons 

The first step towards overcoming Aquaphobia is getting swimming lessons. The caution here is to have a slow and gradual exposure to water by a trained swimming instructor. The teacher must first teach breathing techniques and relaxation techniques to the person. Normally such a person tenses up in water, this makes floating difficult. Thus, relaxation of the body and performing gentle strokes will help them float. So, the more comfortable they get in water, the more they get confident being in it and overcome their fear.

 

A good swimming instructor would also enlighten his fearful student on the anatomy of the human body before he ushers him or her in water. Since, the commonest fear of an aquaphobic is that he will sink like a stone the minute he steps in a pool, a realisation that our bodies normally float since they are made up of cavities in our bones and that our lungs have air sacs maybe quite a relief. In fact the instructor can illustrate this by going face down into the water and holding his knees close to the chest. The water will push the instructor to the surface. Thus the only way one can sink to the bottom is if he is tied to a rock or a metal ball.

 

Sometimes, our fears defeat all our logic and rationale and still interfere with our day-to-day life like our job, our studies. If that’s the case with you then it’s a good time to take advice from a therapist.

 

Cognitive behaviour therapy

 

This is a technique that offers a reality check on one’s fears. Here, the person plays a more active role on his/her fears.

 

Neurolinguistic programming

 

Here, the fear is nothing but a conscious mind game that can be revised or re-programmed to yield a more positive and favourable result.

 

Clinical hypno-therapy

 

It is a technique that addresses the subconscious to unravel the cause of the fear. Using a suggestion under the influence of hypno-therapy, the ramification being, that water is viewed as a non-threatening object, consequently, the mind relaxes and does not hyper-react in the presence of water.

 

Regression and Past life therapy

 

Sometimes, fear of water can go as far as a difficult birthing process or discomfort when in the mother’s womb. For some a traumatic experience in water from another lifetime may spill over in their present life. The same fear surfaces to create havoc. Under guided hypnosis re-living the past experience can be a healing journey. If required the therapist may reframe or rescript the incident therapeutically to completely annihilate the fear.

 

Nonetheless, if your friend or family member suffers from aqua phobia, you don’t have to be a trained therapist to help them. With support and encouragement you could take the plunge into the deep blue with a smile.

 

The writer is a homoeopath, psychologist and counsellor

Source: Bombay Times



Snorkeling Despite a Fear of Water

Posted Oct 19 2007 1:48pm

|When we were on our honeymoon in Hawaii, my husband and I did the typical touristy stuff, which included snorkeling. Seems pretty tame|

|to most people, but it was a huuuuge deal to me because of a persistent fear of the water (particularly a large, stormy entity like |

|the ocean). It's kinda pathetic. I can swim (well, barely) but before our trip, I was totally clueless about basics like treading |

|water and even (gasp!) holding my breath underwater for more than 10 seconds. So from the very beginning of our honeymoon, my husband |

|took me under his wing and decided that he was going to get me accustomed to swimming, because come hell or high water (no pun |

|intended), we were going to go snorkeling together. The idea of being in 40-60 feet of ocean water, along with the unpredictable |

|entities that populate the sea, was too much for me--it made me break out in a cold sweat, just thinking about it. I mean, what if I |

|drowned? I'd heard that it was possible to drown in your own bathtub--for an unskilled coward like me, was venturing out into |

|uncharted (by me) territory the wisest decision? |

|After a failed attempt at kayaking (in which we tipped over the kayak and I found myself holding onto the boat for dear life) and |

|several aborted attempts to go out into the ocean, I found myself getting tired of one thing--the fear that I'd imbued the whole |

|swimming enterprise with. I saw children and adults of all ages splashing away and having a fine time in the water, so why couldn't I?|

|Was my fear really so paralyzing that I couldn't do what so many other people do without even thinking? |

|As the days passed, I became more and more confident about being in the water. Having a four-foot pool at the condo we were renting |

|was helpful as far as getting a non-threatening intro to being in water for prolonged periods. Then we got some snorkeling gear and |

|headed out to the ocean. I always made sure my husband went in first to make sure wherever we went wasn't too deep. |

|Getting used to the claustrophobic feeling of having snorkeling gear was a little hard at first, especially because I was so paranoid |

|I had to keep popping my head up to make sure we weren't too far from shore. Also, since the water we were in was more shallow, I |

|scraped myself on coral reefs a lot in my haste to stand up in the water. |

|On the last day of our honeymoon, we finally took the big plunge...into 40 feet of water. We basically took a catamaran cruise that |

|led us to the picturesque north shore of the island. My stomach was in knots the entire way there, which the choppy journey and my |

|penchant for sea-sickness didn't help. Even though I knew my husband would be right by my side, and despite his assurances that there |

|was no way I'd drown, all these crazy ideas kept racing through my mind. What if I couldn't tread water? What if I got water in my |

|mask and drowned? It was driving me crazy to the point that I just wanted to get the damn activity over with. |

|But what do you know? I actually had FUN. Sure, I was the last person in the water, and it took a little coaxing on my husband's part,|

|but it was such a liberating thing to be floating face down, with yards and yards of water below me. I felt like a goldfish in a |

|ginormous tank. I actually ended up staying out in the water way longer than anybody else (and didn't have a problem treading it |

|either). In conclusion, I had one of those warm fuzzy moments where I got to bask in the knowledge that I did something that scared |

|the bejeezus out of me. On to the next physical challenge! |



Cognitive-Behavioral Therapy

The goal of cognitive-behavioral therapy (CBT) is to regain control of reactions to stress and stimuli, thus reducing the feeling of helplessness that often accompanies anxiety disorders. CBT works on the principle that the thoughts that produce and maintain anxiety can be recognized and altered using various techniques that change behavioral responses and eliminate the anxiety reaction. Many studies have shown that a combination of CBT and medication works best for treating anxiety disorders.

