For Sky news, this is connections.

I'm Rachel Steven.

This hour we're facing our fears.

Literally.

We're talking about phobias.

Everyone has moments of fear.

Maybe you're afraid of flying or heights or speaking in public.

Maybe it's spiders, snakes or clowns.

But some fear goes deeper than being creeped out or nervous.

Phobias can disrupt your life, and they're more common than you think.

According to the National Institute of Mental Health, about 12.5% of U.S. adults experience a phobia at some point in their lives.

But how do you know if what you're feeling is a phobia, anxiety, or just plain old fright?

And for those who have phobias, how can they be treated?

From old school methods like flooding to newer approaches like cognitive behavioral therapy.

The landscape of treatment is changing and so is the understanding of what actually works.

To help us sort through all of this.

I'm joined by two experts who work directly with people managing their fears.

Janell Holmes is a licensed clinical social worker with Rochester Regional Health and she is school based.

And I have Rachel Glaser, also a licensed clinical social worker in private practice specializing in anxiety, OCD and phobias.

And I'd like to remind our listeners that you can you can share your experiences and ask questions.

Just let us know if you struggled with the phobia and join the conversation at 1844295 talk.

That's 825 5 or 2 639994.

That's our local number.

Or you can email us at connections at Zorg or comment on our YouTube channel.

All right.

Now all the fun stuff.

Let's begin ladies.

Now we'll start off by asking both of you what can you define what a phobia is?

Because the word phobia gets tossed around a lot.

So what's the difference between a phobia and just having fear?

A fear?

Any either one of you can answer.

I know you're just looking.

I guess I'll take this one.

You can.

Yeah.

Talking to Mike.

Yeah.

So the difference between fear and phobia with a phobia, it is extreme, is irrational.

And it impairs the person's daily functioning.

It's an extreme fear, to something either a real or perceived threat.

And the response to this fear is disproportion to the actual danger associated.

Yes.

So that's the difference between fear and phobia.

Everyone experiences.

Fear is one of the things that we were all blessed with.

It helps us avoid danger.

What phobia?

It is someone who is very devoted avoidant of this specific situation.

Object activity.

And the avoidance can lead to panic and anxiety like symptoms.

Yes.

So that's the difference between fear.

So everyone experiences some components of fear in their lives.

However, with a phobia this is someone who avoids certain situations, avoids, social situations, even avoids flying.

Yes.

And so?

So this is some sort of anxiety or is anxiety different than a phobia?

And or.

Rachel, if you like to answer.

Sure.

So, phobias fall within the realm of anxiety disorders in, DSM five, which is the sort of the Bible by which we diagnose, mental disorders and anxieties, in turn, fall within mood disorders.

So the overall umbrella mood disorders, then anxiety disorders and phobias are a type of anxiety disorder.

And then we have certain delineated phobias that are diagnosed.

Okay.

So so can we go into that.

The specific phobias I know they're social phobias.

A rogue author.

So phobia is what can we tell us like social.

What what's going on with the different types of phobias here.

Yeah.

So we have social anxiety disorder which used to be called social phobia.

But in the DSM five the the name was changed to social anxiety disorder.

And then we have agoraphobia, which is yes, which is kind of a fear of losing control or embarrassing oneself and not being able to access help when out of the house.

So in different areas.

But losing control and not getting help.

Separation anxiety disorder used to be only diagnosed for children, but now it is also diagnosable for adults.

And that's of course a fear of being away from one's attachment figure or significant other.

Yes.

Avoiding being away.

And specific phobias would be the other one.

Specific phobias are like you've been mentioning the fear of animals.

Fear of flying.

There's an other category.

There's five specific five subtypes of specific phobias.

So, so for you, for you to be categorize your fear as a phobia, you must be exposed to it.

Or is it something that you can think of and get a reaction?

Or you must be.

It must be present in your face?

Must you have to be exposed to it for you to consider it a phobia?

Actually, no.

Okay.

No, you do not have to be exposed to it.

However, we do see that sometimes people who have a parent who has a specific phobia, it can be learned behavior for the child to experience some of the same symptoms as the parent.

But no, it's not something that you have to directly be exposed to, or it doesn't have to be, visibly in your face for you to have some of those, symptoms or that reaction to this object.

So, so I do feel like some phobias are misdiagnosed or misunderstood.

I would say that they're actually under diagnosed.

Okay, absolutely.

So, as you talked about a little bit in your intro, only 12% of American adults, are classified as someone who experience, a phobia of some sort.

