Chapter 13: Specific Phobia Part 3

Question 1

List 2 commonly used relaxation techniques:

Answer 1

• Breathing retraining

- Exercise

Question 2

Describe how breathing is affected due to phobic reactions:

Answer 2

• Over-breathing may occur as part of a phobic reaction
• Respiration rate normally increases in the presence of a perceived threat. They may breathe faster and deeper than necessary (hyperventilation) or get into a pattern of uncontrolled rapid and shallow breathing (tachypnea).

Question 3

Describe the consequences of excessive breathing (over-breathing):

Answer 3

• We take in more air than the body actually needs.
• This can upset the balance of oxygen and carbon dioxide, resulting in a low level of carbon dioxide in the blood.
• Too little carbon dioxide can cause reactions such as dizziness, light-headedness, blurred vision and pins and needles, all of which are associated with a panic attack and can heighten feelings of fear and anxiety.

Question 4

What is breathlessness (caused by over-breathing)?

Answer 4

A sensation of shortness of breath or difficulty breathing, which is a common reaction that can be both distressing and frightening.

Question 5

What is the overall effect of over-breathing?

Answer 5

A counterproductive cycle may be created as a person can become more fearful or anxious because they feel breathless, which leads to more difficulty breathing and other fear, anxiety, or panic symptoms.

Question 6

What is breathing retraining (breathing training)? What does it help to maintain, what does it involve, and what is its goal?

Answer 6

An anxiety management technique that involves teaching correct breathing habits to people with a specific phobia.

• Helps people maintain correct breathing or correct abnormal breathing patterns when anticipating or exposed to a phobic stimulus, so it may also help reduce anxiety or alleviate some of its symptoms.
• Generally involves slow, regular breaths in through the nose and out through the mouth.
• May also involve teaching the individual how to quickly restore the level of carbon dioxide in their blood if they start over-breathing (Eg. Breathing with pursed lips as if to blow out a candle, or by covering the mouth and one nostril while breathing through the other nostril)
• The goal is to slow the respiration rate, promotes a ‘normal’ , regular breathing pattern, prevent over-breathing and maintain the correct balance of oxygen and carbon dioxide in the blood.

Question 7

What does exercise involve?

Answer 7

Physical activity undertaken to improve or maintain one’s physical condition.
-Provides relief from or alleviates some of the symptoms associated with fear and anxiety

Question 8

Generally, exercise may be helpful as an intervention in one or more of the following ways:

Answer 8

• Promoting relaxation and thereby providing relief from anxiety
• Providing distraction or ‘time out’ from phobic stimulus, fear and anxiety
• Coping with the stress and associated physical reactions (Eg. Stress places a demand on the body for energy and in the process uses up stress hormones)
• Increasing tolerance to some of the fear and anxiety symptoms (Eg. Exercise can cause physical reactions like those for fight-flight or a panic attack, such as rapid heartbeat, sweating, shortness of breath), enabling symptoms to be experienced and controlled in a non-threatening way, and possibly improving coping ability through repeated exposure if exercise is regular.
• Altering brain chemistry (Eg. Promotes the release of mood-enhancing endorphins, thereby promoting a sense of wellbeing and indirectly providing relief from anxiety)

Question 9

What is psychoeducation? What assumption is it based on, and how the programs provided?

Answer 9

Involves the provision and explanation of info about a mental disorder to increase knowledge and understanding of their disorder and its treatment.

• Based on the assumption that increased understanding of symptoms, treatment options, services available and recovery patterns enables individuals with a mental disorder to cope more effectively.
• Psychoeducation programs can be provided in an individual or group format.

Question 10

Give 3 examples of what a psychoeducation program for a specific phobia may include info about:

Answer 10

• The nature of the disorders and its diagnosis
• Role of a phobic stimulus
• Challenging unrealistic or anxious thoughts

Question 11

Describe how families and supporters can help to challenge unrealistic or anxious thoughts of individuals with specific phobias:

Answer 11

• People with specific phobias tend to have anxious thoughts that tend to overestimate how bad it will be if they are exposed to the phobic stimulus and also tend to underestimate their ability to cope.
• Families and supporters can help by encouraging the person with a phobia to test or evaluate their unrealistic or anxious thoughts when exposed as well as not exposed to a phobic stimulus and by supporting them through this process.

