Drug Therapy vs. Behaviour Therapy to Treat Claustrophobia and Anxiety - Essay Example

Research study comparing the different forms of treatment for Claustrophobia and anxiety symptoms. Drug therapy vs. Behavior therapy or a combinationof both. Human mind develops fear for certain matters and such fear creates certain mental situation in them. This fear is known as phobia. It is said to be a form of anxiety syndrome that leads to an irrational fear of certain situations or objects. Human mind is susceptible to several phobias and Claustrophobia is one of them. It is, incidentally, also one of the most common phobias prevalent in many countries. Its main characteristic is the feeling of extreme fear while being in enclosed spaces. So it is termed as a situational phobia as it is produced by being in certain situations. A traumatic childhood experience like getting stuck in a confined space can trigger this phobia. What causes Claustrophobia? Almost always, it can develop due to some traumatic experience in childhood like being trapped in a small space. It could also develop in later stages of life when one is stuck in a confined space like in an elevator for some length of time. These experiences lead to associations and if one happens to be in a similar circumstance it could “trigger a panic attack.” What are the symptoms of Claustrophobia? What happens when a person finds himself or herself as the case may be, in a confined space? He may start sweating profusely. Or his heart beats at a faster rate. He feels nauseous and has fainting fits. He feels lightheaded and giddy. He has a tendency to shake all over. Then there is hyperventilation and the feeling that some physical harm is about to happen. There are some common situations in which a claustrophobic can feel anxiety. While inside a room his eyes are always on the exit. If driving along in a car, he has a tendency to avoid roads where there is heavy traffic. The person avoids elevators as much as possible while inside a building. At parties, he can be found near a door. Such persons cannot stand being on an airplane. In extreme cases the sight of a closed door can bring forth an attack of the phobia. The disorder can have harmful social and psychological implications as the patient will go out of his way to avoid situations in which he thinks he will undergo an attack. This often leads to isolation in society and can result in depression. So it is clear that for a sufferer the prospects of a normal life are bleak, to say the least. So what can one should do to alleviate the misery? When we are looking for indications of past studies on the subject, two important ones conducted at Vanderbilt University in USA and the Department of Psychology, University of Texas become most relevant. These studies “examined predictions derived from Reiss and McNallys (1985) expectancy model of fear behavior and Banduras (1988) self-efficacy theory.” In the first study, 138 persons were involved. When tested, they displayed “marked claustrophobic fears.” A series of scales were used “to measure Suffocation Concerns, Entrapment Concerns, and Coping Self-Efficacy.” In the second study 202 persons were involved. They too displayed marked claustrophobic fears as in the first case. In “confirmatory factor and reliability analyses showed that these scales reliably tapped relatively discrete constructs. Predictions derived from the Reiss and McNally expectancy model and Banduras self-efficacy theory were examined using behavioral, subjective, and physiological measures taken during a claustrophobic Behavioral Approach Test (BAT).” Coping Self-Efficacy accounted for unique variance in subjective fear and heart-rate reactivity, but did not produce significantly better classification of participants behavior beyond the expectancy model variable set. The expectancy model variable set meaningfully predicted behavioral approach, with the interaction between Expected Anxiety and Anxiety Sensitivity adding significantly to the classification beyond all other variables. These findings suggest that the expectancy model and self-efficacy theory provide meaningful and nonredundant accounts of phobic reactions.” (David P. Valentiner1, Michael J. Telch,2   Diana C. Petruzzi2 and Molly C. Bolte2) It goes without saying that the person who suffers from this singular ailment should have treatment. Since the fear occurs in the mind the problem is more subjective in nature. Under the circumstances one would come to the conclusion that treatment given should be more on the lines of psychotherapy than on the chemotherapy one. But the ironic thing about the matter is that there is no cure for Claustrophobia. Treatment of any kind can only alleviate the symptoms, bringing down the level of panic and anxiety. So once a claustrophobic, always a claustrophobic, to use the cliché somewhat differently. Now let us examine both sides of the coin. First, let us take the case of chemotherapy the usual form of treatment for most ailments. Some doctors do advocate it, but how successful are they in bringing about a reduction of the symptoms? Drugs commonly used to treat the syndrome are tranquilizers and anti depressants. Also used are antipsychotic agents, antimanic or mood-stabilizing agents, antidepressants, and antianxiety agents. To lessen the physical symptoms of anxiety such as a pounding heart, drugs known as