Yes.

I will say that there's probably a little more.

Rachel, I how can you speak to this?

Would you say that there's more individuals who may be experiencing a phobia and it's not clinically diagnosed?

Absolutely.

There's, we have evidence that it's underdiagnosed in certain populations.

Men are far less likely to be diagnosed than women.

And, likewise, white people are more diagnosed than people of color.

Yes.

And both of those groups, we think it's because of the stigma associated in those groups with coming forward and saying that you have a significant fear or phobia.

Yeah.

And can you speak on this stigma?

Is there?

No one wants to say, like, I'm petrified of something.

Is is it the fear of being judged or talked about or not understood?

That's a layered question.

There.

They're good for those.

Yes.

That is extremely layered.

There's so many components to that.

I think mental health in general is, stigmatized.

We're doing a lot of work to try to release some of the negative connotations associated with someone who says, I'm struggling.

Yes.

Right.

So there might be a little bit there with someone just not being comfortable to say that they need assistance or they will require a little bit more help.

And then yeah, it may be cultural.

Like Rachel spoke to, gender based, like Rachel.

Rachel spoke to.

I don't think men are as open with expressing some of the things that they may experience or how they, will require help as well as the black and brown community.

It's just a lack of education, a lack of knowledge.

And for Rachel, I want to ask you, can you explain the criteria for diagnosing phobias?

How does someone go from just being fearful or anxious to being diagnosed with the phobia?

Sure.

So, a phobia is more of an extreme fear, and it's characterized by avoidance.

And to me, the most important factor is that it's really affecting the person's life.

So it's affecting their relationships, affecting their job, affecting them socially.

For children, it may, really impact their ability to go to school or go to activities when it crosses that line.

We would call it a phobia.

There's certain criteria in the DSM that they must meet, such as this must be going on for six months or more.

It must be impacting their life.

Certain things that you have to have.

I forget what it is.

Let's say four out of eight of these criterias.

Yeah.

But I can give you some examples to help illustrate.

So.

Yeah, sure.

So, like, personally, I don't like spiders.

I would say I'm afraid of spiders.

I, I maybe even if I see a spider, I'll go away from it before eating it.

But if it were to become to the point where I wouldn't go in my basement because I've seen a lot of spiders down there, or, maybe if I were to see a spider, I wouldn't be able to go to sleep for the entire night.

And I'd stay vigilant watching for more spiders.

That's crossing over into a phobia.

It might impact my relationship with my husband, with my children.

And affect their lives, too.

Yeah.

And you mentioned the time frame, right?

Because I've seen a lot that phobias last about six months.

Is there a timeframe on on phobias?

And how long they do last?

It is individual.

Yeah.

Definitely case by case, but, six months is the criteria to be diagnosed with a specific phobia.

So it has to be something that is persisting for at least six months before it will meet that one specific criteria in the DSM five.

But there is case by case.

There are some people who grow out of it.

I know children, people in adolescence experience a greater percentage of phobias and is something that they're able to grow out of and adulthood.

Maybe overcoming this fear or exposure to this specific situation or object.

So exposure?

Oh, yeah.

Yes.

Go ahead.

You know, like I want to just mention, one thing going off of what Janelle said.

Certain phobias are common in children and are developmentally appropriate.

We don't call them a phobia.

So separation anxiety usually develops maybe between 12 and 18 months.

It goes away on its own.

Yes.

Fear of monsters.

Maybe, you know, can develop a little bit, in in a child, maybe age 3 to 5, developmentally appropriate goes away.

But when when childhood phobias persist and aren't treated, it makes mood disorders both anxiety and depression, more likely later in life.

So are these are phobias contingent on other, mental health disorders like anxiety or OCD or do you have to have these underlying conditions for it to be a phobia?

You do not have to have the underlying conditions, but there is a higher rate of a comorbidity.

So there is something else going on here.

I do see that individuals who have a phobia also struggle with generalized anxiety disorder symptoms, depressive symptoms, OCD like symptoms.

It doesn't have to co-occur.

But the likelihood is more significant than someone who is not experiencing a phobia for, for example, like agoraphobia is much more common in somebody with panic disorder where they're afraid of going out and about having a panic attack and not being able to access, help or support.

And are phobias genetic?

I know this, I know you mentioned it being genetics or or learned behavior.

It is possible.

It is possible.

They can't speak to all phobias.

Individuals are able to develop phobias.

Singular to their family system.

But it is possible.

And I know both of you are with treat children, right?

How is that?