A number of CBT approaches work well for treating many types of anxiety disorders. Studies suggest that CBT is also helpful for patients who have additional conditions, such as depression, a second anxiety disorder, or alcohol dependency. (It may take longer to achieve a successful outcome in such cases, however.) CBT is often given along with drug treatment. A study in the Journal of the American Medical Association found that children and adolescents with OCD responded better to CBT alone than the antidepressant setraline (Zoloft) alone, but most patients did best when they were treated with a combination of CBT and sertraline.



Aquaphobia

All of us have fears of one kind or another.  Most of the more common ones are very healthy and help to ensure our safety in dangerous situations, examples being – fear of disease, infection, being buried alive, fire, tornados, vicious wild animals, poisonous snakes and things like pianos falling from high altitudes.  All of these things have the potential to hurt you, and having a healthy fear of them could save your life.

Phobias take these fears way beyond the norm.  They are irrational, excessive, unreasonable, and accompanied by extreme anxiety.  Symptoms  include a racing heart, shortness of breath, sweating, chest or stomach pain, trembling, loss of control, passing out,  or, in other words, a full blown panic attack.  Not pretty.   And if your phobias include things like fear of looking up, bald people, telephones or fog, you really should try to face and over-come them, because some of these things are hard to continually avoid.

I think a lot of phobias originate in childhood.  I used to have an irrational fear of big black dogs, which I only ever saw in nightmares, so it was hard for my parents to help me get over that one.  He was my own personal monster under the bed that wagged his tail and still managed to be menacing. I’m still uncomfortable around big dogs, but I don’t run away screaming if I see one.   I used to fake fear of vegetables, more specifically long green snake shaped ones named asparagus, but my mother never took that one seriously.   I don’t know where my water phobia originated exactly, but I did have two water-related incidents in my childhood that were somewhat traumatic.  The first was my brother holding my head under water as a joke.  Perhaps if I had been big enough and strong enough to reciprocate I would have been better able to grasp the humor involved in this activity.  The second incident involved snatching a one year old child out of the water after he toppled over into it face first.  I suspect that kid has grown up with a fear of being wrenched into the air and clutched tightly to the breast of a screaming freaked out crazy person.  Sorry kid.  I thought I was saving you from drowning. 

My water phobia wasn’t exactly disabling, but it was troublesome and sometimes embarrassing.  I grew up on the shores of Lake Huron but I never learned how to swim.  I could wade in up to my knees and stay perfectly calm.  When the water got waist high, I would start to gasp and my heart would race.  Back then saying you didn’t want your hair to get wet was an acceptable excuse for not going in any further.  I could take a shower but I could NOT get my head or face wet – face and hair had to be washed separately.  Getting into a boat made me ill.  Seeing Niagara Falls up close for the first time was truly frightening.  Honestly,  I even had to hold my breath watching deep sea divers on t.v.  Then I met my husband who is part fish apparently.  He wanted me to jump off the dock at his cottage into the river and I burst into tears at the mere suggestion.  I have to give him credit;  although he could not understand it, he did try really hard to deal with it by saying and doing all the right things.   ”I’m here – just tell me what I can do to help, whenever you’re ready.  Meanwhile, put on this life jacket, here’s one to sit on in the boat, and here’s one to hang on to just in case.  No crying, okay??” The big problem with phobias is that you KNOW they’re irrational.  You know you are being ridiculous, but you feel powerless to change things.   

When our daughter was a baby my husband would pour buckets of water over her head in the bath tub.  It made her gleeful.  It made me gasp for breath and want to strangle him.  When she was a year old he held her in his arms and jumped into the deep end of a swimming pool.  My heart stopped I swear, but they both popped up laughing and she was squealing “again!”   That’s when I finally made up my mind to do something to face this stupid fear and get over it, so that I would not pass it on to my children. 

I got private swimming lessons from a good friend who taught children how to swim.  This may not sound like a great feat to anyone else, but after several weeks I had officially passed the tadpole level.  I was able to splash water on my face and live to tell about it.  I was able to put my face into the water and blow bubbles.  I was able to float on my back and breathe at the same time.  And I was able to hold my nose and dunk my head under water without having a panic attack.  I still don’t like to do that one, but I know if I had to I could.  Eventually I learned to dog paddle, tread water, and get more than two feet away from the dock without passing out.  Oh, and wash my hair in the shower.  That was a big one.

