Why do we have fears? Interview
Fear is part of our lives. It also plays a big part in stories. Jana investigates why we have fears, why sometimes our fears can turn into phobias which make life difficult for us.
If you haven't heard it already, you might like to listen to Jana's story, Fear - before you listen to this interview.
In this edition of Jana's Studio, Jana interviews Andrew West, a psychiatrist who works with young people and children.
(Follow Andrew on Twitter) or read his book.
Hello and welcome to Jana’s studio, Storynory’s factual programme where I talk to fascinating people about fascinating things.
In this episode we are looking into your mind.
Have you ever had a fear?
Are you afraid of the dark? Spiders? Meeting new people? Many of us have fears or anxieties that can make our palms sweat and our hearts beat faster. Sometimes they pass as quickly as they come over us. But some of us live with deeper fears, called phobias. If you have a phobia which is particularly strong, it can prevent you from leading a normal life.
In a moment, I’m going to be talking to Andrew West, a psychiatrist who works with children and young people. I’m going to be asking him about phobias and how we can overcome them.
This programme will be especially interesting if you’ve heard my story, called ‘Fear’.
Spoiler Alert!
If you haven’t heard the story already, listening on to this interview will give away some of the twists and turns of the plot. So it might be a good idea if you go back and listen to the story now!
Anyway, here is a little extract from the story where our heroine, Emily, comes face to face with her greatest fear in life!
There were those times when Emily was younger, that she had tried to overcome her fear. She’d muster up the mental strength to venture out for a family walk and face her fear, but it usually ended in tears and a feeling of dismay.
“Daddy, daddy no! Quick! There's a dog coming! No! Help me!” she shrieked. “Just hold my hand. It'll be fine.”
“Oh no, no! It's off the lead. It's coming!” And then, she'd hold on to her dad for dear life, heart beating fast, until the owner and perfectly nice dog passed her. It had to be some distance away before she could let go of her dad’s hand and breathe a sigh of relief again.
And that was Richard Scott, reading an extract from the story, ‘Fear’.
To help me understand more about phobias, I'd like to welcome my friend, Andrew West. He is a doctor who specialises in treating emotional and psychological problems in young people up to the age of 18. I began by asking him what a phobia is?
Andrew West with Sophie and El. Sophie and El joined Jana to ask Andrew questions about Phobias.
Andrew: A phobia is a fear which is exaggerated and which stops you doing things that you very much want to do or need to do. We've all got things that we are frightened of and it's a jolly good thing that we do because you have to be frightened of some things.
Jana: Yes.
Andrew: Because some things are dangerous. But it becomes a phobia if you are more frightened than you really need to be and if it gets in the way and stops you doing things.
Jana: And that's why people have phobias?
Andrew: I think some people have hard wiring that makes their fear systems more reactive than others. If you've got a car that can get from 0 to 60 in about 4 seconds or whatever it is, you have to be able to be fairly gentle with the controls. I think that some people have a system that can accelerate to a very high level of a fear and agitation and excitement and so on very very quickly, but then I think also the experiences that you have, can make a big difference. So I think if something very shocking happens to you, it can mean that you're more frightened than you need to be about certain situations.
Jana: Before we go any further, there are a couple of young Storynory listeners here. Their names are Sophie and El.
Andrew: Hi Sophie. Hi El.
Jana: So let's start with Sophie. Hi Soph, how old are you?
Sophie: Hi, I'm 7 years old.
Jana: What would you like to ask Andrew?
Sophie: Hi Andrew, I’d just like to ask you if you had a fear growing up, or if you have one now?
Andrew: Soph, brilliant question. I was quite frightened of dogs actually. That's one reason I like the fear story as well. I used to be quite frightened of dogs. I can remember running and then seeing a dog and slowing right down and walking.
Sophie: My Mum used to be very afraid of dogs, but she's better now. I think it's because she had no choice because she has too many dog friendly people around her.
Andrew: I never had a pet when I was growing up. Some of my brothers and sisters have dogs. We didn't have dogs when I was a child. I think I would have been less frightened if we’d had dogs.
Jana: Ok, thank you Andrew. And El, hi. How old are you?
El: I'm 8 years old.
Jana: What would you like to ask Andrew?
El: Hi Andrew, I’d just like to ask you, if you weren't doing this job, what job would you be doing right now?
Andrew: I really, really don't know. But, I love music. I wanted very much to be a violin maker at one time. I do wonder if that could have been a different life. Yes that's one I think about quite a lot, being a violin maker.
El: My sister is afraid of spiders. What could help her to overcome it?
Andrew: That's a brilliant question. It goes right to the middle of what we’re talking about, doesn't it? Today, talking about fears and phobias. If your sister’s afraid of spiders, It depends a lot how afraid she is. Can I ask you, does it stop her doing anything that she wants to do?
El: Not really, but sometimes when it's in places that she wants to go, she might stop and call my mum.