What does that treatment look like when you treat children for specific phobias?

So are you asking one of us?

Yeah, I you guys are doing a good job.

Just, you know, bouncing off each other.

So whoever wants to ask, answer.

Okay, I'll take a whack.

So I spoke I spoke to exposure, of this object situation or activity, which is something that we do definitely with the littles.

So say a kid has a fear or an phobia of basements.

Definitely developmentally appropriate.

Earlier in life.

As we grow a little older, 16 years old, you're still scared of monsters.

We have to talk about it, right?

Definitely something that we have to expose the kiddo to.

So gradual, slow, inviting.

This object, this situation, this activity into the kid's life is definitely at a slow pace.

Yeah.

It's not something that you will just jump the monster at this kiddo, right?

If they're expressing that this is a extreme fear for them, we don't want seven monsters running around.

But we would like one little small monster.

Maybe we can do it in a stuffed animal version, and then gradually grow up as the kid is able to sort of get a a better understanding or be able to tolerate the stuffed animal.

Now we can bring maybe something that walks hand but is only six foot and then, you know, six inches and and go up to six feet.

And it's definitely slow is gradual and it's whatever the kid can absorb at the moment.

Yeah, I know Rachel, we talked a little bit about some of what you've done.

As far as, like matching, you have different, tools or assessments you use when, when pertaining to kids and phobias.

Yes.

So I, I love working with, kids on their phobias, specifically doing exposures.

And I like to get creative.

So, for example, like, vomit phobia called a media phobia is actually a very common childhood phobia.

And exposure is is necessary and it can be fun, believe it or not.

It's fun dealing with with throw up.

Okay.

It's fun to get creative, to find ways to expose the child to a low level of fear, and then, like Janelle was saying, working up to higher and higher levels of fear.

But we, we brainstorm to come up with an exposure hierarchy.

So maybe, you know, ten different things that the child can identify from something that would be very mildly fearful, make them mildly fearful to ten being the highest level of fear they can imagine.

And those things could range from, we've I've downloaded emojis, vomit emojis on my phone and have the child do the same thing and then texting each other, little pictures of, you know, vomit emojis.

We've written stories about vomit, silly stories.

We've played a memory card game where we have matching pairs of different words for vomit that we have to match up.

We've used disgusting flavors of jellybeans to actually, you know, have exposure to disgusting or fearful tastes that the child might be afraid would make them vomit.

And then gradually, over time, we move up to, let's eat a feared food like, you know, slightly expired yogurt or something.

Let's go to a restaurant that you've never been to where you might be afraid of somebody vomiting, things like that.

And a vomit phobia.

I've never heard of this.

Are there other phobias that people may have never heard of that you've treated?

And how was that treatment like?

Because I've never heard of vomit for you.

I've heard about the fear of circles.

Right.

Is that that's the thing.

Because we always hear about arachnophobia, right?

And the fear of heights and the of phobia.

But what are some other phobias that we may not have heard of that you've treated?

I've kind of let Rachel say that's fine, because, the fear of vomit was, is something that I see quite often.

It's much more common than people realize.

But there are some that stem from the fear of, I like this.

This is intriguing to me.

Where where does that stem from?

Yeah, in my experience, it starts with the child vomiting or witnessing somebody else vomit.

Yeah.

And then goes from there.

Absolutely.

So, you know, definitely some a kiddo who has experience probably like a severe sickness or illness at some point and did not like the way it felt for them and never want to experience that.

Again.

Yes, it sort of manifests into this phobia of vomit.

Yeah, I, I want to continue elaborating on that.

And where do phobias stem from?

Right.

It has to be something you're exposed to, that you had a horrible experience with and it just sticks with you.

Can you explain where do most of these phobias come from?

How does this fear develop to the point where it becomes the thing where you don't want to do anything?

So in my experience, it does most often come from a previous exposure or traumatic experience.

Yeah.

So, you know, fear of flying could come from, a scary flight that they were on or a fear of driving could come from a car accident.

And I've treated people with those experiences.

The, the other way, as we talked about it, it could come from seeing a fearful parent.

So a parent who's afraid of dogs, is more likely to have a child who's afraid of dogs, and the child witnesses the parent being fearful, avoiding the dogs, having a physical reaction when they come across a dog.

And then genetically, if you have a first degree relative with a phobia, you are much more likely.

Don't ask me.

The statistics like you are much more likely to, have a phobia yourself.

Oh, wow.

So I know a lot of us.

I actually have a fear of flying, right?