My kids both love the water.  They are both excellent swimmers.  I didn’t damage them for life.  My daughter thinks in another life I probably died at sea.  She has a spider phobia, so she knows what this irrational kind of fear feels like.   My son went through a phase where he had an irrational fear of chinese food, but I think that was more visual than anything else.  And if you’re hungry enough, you can get over that one in a hurry.  My husband has a sort of phobia about snakes.  He can NOT handle them.  But since its not something you have to deal with every day I think its a minor phobia and really not worth stressing over. 

There are still some water related things I avoid.  You could not pay me enough to ever go down a water slide.  I don’t think I’d be very good company on an ocean voyage.  Water skis are something I don’t want to put on, even on dry land.   I won’t ever be an Olympic diver.  If I never see Niagara Falls again I can live with that. 

I love a rainy day.  I love mist and fog and drizzle.  I like to walk in the rain, and I love to watch a down-pour.  Thunder and lightning – very exciting.  lol.  Walking through puddles after the rain is exilarating.  I think the difference between these things and my fear of the murky depths is the presence of a lot of AIR. 

Just wanted to add a couple more of my coping skills.  This first one is silly, but I’m proud of it because it works well.  (The second one I’m not so proud of….)  To get to our island camp on the Winnipeg River we have to go by boat.  It isn’t far – lots of people, my kids included, have swam there and back.  I figure I might be able to make it half way, so when I get into the boat I keep my eye alternately on the point of departure and the destination.  The water can be dead calm and nothing short of the loch ness monster showing up could cause us to capsize, but I need to have a plan of action should it happen.  As we leave the shore I mentally picture myself being able to swim back to it.  We go a little further, I could still make it.  We’re almost half way, I could still survive.  Now we’re half way, and I would have to choose which way to go….this way….that way…..okay, now we’re closer to the island and I’d be able to swim to it if I had to.  Dilligent concentration of this sort has kept me alive, there is no doubt in my mind.  When we go fishing I’m fine as long as the shore is within attainable distance.  BTW, there is nothing more brain numbing than fishing.  The only thing that keeps me concious is knowing that it may be possible to drown in your sleep. 

Now for the second coping skill, which I don’t recommend very hightly at all.    One  long ago very hot summer evenning after a wedding reception (at which I had entirely too much to drink)  we and an enebriated group of friends decided to go skinny dipping at the island.  It seemed like an inspired notion at the time.  Only four of us ended up being brave and foolish enough to do it, and I was one of them.  No life jacket, no swim suit, no problem.  I remember thinking to myself, what’s the worst thing that could happen?  My drink might spill and that would be a shame, but not the end of the world.  My husband still shakes his head in astonishment at the memory of it.  He thought it was the big break-through.  His aquaphobic spouse, treading water a good three feet from the ladder.  With himself mere inches away of course, having to be reassured every three seconds that I was fine.  I am FINE.  Fine.  Get-away-from-me-I-am-FINE!  I wasn’t fine at all of course.  And the next day I was sober and aghast at what I had done.  I could have drowned.  Naked.  OH…MY….GOD.  Strangely enough I didn’t develop a booze phobia, although that might have been a good thing.  (Hey kids!  You should have seen your mother last night!  She was swimming without a life jacket!! )  (Please, SHUT UP.  I have a serious headache.)

November 7, 2006 - Posted by grandmalin | Just My Life | | No Comments Yet

|Swimming about. From | | |

| | | |

|w the secret, swimming can be a lifelong form of pleasurable and invigorating exercise. Fortunately, for adults who have spent a | | |

|lifetime either too afraid to swim or just uncomfortable in the water, this is a secret eager to be shared because it doesn’t | | |

|actually belong to the swimmers but to the water itself. It’s simply this: The water wants to hold you up—that is its nature. It | | |

|should help you in overcoming your fear of swimming to know that no matter what your weight or height, you will find that the water | | |

|has no problem lifting you. The simple steps below are meant to gradually introduce you to this feeling of the water’s support. | | |

|There are a few keys to overcoming your fear. You must feel in control, which involves proceeding in small steps. As you go through | | |

|the process offered here, move at your own individual pace. Whenever you feel too afraid, return to the point at which you are | | |

|comfortable. This is crucial. It’s perfectly fine if it takes you months to feel safe in the water; after all, it’s taken your whole | | |

|life to get to this point. | | |

|[pic][pic][pic] | | |

| | | |

|Another important key is to find a buddy, someone who will do the drills along with you in the water as often as possible. If you can| | |

|find a friend at your same level, that’s great. Most vital is that your buddy give you support—real support—the rah, rah kind. She | | |

|cannot tell you your fears are silly. He can encourage you but not push you to go faster than you want. Your buddy should also be | | |

|someone who helps you feel playful because play is an essential aspect of the water. Also, you must praise yourself throughout this | | |

|process, especially when it seems especially tough. | | |

|Before starting: | | |

|At first you can just sit on the side of pool, dangling your feet or sitting on steps, just breathing and trying to relax. You may | | |

|want to close your eyes and imagine a place or situation that you find safe. You can use this image at any point that you become too | | |

|fearful. Eventually get into the water up to whatever depth you like, probably not any deeper than your chest. You may spend your | | |

|first sessions walking around, getting used to the water. If you and your buddy want to stand there and chat, go ahead. | | |

|Whenever you feel ready, you’ll begin these extremely simple steps. Your goal is just to reach the level of a good solid dog paddle, | | |