Andrew: Yes, ok. So she might be worried about going into some place and she'd call your mum to help her. It sounds to me as though she probably hasn't really got a phobia, but she's frightened of spiders. If she wants to be less frightened of spiders, basically she needs to spend more time with spiders and she needs to probably do that gradually. It won't be helpful to her probably to suddenly have millions of spiders all over the place because she'd just be terrified, wouldn't she? So she'd need to do it gradually.
Jana: Well, thank you Sophie and El for some great questions.
Andrew, what are the most common phobias that you see in children?
Andrew: I see social phobia. Quite common in children.
Jana: What is social phobia?
Andrew: Social phobia is when you're frightened of social situations. It's quite common for children not to be very comfortable about meal times at school, for example.
Jana: Oh right.
Andrew: And in some children, that is a phobia.
Jana: Would it stop them from going in?
Andrew: It could stop them from going in. It could stop them from going to school. And quite often, alongside that is fear of public transport, for example. This can be very handicapping actually. It can make it hard for you to go shopping.
Jana: Ooh I can imagine, yeah.
Andrew: Hard for you to go to school. Hard for you to eat out in restaurants. That's quite a common one.
Jana: What can you tell me about panic attacks?
Andrew: Panic attacks are times when your fear system is firing off very energetically. It prepares you to either fight something or to run away from something and that makes the heart beat faster.
It makes you breathe faster and quite often it makes you want to go to the loo as well. Quite often those symptoms, the heart beating and so on, they make people more frightened and the more frightened they are, the more they pant and more their heart beats. And so that's a vicious circle that gets worse and worse and worse.
Jana: It reminds me of the story of Emily when she wet herself accidentally.
Andrew: Yeah yeah, absolutely because the last thing you want to be doing if you're running away from somebody is having to go to the loo. So part of the animal response to fear is to get the loo thing out of the way as quickly as possible so that's how that can happen sometimes. That's not a typical part of a panic attack. The most typical is feeling like you're short of breath when actually you're breathing too much and feeling your heart beating too fast and then because people breathe too much, it changes the chemistry in their blood so then they can feel weird. They can feel light-headed like they might faint, or they can feel pins and needles, sometimes around their mouth or in their fingers and so they can feel weird and of course that's frightening too.
Jana: I've been there. I remember. So how can you overcome a phobia?
Andrew: The key to overcoming a phobia is to stop the avoidance of the thing that you're afraid of. So what happens in a phobia is that you're so afraid of the thing, that you will do everything to avoid it.
Jana: Right.
Andrew: You'll take a long route to town or you'll never go into a certain room or there'll be a whole pile of things that you can't do.
Go on buses, it depends what the phobia is of. The key to treatment then, or the key to overcoming it, is stop the avoidance.
Jana: I think that would take a lot of courage, maybe too much courage.
Andrew: You're right about courage. I think you do need a lot of courage to overcome a phobia. It can be very, very, very very frightening. That's why usually it's helpful to start gradually and to start at little things. In your story about fear, you know when Emily visited Heidi, Heidi had the puppy didn't she?
Jana: Yes.
Andrew: I seem to remember Heidi was holding the puppy.
Jana: Yes, he was being restrained.
Andrew: Yes and Emily was able to be in the hallway or something with them. That was in a way starting gradually, because she knew that this was a small dog being controlled and she wanted to be with her friend.
Jana: That's right, yeah. What if there isn't this heavy need to face your fear? In the story, Emily's worries about losing her friendship with Heidi, really does outweigh her fear of dogs, so it kind of enabled her to face it. So what if for some people, there isn't that incentive?
Andrew: Well i think if there isn't that incentive, then it probably means that they don't need necessarily to treat their phobia. What you've just said about Emily's friend, Heidi, and her fear of losing her friendship with Heidi, is really important. She found a fear that was even bigger than her fear of dogs so that gave her the motivation that she needed. The courage, if you like, that she needed.
Jana: Just listening to this, does give me a chill. For years I remember I wouldn't allow myself to look at a picture of a snake, or even see one in real life. What was worse, I couldn't even say the name of the creature. I remember once I turned over a page in a magazine and there it was, just jumping out at me. So I totally freaked out. I do remember the distress that I felt. I still remember it. This was years ago. But can you explain why you think it got so bad? That I couldn't even look at one in a magazine or say the name?
Andrew: Well, for a start, snakes, and I hope it's alright me using the word, if you're feeling uncomfortable. But in a way we ought to make sure that we go on using the word.
Jana: Mmm.
Andrew: So that you don't become more frightened of it again.
Jana: Right.
Andrew: In a sense you need to practice it. Snakes are sometimes quite dangerous. I don't know how it started, but with the first fears what you probably did then was you made sure you avoided that situation rising again.
Jana: I did.
Andrew: Now, what happened was, then, and I'm guessing that you felt alarmed in a certain situation where you thought you might see a snake or have to say the word or somebody else might say the word or something like that, and your anxiety would rise. And that's uncomfortable. And then what you want is for your anxiety to drop. You want it to go away. So what you did, was you avoided that situation. You ran out of the room, or you closed the book or you blocked your ears or you, whatever, I don't know what you did. But you did something to reduce the anxiety.
Jana: Avoidance.