And we spoke about this a little bit.

It's not a phobia because I actually get on the plane.

So a phobia with me would be me, not going to the airport.

Where would that where where is that line drawn?

It's definitely case by case.

Right.

And we did speak to this a little bit before we got on air here.

So my example of an extreme phobia in regards to flying would be someone who has a vacation plan to Los Angeles, and we're flying out of Rochester, New York.

Okay, our flight will probably be with a layover six hours or so.

Someone with an extreme phobia of flying will prefer catching an Amtrak, which may potentially take 36 hours for them to get to California.

Yes.

So it is the difference is that you will still get on this flight to go to Los Angeles.

Maybe a little worried about turbulence.

Yes, maybe a little worried about maybe your stomach becoming upset or something may be happening on this flight.

But you're able to get on, you know, you're not having a panic attack the whole entire flight there.

You're able to sort of sit there.

Maybe you had a coffee and that calms you.

So those type of things is where the differentiates a fear and a phobia.

So I have a comment here.

From someone who wants to remain anonymous.

And they said I apps.

I absolutely have a phobia of frogs.

Everyone in my life makes light of it, but they don't understand the power these things have over me.

A lifetime of frog loving brothers and semi sadistic neighborhood kids have cemented this fear in me.

I try to keep this fact quiet to those around me because they could make me do nearly anything they wanted.

If their leverage was a simple toad found on the forest floor.

So this this, I want you to respond to this.

So being exposed to ill treatment as a child could develop this phobia.

Yeah.

Yeah.

For sure.

If I'm, if I'm telling my sisters that I'm afraid of frogs.

Yes.

And they go and find a frog.

Yes.

And, and put it in my face and I scream and I yell, it can create something to just like, almost a traumatic like response to frogs.

Yes, for sure.

Because if I see this frog, I correlated to have being fearful and scared and I'm not sure what I should do.

Everyone experiences things a little bit different, but for sure.

And, and here she says, she keeps it quiet around people, right?

So no one uses it against her.

Is this something that you should keep quiet if you're around people?

Well, her fear of frogs is very specific.

Where she's not likely to encounter frogs, very frequently in the course of her day.

Well, depending on her career and where she lives.

So the type the fearful stimulus is may really dictate how quiet the fear can be kept and how many people have to know about it.

So with agoraphobia, someone may be afraid to go grocery shopping.

So that really impacts people around them.

A lot of, you know, they may get a lot of support from family members who do their shopping.

And a lot of people know about it.

Yes.

Yeah.

So as far as children, what can parents do?

I know we hear about speech treatment.

What can you I know, Rachel, you have a lot of experience with this type of, treatment.

Can you tell us about space treatment?

I love talking about treatment.

Yeah, you got really excited.

I do, it's it's a newer type of treatment, newer than CBT or cognitive behavioral therapy, which is sort of the gold standard, but space treatment, it was developed by Doctor Ali Liebowitz out of Yale.

Research is now showing that it can be as effective as CBT with a child or with parents, rather than working, directly with a child in CBT.

So the unique feature is that, parents are are in treatment.

So I'm working with parents to treat the child's anxiety.

It's absolutely a treatment for the child's anxiety, not just support.

Yeah.

But it's a way to make an impact.

Often when a child is not saying, hey, you know, sign me up for therapy, I want counseling, I need to address this fear or phobia.

But parents notice it and notice how it's impacting the child's ability to get through life.

And they want to see change.

It's such a powerful method because you can't make someone change.

You can't make someone less anxious by saying there's nothing to worry about.

But when a parent uses their own behavior, which is the focus of space treatment, it's it's really very powerful.

No one can take that away from them.

Yeah.

I can tell you a little bit about what it is.

Yeah, yeah.

Can we go into can I know it stands for something, right.

Yeah, yeah.

For any.

So space treatment stands for supportive parenting for anxious childhood emotions.

And it focuses on, changing parents behavior and communication patterns.

So, it's we're we're trying to increase parental support for the child.

So support mostly in the form of how the parent communicates.

Support can be thought of as being, two factors that really make up support.

One is acceptance or empathy, accepting that the child is afraid.

Okay.

So, statement like, I know that you're so scared of that dog across the street right now.

And then, the second part is confidence.

So confidence in the you bit in the child's ability to get through that fear.

So that could sound something like, you know, having said, I know that you're so scared the confidence piece would be and I know that you're going to be able to tolerate, that fear that you're having right now.

Yeah.

We want to move away from the tendency that parents have to have, protect, want to protect the child by saying something like, this is scary.