|which despite its name is a terrific exercise. At the dog-paddle level, you can stay afloat comfortably, move around and get a great | | |

|20 minutes of aerobic activity. | | |

|1) Stand facing the pool wall; hold on to the side and stay in that position throughout this step. All you are going to do is lift | | |

|one leg behind you, bending comfortably at the knee, and let it drift down--kind of slow-motion kicking. The point is to feel how | | |

|once you give that leg the chance, it starts floating. Close your eyes and feel how the water supports your leg. Play around with | | |

|this feeling and then try your other leg. | | |

|2) In the next step, you’ll do a similar motion with your arms. Turn now to face the water. With elbows bent, hold your arms so that | | |

|they’re facing forward, resting on the surface of the water. Your arms should not be pressed against the sides of your body but at a | | |

|comfortable distance. Now, simply press your arms into the water and release them. Gently, as you did the kick. Press and release, | | |

|press and release. Feel that when you press down in the water, your arms spring back up. The harder you press, the more your arms | | |

|want to float to the surface. | | |

|3) In the next two steps, use your arms in whatever way you like. In this drill, just remain standing at the same depth and take | | |

|small, gentle jumps in the water. Again, do this as long as you like, just concentrating on how your body feels in the water. | | |

|Hopefully doing this with your buddy will keep you from feeling silly. If not, bring a kid. They make great covers for silly | | |

|behavior. | | |

|4) You will now need to move a bit deeper into the water but not deeper than shoulder level--just so that your body is submerged when| | |

|you comfortably bend your knees. If at any time you feel too out of control, just go back to whatever step feels safe and proceed | | |

|from there. In this step, you continue to jump, but with your body under water, the jump feels more like a bounce. You’re going to | | |

|bounce as long as you like in this position. At some point, try bouncing a little higher, bringing your bent legs toward your chest. | | |

|Keep bouncing and as you continue, see if you can increase the amount of time your legs are off the pool floor. | | |

|5) This step should feel very playful and give you the strongest sense so far of the water’s ability to support you. You’re going to | | |

|combine the bounce with Step 2. Start bouncing. Eventually, while you are in the up position, press your arms down into the water as | | |

|you did in Step 2. The two movements must be in opposition, arms down, and legs up. What do you notice? Pressing your arms down seems| | |

|to push your legs up. Stay with this step until you feel really secure with it. Remember to praise yourself! | | |

|6) Once you feel in control with Step 5, you’re going to move your hands in the dog paddle motion but with your legs stationary. All | | |

|you do is make circles with your arms. They should be relaxed and in front of you, with elbows bent and hands slightly cupped so that| | |

|you’re moving water toward yourself. | | |

|7) This step may feel a little awkward and combining it with Step 8 might actually be easier. You’re going to bounce while your arms | | |

|dog paddle. Keep extending the length of time your legs are off the pool floor. Play around with this step till you feel as | | |

|comfortable as possible. | | |

|8) This is it! Now you're going on to the complete dog paddle, with legs fully off the pool floor. While dog paddling with your arms,| | |

|jump up and begin making similar circular motions with your legs, as if you’re working a bicycle wheel. Your legs will need to be | | |

|more-or-less under your body. This is the big step so relax and take as long as you need to reach it. Remember, this whole process | | |

|might call for a few months of working on these steps. | | |

|9) Congratulations! Once you have mastered the dog paddle, you can add another position that will give you an even fuller sense of | | |

|floating. While doing the dog paddle, press your chest into the water, arch your back and let your butt rise to the surface. It | | |

|doesn’t matter what order you do the steps in, as long as they work to make you float. You’ll find that when you go through these | | |

|steps, your legs will start to move behind your body. Just as pressing your arms helps your legs to rise, pressing your chest will | | |

|help your whole body rise. Arching your back adds more pressure onto your chest and your bottom acts as a buoy. The more you | | |

|exaggerate this position, the more easily you’ll float. | | |

|Now that you have mastered these drills and feel secure in the water, you be ready to learn techniques for the basic swimming | | |

|strokes, probably starting with freestyle. Join a class or have a trusted friend who loves to swim start you off. Remember, take as | | |

|long as you need through this process. Once you feel safe enough to swim, reward yourself for your bravery. You deserve a gold medal.| | |

Written by Sheri Stein - © 2002 Pagewise

Phyllis Lear never learned to swim and nearly drowned when she was eight. The scare left her with a lifelong fear of water and a stubborn will to conquer the problem. She doggedly took beginner swim lessons. “I failed every single time,” she says from her home in California. “You’d think it’s not so hard, but for me it was hard. You’d go for an hour, get in the pool and it’s freezing, and nobody ever worked on my strokes.”

Then Lear spotted an ad for a swim clinic specifically for aquaphobic adults. It’s run by Paul Lennon, a former competitive swimmer who uses exposure therapy to treat aquaphobia. Lennon holds his Adult Aquaphobia Swim Centre workshops (beafish@) all over the world, renting swimming facilities such as the YMCA, and acclimatizes his clients in warm water for six hours straight on the first lesson. His clinics, for which he charges US$995, run for six hours a day, five days in a row. Lear, who was then 64 and “in pretty good shape,” had signed up. But when she learned about the exposure therapy, she thought, “Who in their right mind can go swimming for six hours? I’m cancelling.” She told her husband. “My husband said, ‘Go and when you get tired, come home.’ ”

Lear recalls, “Some people couldn’t put their head in the water. All they did was practise putting their face in the water. I could put my head in the water in the shallow end and not be freaked out. Paul had two other instructors with him and a lifeguard. We felt extremely safe. They got in the water with us. In those six hours, I was never tired. The warm water was a huge plus. We never got cold. I would bring water and power bars. Anybody can get out at any time. We kept our snacks right by the pool.”