Andrew: Yes. That was avoidance exactly. And so I think in a way you became addicted to avoidance. You started to avoid more and more.
Jana: That's right.
Andrew: And you avoided not just books, but also the word or all sorts of things.
Jana: Actually that really makes sense because the more I avoided it, it just got worse and worse. I couldn't even go to the zoo. And I also think there's a lot of people out there that are too shy or embarrassed. So they say nothing and they're just living and suffering in silence, which is no good either.
Andrew: Yes.
Jana: I know it sounds awful. It's quite humiliating actually.
Andrew: Well I think you said another important thing. I think people with phobias quite often feel very ashamed often. And it's a great pity because it's absolutely natural in a way. We had to evolve with fears of snakes because if we hadn't been afraid of snakes, we’d have been stung by them or bitten, or whatever the right word is, by them all the time.
Jana: Thank you very much Andrew.
Andrew: You're very welcome.
Jana: What are the best and worst things you can say to help someone with a phobia?
Andrew: One of the worst things is to make people feel more humiliated. I think that telling people that they're stupid or silly or you know, snap out of it as though it's possible you know.
Jana: It doesn't help.
Andrew: It doesn't help. And I think it can make people feel worse. I think one of the best things to do is to explain that you don't share the fear yourself, but you understand that the other person is very frightened and you're going to stick around, you know. I'm not going to break off my friendship with you because of it or I'm not going to think less of you because of it. So I think that that just lets you know that not everybody is afraid. I mean of course you know that, don't you?
Jana: Yeah.
Andrew: I think that it's helpful to see people around who aren't afraid. As long as they're not making fun of you or being horrible to you.
Jana: So in the story, Heidi did the right thing then by getting a puppy, even though there was a kind of awkward moment where they're going to lose their friendship?
Andrew: Yes. And it's a great story actually, because of that, I think. I think it was the right thing for Heidi to do for Heidi. No question. She wanted a puppy, didn't she?
Jana: Yes.
Andrew: So she really really wanted a puppy.
Jana: She did.
Andrew: And it would have been a great loss and a great shame and she would have ended up hating Emily if she didn't have a puppy because of Emily. So in a way, by doing what she wanted, not cruelly.
Jana: No, it wasn't cruel.
Andrew: It wasn't cruel. But that way at least she didn't have to hate Emily. She could go on liking Emily actually. If she had stopped herself from having a puppy because of Emily, she would have been angry with Emily. And that would have been worse really.
Jana: She would have resented her, wouldn't she?
Andrew: Yeah. If you do need support and help, sometimes that can be friends who can support you, and that may well be enough. Supportive parents who understand and don't help you to avoid all the time. But also they don't make you feel stupid and silly.
Jana: It's difficult though is t it because when you love someone you care about their wellbeing, you do anything to, as you say, parents or really good friends, to support them in the way that the person wants, but it might not necessarily be good for them in the long run.
Andrew: No, no. So I think quite often, anxious children have got anxious parents. That's a double problem because of course, you've inherited the hard wiring, maybe. But also then you may have a parent who gets very panicky themselves around situations, and that's likely to make you as a child more wary of those situations yourself. A friend can help and then sometimes there are self help books and there are computer programmes that you can use. And then if get really really stuck, it can be important to have a psychologist or another professional helping you. And then yeah, they can help you. And I think that they help because it can be really tricky. It's quite important to learn a way of relaxing. So one of the early things that a professional would do under these circumstances is to teach somebody a relaxation technique of some kind.
Jana: Ok.
Andrew: And then somebody is more able to survive in an anxious situation. They don't need to run away so much because they can calm themselves. And then what the psychologist would do, is they will help you to make a list of all the things to do with, let's say, snakes or spiders or whatever it is, you know, everything to do with it. Make a list of all the things that bother you, all the situations you avoid that you really really hate and you're really anxious about. And then you make a ladder out of that list, where the least troublesome things are at the bottom.
Jana: Is it effective? Does it work?
Andrew: Yeah. It does, it works really really well. So what you do is, you overcome the fears at the bottom of the ladder and then you take a step up the ladder and overcome those fears.
Jana: Right. Well, thank you so much Andrew for joining me today. I certainly find this topic very fascinating and very helpful.
Andrew: Thank you Jana for inviting me. It's been a great pleasure. We've covered a lot of things. We haven't said everything that could be said about phobias and fears. But it's a very very important topic and I think if this is helpful to people in some kind of way, then I'm delighted.
Jana: Oh wonderful. And a big thank you to Andrew for giving us his insights into fears and phobias! Andrew has written articles, tweets and blogs about mental health. His book, called ‘Being with and Saying Goodbye’, is written for adult reading, and is about how he thinks professionals could be better at helping, not just children, but everyone, including each other. The links to his book and blog are on the website.
http://www.karnacbooks.com/product/being-with-and-saying-goodbye-cultivating-therapeutic-attitude-in-professional-practice/37316/
Home Page: Therapeutic Attitude
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Until next time, take care and thanks for listening. From me Jana, at Storynory.com. Bye!