Let's get away from that dog or parents can often make demanding statements, which would sound like there's nothing to be afraid of, which sounds kind of like a gentle, reassuring statement.

But it actually, negates what the child is feeling.

The child is scared.

Yeah.

I want to talk about state like statements that could actually enhance phobias.

Right?

Or kind of counter away from, from treat positive treatment.

And, what are some things that people say when someone has a phobia that that works against that, leaving that fear a big one, right.

Clowns are not real.

Oh, oh, clowns are not real.

They are very real to the person who are experiencing them.

Okay.

So definitely something that you want to move away from, like Rachel spoke to in negates whatever the person experiences, is, dismisses, everything that they're going through.

So just being a little bit more aware and having that empathy.

Wow, these clowns must really frighten you.

Yes.

Right.

I'm not able to relate to it.

I think it's just a red nose.

Silly guy.

But I understand that it makes your anxiety go up.

You are experiencing panic like symptoms when you see this clown, right?

So just being able to understand what this person is experiencing is very important.

Another one, if someone says this, they're they have a phobia of mice.

When someone says, oh well, they're smaller than you.

Oh, you're just making me feel horrible.

I know, come around me if you have.

I'm sorry about that.

So, Yeah, they are much smaller than even a little baby, but they it doesn't take away from the things that this person is experiencing when they, they see a mouse, or that they know that a mouse is potentially somewhere close to them.

And this does this work for adults as well?

I know children and adults absolutely can.

We could talk to adults differently.

No.

Yeah.

We can always talk to them differently.

I'm always going to be team talk to each other a little bit more gentle for sure.

So definitely works with children, works with adults as well.

And Rachel, what is like does this work for children and adults like are there different treatments that work better for children than they do adults and vice versa?

Sure.

Like what I was describing with, working my work with parents in space treatment is really aimed at getting parents to speak differently to their children.

And then there's a second component of that, of changing the parents behavior.

Also, that's a whole, another major focus of space.

But can we talk to children differently?

Can we recognize their fear?

They are scared.

You're not going to convince them not to be scared of the dog.

So let's instead support that they are scared and and express confidence that they can get through their fear.

And then let's focus on your behavior.

Okay.

So the focus really in space is changing parental accommodations.

So accommodations are kind of the way that parents tailor their behavior or to their children's anxiety.

So things that parents may do or avoid doing in response to their children's fear.

So to to get back to the fear of dog example, a parent may, be walking down the street every time they come upon a dog.

If they're with their child, they cross the street.

Okay, that's a clear accommodation.

Yes.

And that's wrong.

That's.

Well, that's not the best way.

Let me handle that.

Let me say this.

If you're in space treatment, first, we want to really up the supportive statements that you're giving your child.

And then we want to slowly pull back on those types of accommodations over time.

So we don't withdraw the accommodations on day one.

And people listening to this, please don't go home and withdraw accommodations.

Please do know that you might, but over time with working with, a therapist, you'll learn how to increase support, to increase your child's confidence that they can get through those scary situations.

And then over time, slowly start to, expose your children to a little bit more of the thing that they fear.

Yes.

And I'm pretty sure treatment changes depending on the phobia.

Right?

Because of fear of heights.

But are we having them climb higher slowly?

Like how are we treating.

It's definitely different.

A much, much, much different.

So like even what the dog example say, you walking down the street and you see a dog and your first response used to be to go in a home, right?

So if we go from going all the way in a house to just crossing the street to just moving to the curb slowly, you know, the stimulus is still here, but slowly, building the the kiddos threshold for how much they can tolerate with this dog.

A fear of heights looks much different.

Yeah.

Climbing a ladder is not something that some therapists may utilize.

That's something that I have ever done.

With the fear of heights, I will say that is definitely case by case.

And you would like to.

You want to know what the source is?

So, I think Rachel spoke to this a little earlier.

Someone who's afraid of, flying in.

They may have had a bad experience.

So really trying to figure out how this originated and also addressing that.

Yes.

Right.

And it's important to to incorporate in the early stages of exposure, just what we call imaginal exposure, which is in session with the client having different ways to imagine in their head the the feared stimulus.

So, for example, if they're afraid of heights, we could talk about them being on a rooftop or being on a ladder.

We could watch a movie about, you know, something to do with heights we could for a child.

They could draw a picture of themselves perched somewhere.

So there's a lot to the imagination before we even have to start with, actual exposures.

And then I think it's really important to for clients to do homework involving exposures in between sessions.