With regular swimming lessons, Lear says, “you hold on to the side of the pool and you kick. We never did that. There was no holding on to the side of the pool. First, Paul teaches you how to float, to get you comfortable in the water. He doesn’t teach you how to tread water until you’re down the line a bit.”

Lennon’s next workshop is this month in California. He told Maclean’s, “I feel bad because I have 3,000 people from the Internet who want to participate in that workshop. We have lots of Canadian students. At least one in every workshop is from Toronto.”

His biggest problem is finding swimming facilities that meet his prerequisites, like the warm water. “I usually operate at 92˚ F [33˚ C].” With exposure therapy, “the water has to be warm so they can relax. It has to be a safe, comfy, cozy environment. No spectators. No cameras.”

Traditional lessons, he says, teach backstroke and breaststroke. “That’s locomotion. That’s not learning to swim. That’s getting from point A to point B and we don’t do that until much later.”

Lear remembers floating and treading water for hours at the YMCA in Glendale, Calif. “The pool had the most interesting tile. Paul would say, ‘Where are you, Phyllis? What are you doing? You’re supposed to be paying attention.’ I was staring at the tile. I got into the tile.”

“Most of my students come to me as a last hope,” says Lennon. “They’ve tried swimming lessons many, many times. They say it’s a social handicap. It’s anticipatory anxiety. Everybody thinks they’re going to be the one who won’t survive the class.” Lennon empathizes with the problem of anxiety. At swim meets, he used to “choke.” “As soon as I know I have serious competition, I don’t do well. Many years later, I was finally diagnosed with anxiety disorder. Nobody knows,” he says. “Everyone thinks of me as so solid and confident and a leader. If they knew I had problems with anxiety, they would faint. But I’ve had problems all my life. I still suffer but I mask it with a facade of confidence.”

That’s one reason he’s never expanded the program. “People say to me, ‘Paul, you’re sitting on a gold mine. You should franchise this.’ But I’ve never had any interest in that. My students trust me. My heart is in it. If someone learns how to teach the program, they haven’t been through what I’ve been through. They don’t have the empathy. Me, I understand nervousness and anxiety and fear. I’ve had to deal with it my whole life. But I have the ability in the water as a swimmer, so it’s a good marriage of the two.”

“The biggest win for me,” says Lear, “was when I went to Hawaii. I dove off the boat and snorkelled. I was like, ‘What is this?’ I couldn’t believe it. My husband couldn’t believe it. I was in the water for an hour.”



Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning therapy developed by a South African psychiatrist, Joseph Wolpe. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy.

Specific phobias are one class of mental illness often treated through the behavior therapy or cognitive-behavioral process of systematic desensitization. When individuals possess irrational fears of an object, such as height, dogs, snakes, and close spaces, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, patients’ behavior to reduce fear is reinforced through negative reinforcement, a concept defined in operant conditioning. The goal of Systematic Desensitization is to overcome this avoidance pattern by gradually exposing patients to the phobic object until it can be tolerated. This will be challenging for the patient at first to deal with the fear, but gradually, most will overcome this fear. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli). Coping Strategies

Prior to exposure, the therapist teaches the patient cognitive strategies to cope with anxiety. This is necessary because it provides the patient with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation, is one type of coping strategy. Patients who have serious anxiety that leads to breathing problems, might be taught to focus on their breathing or to think about happy situations. Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome. For example, a patient with a snake phobia might realize that they imagine any snake they encounter would coil itself around their neck and strangle them, when this would not actually occur. These patients need to see that not all snakes are large and that most snakes are completely harmless so that they can get over their fear. Research at the University of Pennsylvania has demonstrated the effectiveness of this technique in helping subjects reduce similar animal phobias.

[edit] Progressive Exposure

The second component of systematic desensitization is gradual exposure to the feared objects or situations. Continuing with the snake example, the therapist would begin by asking their patient to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 5 of 100, while having several live snakes crawling on one’s neck would be the most fearful experience possible. Once the patient had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the patient is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes.



Systematic Desensitization

Using Systematic Desensitization to Conquer Your Fears

By Sheryl Ankrom,

Updated: June 08, 2009

Health's Disease and Condition content is reviewed by the Medical Review Board

Joseph Wolpe, a pioneer of behavioral therapy, developed a technique called systematic desensitization for the treatment of anxiety-related disorders and phobias. This technique is based on the principles of classical conditioning and the premise that what has been learned (conditioned) can be unlearned. Ample research shows that systematic desensitization is effective in reducing anxiety and panic attacks associated with fearful situations.

Systematic desensitization usually starts with imagining yourself in a progression of fearful situations and using relaxation strategies that compete with anxiety. Once you can successfully manage your anxiety while imagining fearful events, you can use the technique in real life situations. The goal of the process is to become gradually desensitized to the triggers that are causing your distress.