Question 12

Describe how families and supporters can help to challenge unrealistic or anxious thoughts of individuals with specific phobias:

Answer 12

• People with specific phobias tend to have anxious thoughts that tend to overestimate how bad it will be if they are exposed to the phobic stimulus and also tend to underestimate their ability to cope.
• Families and supporters can help by encouraging the person with a phobia to test or evaluate their unrealistic or anxious thoughts when exposed as well as not exposed to a phobic stimulus and by supporting them through this process.

Question 13

Describe how families and supporters can help to not encourage avoidance behaviours of individuals with specific phobias:

Answer 13

• Often, family members and supporters encourage or reinforce avoidance behaviours out of concern for the person because observing phobic reactions in a loved one can be personally distressing.
• Through psychoeducation, family members and supporters may learn about the importance of gently and calmly encouraging and supporting the individual not engage in avoidance behaviour, possibly also challenging the behaviour.
• This can help the individual realise that through repeated experiences of facing their fear, they will begin to realise the worse insn’t going to happen.

Question 14

Explain why avoidance behaviour is a perpetuating factor for individuals with specific phobias:

Answer 14

• While avoidance behaviours can make the individual feel better in the short-term, it prevents them from learning that their phobic stimulus may not be as frightening or overwhelming as they think.
• They also never get the chance to experience control over fearful situations.
• The phobia is not only perpetuated by avoidance behaviour, but it can become increasingly fearful and more psychologically overwhelming.

Question 15

What does CBT aim to do in relation to specific phobias:

Answer 15

Aims to assist the individual to develop a new understanding that their feared stimuli are not (or unlikely to be) dangerous, so their avoidance and safety behaviours are unnecessary and unhelpful in the long term.

Question 16

What does avoidance behaviour involve?

Answer 16

Actions that help avert any contact, exposure or engagement with a feared object or situation (staying away).

Question 17

What is safety behaviour? Give an example:

Answer 17

Where the individual may not directly avoid a phobic stimulus but are willing to have contact with it if certain precautions are in place.
Eg. Someone who is fearful of insects may wear a hat, heavy gloves, long trousers and boots when gardening.

Question 18

Describe how the cognitive component of CBT can help individuals with phobias to overcome their fears (what may the individual be encouraged to do, and what may this include):

Answer 18

• The individual will be encouraged to identify their fear-and-anxiety-related thoughts as they are likely to reflect cognitive biases.
• Once the individual can recognise unhelpful ways of thinking that are contributing to their fear and anxiety, they will be better able to make changes to replace these with new ways of thinking that reduce fear and anxiety.
• May include self-discovery of flawed thoughts underlying their maladaptive feelings and behaviour. Others, by contrast, may take a more direct blunt approach to explain to the individual why their thinking is flawed.
• The individual is then encouraged to look for evidence that supports their fear cognitions and evidence that does not support them.
• Sometimes a person’s cognitive distortions result from a lack of info or from inaccurate info. One way of changing thinking is to encourage the individual to gather accurate info about their phobic stimulus.
• A person may also be advised to take a course that has an ‘education component’ and provides accurate info about relevant phobic stimuli.

Question 19

Describe how the behavioural component of CBT can help individuals with phobias to overcome their fears (what could it include, and what does it achieve):

Answer 19

• Could include teaching a relaxation technique, breathing retraining, promoting exercise and/or encouraging activities that are rewarding, pleasant or give a sensation of satisfaction.
• All of these can help distract from or reduce fear and anxiety. The individual is also likely to be taught to help them actually cope with fearful situations. This can be achieved through a behaviour therapy called systematic desensitisation.

Question 20

Outline 1 difference between stress and anxiety:

Answer 20

Stress occurs when a person perceives they cannot cope with a current stressor, whereas anxiety occurs when a person perceives they cannot cope with a stressor that may occur in the future.

Question 21

Outline 1 similarity between stress and anxiety:

Answer 21

Both stress and anxiety can be adaptive to functioning; that is, mild amounts of stress and anxiety can be helpful to a person’s functioning.