And so for children, I like to involve the parents to help, you know, remind and reinforce the child that, they should be doing their homework a little bit or a few times a week, let's say, I, I equate it to, you know, if you were taking tennis lessons, and you, you go to a tennis coach once a week, well, over time, you'll maybe slowly improve your tennis game, but if you on your own hit tennis balls in between your once weekly lessons, you're going to see more improvement quicker.

Absolutely.

Right.

We're here talking about phobias.

We're going to take a quick break.

If you would like to join the conversation or tell us about a phobia that you possibly have, you can call it toll free at 1844295 talk.

That's 8255.

Or you can call our local line (585) 263-9994 or email us at connections@wxxi.org, or comment on our YouTube channel to take a quick little break and we'll be back to face our fears right here in connection.

I'm Evan Dawson, coming up in our second hour, a special rebroadcast of a conversation with Sean Nelms about his trip to Ghana.

Nelms is a longtime local superintendent and community leader, and one of his life goals was to take his children to see Ghana, to see the beauty, to experience the culture and to see the slave castles and everything associated with them.

And he came back, he says, changed the story.

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I'm taking a little break this summer, but that doesn't mean connections is going away.

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Each day, we'll bring back some of our and your favorite conversations from the show.

It all begins the week of July 14th.

UN connections, and we're back with this episode of connections.

And we're talking about phobias.

And with me, I have two licensed clinical social workers, Janelle Holmes and Rachel Glaser.

Here with me, the experts.

And we would like to talk about can phobias be cured?

Can they be cured?

Cured is, you know, that's that word.

Yes.

That word.

That is a very, funny word.

That's something that I like to use, personally, but there is a combination of treatment modalities that can be used.

I know before the break, Rachel spoke to space, which is a treatment to for therapists to work with parents of children who are experiencing phobias.

There's also, medications that are available for individuals who are experiencing phobias.

There's beta blockers, which essentially blocks the body's response to adrenaline and other stress hormones.

There's also anti-anxiety medications that can sort of help manage some of the anxious symptoms that someone may be experience nursing, as well as other treatments like cognitive behavioral therapy.

And I know there's there's an article, a German study published last year found that people who have phobias may have a different brain structure than other people.

They found that people with phobias had increased thickness in some parts of their frontal cortex.

Is is something that we're familiar with or is this is this I, I'm not personally aware of that study, but, I can talk a little bit about brain structures and what structures are involved in the fear response.

Yes.

Rachel, thank you so much.

I, I do like to I like to educate, do some psychoeducation about, this with clients just so they know what the fear response is.

So we, we talk about the fight flight or freeze response.

Comes from there's an analogy with cavemen and brain, if you've heard this before, where if you if you think back to early humans, we evolved to have, a brain that quickly sent an alarm signal to our body to react when we were frequently faced with a threat of danger that could be life threatening.

So if a caveman came out of his cave and he's picking blueberries and he encounters, saber tooth tiger, he doesn't have to think he his body, his brain goes into fight or flight mode, and he's getting ready to to either fight or flight, and blood is rushing to his extremities.

Blood flow to the brain, sort of, slows down.

And in that moment, we I can show you sort of with my hand, if you'd like, the, the model of the brain that I talk to clients about.

So if this is the amygdala, can you see my hand?

I don't know, but I can we I don't know if this is on, but, but if you're if you're touching her thumb, if we think of the thumb as the amygdala, that's kind of the, caveman brain or old brain, part of our brain that reacts quickly to threats.

It's normally tucked inside the prefrontal cortex, which is the structure in the brain that you mentioned in the German study.

So the prefrontal cortex is controlling our brain and our behavior when we're in a calm state, when we become, stressed in a very anxious or phobic state, what we call it is we flip our lid.

So the prefrontal cortex, that's where that came from.

Yes.

Well, okay.

This is great.

I love this demonstration.

It's just an easy way to understand these two brain structures.

So the prefrontal cortex goes away and the caveman brain sort of takes over for our functioning.

And the problem is we evolved to have that brain reaction.

The alarm system.

But most of the things that we're encountering and having a stress response to today are not really warranting that type of a reaction.

They're not really threats to our safety.

Correct.

So we're overreacting to we have developed a low tolerance to real and perceived threats.

Okay.

And I want to touch on new phobias that are developing.

Right.

I don't know if you heard about normal phobia.

Have you heard about this?

It's it's, fear of being without one cell phone.

Right?

And.

No, no mobile phone, no bulb, no mobile phone phobia.