Learning to Relax

Before you can begin gradually exposing yourself to your feared situations, you must first learn and practice some relaxation techniques. Some techniques commonly used in relaxation training include:

Deep Breathing

When people are anxious, they tend to take rapid, shallow breaths that come directly from the chest. This type of breathing is called thoracic or chest breathing. When you’re feeling anxious, you may not even be aware that you’re breathing this way.

Chest breathing disturbs the oxygen and carbon dioxide levels in the body, resulting in increased heart rate, dizziness, muscle tension and other physical sensations. This may may signal your body to produce a stress response that contributes to anxiety and panic attacks.

Progressive Muscle Relaxation

If you have panic disorder, agoraphobia or another type of anxiety disorder, you may experience frequent muscle tension. In fact, chronic muscle tension may be so automatic that it seems normal, and you may have forgotten what it feels like when your muscles are completely relaxed. By employing the progressive muscle relaxation technique, you will be able to quickly rediscover the distinctions between relaxation and tension of various muscle groups.

Visualization

By imagining yourself in a peaceful, stress-free setting, you can reach a state of mental and physical relaxation. For example, imagine yourself sitting by a beautiful, peaceful lake. Focus on the scene for a period of time. Feel the soft sand on the bottom of your feet. As a gentle breeze sweeps across the water, imagine the warm air on your face as you watch a magnificent sunset on the horizon.

How Systematic Desensitization Works

Before beginning systematic desensitization, you need to have mastered relaxation training and developed a hierarchy (from least feared to most feared) list of your feared situations. If you have difficulty getting to a state of relaxation or identifying your anxiety hierarchy, you should consult with a professional who will be able to provide you with guidance.

Systematic desensitization begins with imaginary exposure to feared situations. Use your anxiety hierarchy to break down the feared situation into manageable components. For example, let’s say you fear going into large stores. You may have the least anxiety walking into the store. As you get further from the exit doors, your anxiety intensifies. Standing in the checkout line represents your highest fear response. You would start the process by focusing on the action that causes the least amount of distress and work your way up. The result is that you will gradually, or systematically, become desensitized to shopping in large stores.



Definition

Systematic desensitization is a technique used to treat phobias and other extreme or erroneous fears based on principles of behavior modification.

Purpose

Systematic desensitization is used to help the client cope with phobias and other fears, and to induce relaxation. In progressive relaxation, one first tightens and then relaxes various muscle groups in the body. During the alternating clenching and relaxing, the client should be focusing on the contrast between the initial tension and the subsequent feelings of relaxation and softening that develop once the tightened muscles are released. After discovering how muscles feel when they are deeply relaxed, repeated practice enables a person to recreate the relaxed sensation intentionally in a variety of situations.

After learning relaxation skills, the client and therapist create an "anxiety hierarchy." The hierarchy is a catalogue of anxiety-provoking situations or stimuli arranged in order from least to most distressing. For a person who is frightened by snakes, the anxiety hierarchy might start with seeing a picture of a snake, eventually move to viewing a caged snake from a distance, and culminate in actually handling a snake. With the therapist's support and assistance, the client proceeds through the anxiety hierarchy, responding to the presentation of each fearful image or act by producing the state of relaxation. The person undergoing treatment stays with each step until a relaxed state is reliably produced when faced with each item. As tolerance develops for each identified item in the series, the client moves on to the next. In facing more menacing situations progressively, and developing a consistent pairing of relaxation with the feared object, relaxation rather than anxiety becomes associated with the source of their anxiety. Thus, a gradual desensitization occurs, with relaxation replacing alarm. Several means of confronting the feared situations can be used. In the pre-computer era, the exposure occurred either through imagination and visualization (imagining a plane flight) or through actual real-life — or so-called in vivo — encounters with the feared situation (going on an actual plane flight). More recently, during the 1990s, virtual reality or computer simulated exposure has come to be utilized in lieu of in vivo exposure. Research findings indicate that mental imagery is the least effective means of exposure; in vivo and virtual reality exposure appear to be indistinguishable in terms of effectiveness.

Systematic desensitization is a therapeutic intervention that reduces the learned link between anxiety and objects or situations that are typically fear-producing. The aim of systematic desensitization is to reduce or eliminate fears or phobias that sufferers find are distressing or that impair their ability to manage daily life. By substituting a new response to a feared situation — a trained contradictory response of relaxation which is irreconcilable with an anxious response — phobic reactions are diminished or eradicated.

Precautions

Because of the potential for extreme panic reactions to occur, which can increase the phobia, this technique should only be conducted by a well-qualified, trained professional. Also, the relaxation response should be thoroughly learned before confronting the anxiety-provoking hierarchy.

Normal results

Desensitization is an effective form of therapy. Individuals who have a positive response are enabled to resume daily activities that were previously avoided. The majority of persons undergoing this treatment show symptom reduction.



WHAT ARE BEHAVIOURAL AND COGNITIVE THERAPIES?