beta-blockers are used. Some even go the lengths of treating with LSD to bring ready relief. In this context, Martin Roth explains the cause of Claustrophobia in another curious way. In his recent BMJ paper on Anxiety Neurosis and Phobic States (BMJ 1969 1: 489-492), he opines, “My submission is that if the evidence of patients under LSD describing what they themselves are convinced is the birth process is admissible evidence, the association between the sensations experienced in claustrophobic sufferers, and the sensations experienced by the fetus during the second stage of labor is a direct one.” (Lake, Frank). It would seem that one’s memories of one’s fetal stage are awakened under the influence of the drug thereby causing Claustrophobia in the person. Very curious indeed. Then there is another method that goes under the name of HBOT, in which the patient is placed in a chamber and the atmospheric pressure is gradually increased inside. The oxygen intake of the body is increased by a very large extent. As a result, the tissues are flooded with oxygen, thereby reversing low oxygen levels that cause lightheadedness and the feeling faintness. In another instance, it is stated that “There are no effective medications to eliminate simple fears. Certain medications can be used to temporarily reduce the anxiety, such as minor tranquilizers. However, these medications do not reduce the fear permanently, and people tend to become dependent on them in order to perform these tasks.” (Welcome to Behavioral Associates). But the facts remain that once the medication is discontinued the symptoms return, stronger than before. So that takes us to the other alternative, to psychotherapy. As mentioned before, the problem is psychological in nature and all the accompanying symptoms are its products. So the treatment should be ‘subjective’. And one cannot always cure an ailment by treating its symptoms and in this case at least, the drugs aforementioned do not. Dr.GraceTsai, in her scholarly article sheds light on this treatment which includes psychoanalytical, behavioral, cognitive, and cognitive-behavioral therapies. These come under the headline psychodynamic psychotherapy. These are more practically-oriented, individualized treatments for mental illnesses. In these the sessions are shorter with the focus on the present and the conscious. “The main objective of the therapist is to help the patient identify faulty adaptations and change these adaptations through repeated behavioral changes.” Cognitive therapy helps patients get rid of negative thoughts and emotions which help them a long way to overcome whatever phobia they suffer from. “Cognitive-behavioral therapy is exactly as it sounds. It is the combination of identifying negative thoughts and processes, as well as modifying negative feelings and behaviors.” Cognitive-behaviorists believe that what has been learned can be unlearned. The cognitive-behavioral therapist will be very specific about what the problems are and provide specific homework assignments for the patient to practice in order to overcome ways of thinking and behaving. Cognitive behaviorists treat mild depression, anxiety, eating disorders, specific phobias (e.g., claustrophobia) and sexual disorders (e.g., premature ejaculation). Besides individual therapy there is group therapy also. In individual therapy the patient meets with only the therapist while in group therapy the meeting is with a whole group with one or two therapists in attendace. Since group therapy focuses on interpersonal interactions, relationship problems are also addressed well in groups.  But the therapist chooses patients for group therapy, people who can benefit from this kind of treatment and those who may have a useful influence on other members in the group. Here patients talk about their individual cases openly. This in itself helps them identify the factors that make them patients. And when things are aired openly and symptoms discussed among themselves, there is a better understanding of the predicament they are in and find ways to escape from it. Fear of any kind is a mental state originating from specific experiences of an individual. All the research on claustrophobia point to the fact that medication is capable of only allowing temporary relief to the suffering individual. But alleviating the symptoms wouldn’t offer relief to the patient. Thus, medication doesn’t seem to be a feasible solution to the problem. On the other hand, psychotherapy, through an effective method to reach into and cure the roots of the problem also seem to be not ideal as it won’t provide immediate relief to the patient. The problem sterns from psychological fear and the aims of the treatment should be focused on removing the fear itself. Personal approach and individualized treatment can only help in treating this case. Additionally medication also becomes necessary for providing immediate relief to the suffering individual. Therefore it appears that a combination of psychotherapy and medication is the best suited method in the treatment of claustrophobia. Works Cited Lake, Frank. Birth Trauma, Claustrophobia and LSD Therapy. International Primal Association. (IPA). Retrieved April 18, 2007, from http://www.primals.org/articles/lake.html Welcome to Behavioral Associates. Retrieved April 18, 2007, from http://behavioralassociates.com/home.asp Read More