Yes.

And this is real.

Yes.

So as technology begins to develop, are we going to see different phobias develop based on technology?

I think as the world evolves we're going to see a lot more change for sure.

There's been a lot of change.

So that caveman, brain, an analogy has evolved, right?

As we developed other skills and other techniques, and we have other things in our toolbox.

But with evolution comes the not so good parts about evolving, where you have this attachment to your cell phone.

I know Covid was a big one where a lot of people had a fear of Covid.

That was new, right?

This was something that we've never experienced before.

So as the world evolves, I believe that phobias will as well is.

Yeah, there are new types of phobias emerging that we haven't heard of.

So yeah, there's, climate change phobia.

Wow.

Which is not diagnosed.

It's not yet in the DSM, but it is becoming more and more something that is seen fear of climate change.

Also, there's a new one called zoo Mo phobia, fear of being on video calls and zoom, zoom, zoom.

So that kind of came out of Covid.

A lot of children suffering from, you know, not being willing to have their camera on during classes, fear of being on video.

And have you seen how technology can help phobia treatment.

So yeah, I think so.

Right.

And this is specific to the phobia.

Yeah.

So like Rachel spoke to sending germ emojis back and forth to a kiddo.

That's a great way to utilize technology.

Small little doses.

There's kids.

I was even thinking shooting back and forth, little TikTok videos.

Everyone loves TikTok right now.

And there's productive ways to utilize technology.

It doesn't always have to be negative, for sure.

So there's there's really good ways to use technology.

And I have a comment here or a question from, Rob.

What do you do for people who have claustrophobic claustrophobia and response to medical equipment like MRI?

How do we treat individuals with claustrophobia that the fear of confined spaces?

Yes.

So the exposure.

Right.

Exposure therapy.

We're not we're not throwing them immediately in a machine.

Hahahahaha I see, I see your face is okay.

No, no, no absolutely not.

But like Rachel shows videos of someone receiving an MRI and going through that process with them, talking about an MRI, saying the word MRI.

I know the claustrophobia is even with elevators as well.

So just let's just look at an elevator.

We don't have to physically step on it.

Let's just push the down button and watch it go watch the elevator, open it and close back up.

We don't have to physically go on.

Even with it visiting a medical room, we can just visit the medical space.

We don't have to go into the room where you receive the MRI.

We don't have to go meet the doctor.

We could just go to the facility in which you would be receiving the MRI.

And always.

We spoke on cognitive behavioral therapy.

Can we elaborate on what that is, Rachel?

Because I know you wanted to speak a little bit on CBT.

Yeah.

So, with CBT, cognitive behavioral therapy, it's it's become the gold standard for treating phobias.

And when I work with children aged 12 and up and adults, that's the modality that I'm using.

It really focuses on looking at a person's thoughts, how the thoughts are generating their feelings, and how feelings in turn are generating their behavior.

And we can imagine that thoughts are like the glasses through which we're seeing the world.

So, you know, you think about rose colored glasses.

Well, we could have phobic type glasses where we see the world through glasses that are are telling us that the world is so dangerous and scary place.

And so that's going to affect.

Let's take a look at, you know, someone with a driving phobia that would be, more likely to have that person see the road as a very threatening place.

Whereas someone who views the world through more rational, healthy glasses would see that, you know, some drivers are good, some are bad.

I'm going to do my best job and and go with it.

But cognitive therapy is, is really kind of a precursor to exposure therapy, where we first look at their thoughts, and what they're telling themselves about what they perceive as a dangerous situation.

And one cool technique that I like to use is the double standard technique where we might look at, I would encourage a client to talk to, imagine that they're talking to their best friend who also has, let's say, a fear of driving.

What would you say to your best friend?

You're probably going to speak more compassionately to your friend and more balanced and not have those alarmist, self statements that you're saying to yourself.

So if that's true of your best friend, is it also partially true of you?

And can we imagine that you could move towards more, rational types of thinking?

Another important thing to consider is, relaxation techniques.

So I've heard of this thing called tapping.

Is that is that something you tap your is your eyelid or there's different techniques that I'm hearing.

I'm more for anxiety.

Right.

And these these nonmedical.

Yeah.

There's certain pressure points that releases, other hormones that settle your nerves or settle some of the stress hormones that you're experiencing.

Relaxation could be deep breathing, right?

It could be grounding techniques.

I like to use the five senses.

That's one of my favorite ones.

The less you sit in a room, someone is experiencing some panic or anxious like symptoms.