Behavioural and Cognitive Psychotherapies are psychological approaches which are based on scientific principles and which research has shown to be effective for a wide range of problems. Clients and therapists work together to identify and understand problems in terms of the relationship between thoughts, feelings and behaviour. The approach usually focuses on difficulties in the here and now, and relies on the therapist and client developing a shared view of the individual's problem. This then leads to the identification of personalised, time-limited therapy goals and strategies which are continually monitored and evaluated. Behavioural and Cognitive Psychotherapists work with individuals, families and groups. The approaches can be used to help anyone irrespective of ability, culture, race, gender or sexual preference.

Behavioural and Cognitive Psychotherapists are usually health professionals such as nurses, psychologists, doctors, social workers, counsellors etc. Whilst all behavioural and cognitive psychotherapists share the above principles, individual therapists may call themselves Cognitive Psychotherapists, Behavioural Psychotherapists, Cognitive Behavioural Psychotherapists or Rational Emotive Behaviour Therapists. These different titles often reflect the preference and training of individual therapists for specific techniques which address problematic thoughts, assumptions and beliefs directly (Cognitive Psychotherapists), address behaviour directly (Behavioural Psychotherapists) or a combination of techniques aimed at addressing thoughts and behaviour (Cognitive Behavioural Psychotherapists, Rational Emotive Behaviour Therapists). Whatever title they use, the approach is commonly referred to as CBT. Most importantly, all therapists aim to help clients achieve desired change in the way they think, feel and behave.

Here is an example of how our thoughts, feelings and behaviour can affect us.

'Sue was nearly asleep and by the time she managed to pick up the phone it had stopped ringing. She had been suffering from anxiety and depression for some time. Her daughter Liz, who had recently moved to London, immediately came to mind. Sue thought: "Something must have happened to Liz! That was the police calling to inform me that Liz has had a serious accident." She felt her stomach churning and her heart pounding at the thought that something could have happened to Liz. Her thoughts raced uncontrollably and she feared she could be losing her mind. She rang Liz's home number several times but there was no reply. Sue took this as further evidence that something bad had happened to Liz. Sue felt so panicky that she stayed up all night, despite taking extra medication. She felt dreadful thinking of all the things that could have happened and even thought of ringing some of the London hospitals. Sue found out from Liz the next morning that she had stayed the night at one of her friends' houses and was fine. Nevertheless, she remained distressed and unsettled and felt unable to go to work.'

WHAT HAPPENS IN BEHAVIOURAL AND COGNITIVE PSYCHOTHERAPIES?

In behavioural and cognitive psychotherapies the therapist and the client work together to: 

    • develop a shared understanding of the client's problem.

    • identify how these affect the client's thoughts, behaviours, feelings and daily functioning.

Based on the understanding of each client's individual problems the therapist and the client will then work together to identify goals and to agree to a shared treatment plan. The focus of therapy is to enable the client to generate solutions to their problems that are more helpful than their present ways of coping. This often involves the client using the time between therapy sessions to try things out.

Therapy is organised over an agreed number of sessions. The number of sessions needed will differ depending on the nature and severity of a client's problem. Typically, sessions are weekly, last an hour and take place over a period of between 10 to 15 sessions, but this can be significantly shorter or longer. After treatment completion client and therapist usually agree to a limited number of follow-up sessions to maintain the progress achieved.



Aims

This leaflet is for anyone who wants to know more about Cognitive Behavioural Therapy (CBT). It discusses how it works, why it is used, its effects, side-effects, and alternative treatments. If you can't find what you want here, there are sources of further information at the end of this leaflet.

What is CBT?

It is a way of talking about:

• How you think about yourself, the world and other people

• How what you do affects your thoughts and feelings.

 

CBT can help you to change how you think ("Cognitive") and what you do ("Behaviour)". These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the "here and now" problems and difficulties. Instead of focussing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

When does CBT help?

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

How does it work?

CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:

 

• A Situation - a problem, event or difficult situation

From this can follow:

 

• Thoughts

• Emotions

• Physical feelings

• Actions

 

Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally. It can also alter what you do about it. There are helpful and unhelpful ways of reacting to most situations, depending on how you think about them.

 

For example:

 

|Situation: |You've had a bad day, feel fed up, so go out shopping. As you walk down the road, someone |

| |you know walks by and, apparently, ignores you. |

|  |Unhelpful |Helpful |

|Thoughts: |He/she ignored me - they don't like me |He/she looks a bit wrapped up in themselves - I|

| | |wonder if there's something wrong? |

|  |

|Emotional: |Low, sad and rejected |Concerned for the other person |

|Feelings | | |

|Physical: |Stomach cramps, low energy, feel sick |None - feel comfortable |

|  |

|Action: |Go home and avoid them |Get in touch to make sure they're OK |

 

 

The same situation has led to two very different results, depending on how you thought about the situation. How you think has affected how you felt and what you did. In the example in the left hand column, you've jumped to a conclusion without very much evidence for it - and this matters, because it's led to:

 

• a number of uncomfortable feelings

• an unhelpful behaviour.

 

If you go home feeling depressed, you'll probably brood on what has happened and feel worse. If you get in touch with the other person, there's a good chance you'll feel better about yourself. If you don't, you won't have the chance to correct any misunderstandings about what they think of you - and you will probably feel worse. This is a simplified way of looking at what happens. The whole sequence, and parts of it, can also feedback like this:

 

[pic]

This "vicious circle" can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.

 

CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them - and so change the way you feel. CBT aims to get you to a point where you can "do it yourself", and work out your own ways of tackling these problems.

 

"Five areas" assessment

This is another way of connecting all the 5 areas mentioned above. It builds in our relationships with other people and helps us to see how these can make us feel better or worse. Other issues such as debt, job and housing difficulties are also important. If you improve one area, you are likely to improve other parts of your life as well. "5 areas" diagram.

 

What does CBT involve?

The sessions

CBT can be done individually or with a group of people. It can also be done from a self-help book or computer programme. In England and Wales  two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks, Beating the Blues is for people with mild to moderate depression.

 

If you have individual therapy:

• You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly, sessions. Each session will last between 30 and 60 minutes.

• In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.

• The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.

• You decide what you want to deal with in the short, medium and long term.

• You and the therapist will usually start by agreeing on what to discuss that day.

 

The work

• With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.

• Together you will look at your thoughts, feelings and behaviours to work out:

- if they are unrealistic or unhelpful

- how they affect each other, and you.

• The therapist will then help you to work out how to change unhelpful thoughts and behaviours

• It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend "homework" - you practise these changes in your everyday life. Depending on the situation, you might start to:

• Question a self-critical or upsetting thought and replace it with more helpful (and more realistic) one that you have developed in CBT .

• Recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.

• At each meeting you discuss how you've got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping.

• They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

 

How effective is CBT?

• It is one of the most effective treatments for conditions where anxiety or depression is the main problem

• It is the most effective psychological treatment for moderate and severe depression

• It is as effective as antidepressants for many types of depression

 

 

What other treatments are there and how do they compare?

CBT is used in many conditions, so it isn't possible to list them all in this leaflet. We will look at alternatives to the most common problems - anxiety and depression.

• CBT isn't for everyone and another type of talking treatment may work better for you.

• CBT is as effective as antidepressants for many forms of depression. It may be slightly more effective than antidepressants in treating anxiety.

• For severe depression, CBT should be used with antidepressant medication. When you are very low you may find it hard to change the way you think until antidepressants have started to make you feel better.

• Tranquillisers should not be used as a long term treatment for anxiety. CBT is a better option.

Problems with CBT

• CBT is not a quick fix. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for you.

• If you are feeling low, it can be difficult to concentrate and get motivated.

• To overcome anxiety, you need to confront it. This may lead you to feel more anxious for a short time.

• A good therapist will pace your sessions. You decide what you do together, so you stay in control.

How long will the treatment last?

A course may be from 6 weeks to 6 months. It will depend on the type of problem and how it is working for you. The availability of CBT varies between different areas and there may be a waiting list for treatment.

What if the symptoms come back?

There is always a risk that the anxiety or depression will return. If they do, your CBT skills should make it easier for you to control them. So, it is important to keep practising your CBT skills, even after you are feeling better. There is some research that suggests CBT may be better than antidepressants at preventing depression coming back. If necessary, you can have a "refresher" course.

So what impact would CBT have on my life?

Depression and anxiety are unpleasant. They can seriously affect your ability to work and enjoy life. CBT can help you to control the symptoms. It is unlikely to have a negative effect on your life, apart from the time you need to give up to do it.

How can I get CBT?

• Speak to your GP. They may refer you to someone trained in CBT - for example, a psychologist, nurse, social worker or psychiatrist.

• The British Association for Behavioural and Cognitive Psychotherapies keeps a register of accredited therapists.

• You can try 'self-help' - using a book, internet programme or computerised CBT. This is more likely to work if you also receive support from a professional.

What will happen if I don't have CBT?

You could discuss alternatives with your doctor. You could also:

• Read more about the treatment and its alternatives.

• If you want to "try before you buy", get hold of a self-help book or CD-Rom and see if it makes sense to you.

• Wait to see if you get better anyway - you can always ask for CBT later if you change your mind.

 

|CHANGE VIEW: 10 key facts about CBT |

|  |  |

|Change: your thoughts and actions |View: events from another angle |

|Homework: practice makes perfect |I can do it: self-help approach |

|Action: don't just talk, do! |Experience: test out your beliefs |

|Need: pinpoint the problem |Write it down: to remember progress |

|Goals: move towards them | |

|Evidence: shows CBT can work | |

 

Useful CBT web links

• British Association for Behavioural and Cognitive Psychotherapies

• Calipso website: calipso.co.uk

• Beating the Blues: products/product.jsp?product_id=1

• For further information on Cognitive Behavioural therapy (psychotherapy/psychotherapy_cognitive_behavioural_therapy.htm)

 

Further reading

The 'Overcoming' series, Constable and Robinson

A large series of self-help books which use the theories and concepts of CBT to help people overcome many common problems. Titles include: overcoming social anxiety and shyness, overcoming depression and overcoming low self-esteem.

 

Free online CBT resources:

• Mood Gym: moodgym.anu.edu.au Information, quizzes, games and skills training to help prevent depression

• Living Life to the Full: Free online life skills course for people feeling distressed and their carers.  Helps you understand why you feel as you do and make changes in your thinking, activities, sleep and relationships.

• Fear Fighter:  (free access can only be prescribed by your doctor in England and Wales)

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