Just sit with me, okay?

What do you see?

What do you feel?

Would you taste?

What do you hear?

Very effective for a lot of my littles.

As well as just picturing them picturing a place that brings them comfort and joy.

A lot of people's mind always go to the beach.

Yeah, yeah, that's.

So that's a comforting place.

Let's just visualize that you're there.

What do you see here?

What do you feel?

Your toes is in the sand.

It's warm.

You hear the waves going, those are things that are very effective.

And we have an email here.

An email question.

Have kids come, come in that are afraid of artificial intelligence?

I, I know this is this is along the lines of us discussing, like, new phobias that may develop through technology.

Have you ever has any kid?

I'm probably not yet right.

But is there any sense of that?

Kids may develop this fear.

So I think that's realistic to think that that fear will develop.

And I can especially see that fear developing in adults.

Yes.

Who are maybe more likely to use AI, and with with experiences with AI.

The fear may be heightened, but I have not personally encountered it.

I could see it becoming something though.

Absolutely.

I have had students talk about the fear of jobs changing, in how we're using robots, fast food restaurants and looking at the trajectory of their lives.

What does this mean for me?

Yeah, as the little who does it have?

You know, post-high school education or trades?

What does this look like from our future?

I've definitely had kids worry about that.

And while we talk about future phobias.

Right.

What about future treatment methods?

Are we starting to develop new treatment methods?

Rachel, you're you got excited.

Know, I could imagine what your treatments would look like in the future.

So, I mean, a newer treatment method is eMDR, Eye Movement Desensitization and Reprocessing that's really been used for trauma, but I believe it's also being used to treat phobias.

There's a lot of overlap with cognitive behavioral therapy.

Eye movement, encourages certain eye movements while, imagining the trauma that somebody went through.

And it could used be used as well for phobias.

Okay.

I, I'm curious as I, I pull apart in the silence.

Cuz eye movements.

How does that work?

Can we, can we speak on.

How does that relate to.

Sure.

A treatment.

So we're when you move your eyes from side to side in a certain way, you're And I'm moving my eye right now because of your, stimulate both sides of the brain.

And then by recalling and either speaking about or imagining the phobia.

You're developing new learning, new understandings, which is kind of the overlap with CBT, where you want new learning to come so that the person can see the world in a new way.

So okay, okay, I think I understand.

So just moving your eyes from left to right can right.

And the therapist guides the eye movement with either a light beam that goes, you know, from side to side or a certain wand, but the the client is keeping their head still and just moving their eyes.

That's one way to stimulate both sides of the brain.

And there are some others as well.

I believe tapping.

Yeah.

Different type of tapping.

Oh, what you mentioned.

Wow.

Lots of tapping.

So our different ways other than because using medication is usually is that usually the last resort we try to.

Expose or case by case.

Case by case I wouldn't say that is the last resort.

It depends also on that specific phobia.

And how how much is impact in the person's life.

And as far what was one thing you wish more people understood about phobias.

That help is out there.

Absolutely.

And it doesn't have to be scary.

No.

Yeah.

No.

Medication only works so well I really believe, other treatment is also necessary.

Maybe in conjunction with medication, but help is out there.

Absolutely.

I definitely second that I think is really important to receive whatever treatment modality that therapist has designed or developed with you, to address some of your phobias and medication is not the end all, be all.

That is for sure.

Well, all right, ladies, thank you so much for talking about phobias.

Are there anything that you would like the public to know that we haven't touched on when it comes to phobias?

Just.

Resources are available.

Resources are available.

I know Rochester Regional Health specifically is treating 4500 students and have been in schools for over 30 years.

So those are really a really important things for everyone to know.

There's help available.

There's, agencies available to to help you guys out with this.

And, I think caretakers play a huge role, in a supportive of the littles.

And we want to just confirm, I just want to state this to our listeners of the material on this program is for informational purposes only and is not intended as medical advice, diagnosis or treatment.

If you have a health issue, always seek the advice of your physician or health care provider.

And Rachel, as we want to, if our listeners would like to contact you, where could they reach you at?

So yeah, go to my website please.

It's w ww dot RG therapy.com and Janelle, if you would like to contact you where could we reach you at.

Hi.

Yeah.

So I'm a senior therapist at Genesee Mental Health center.

I'm school based and I'm working straight out of Great Central School District.

All right, well, today we faced our fears this hour.

Thank you, ladies, for all your expertise and your wisdom and thank you for stopping by.

Thank you.

Thank you for having us.

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