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You and Your Computer Can Fight Your Fears Together

By Mike Fillon
WebMD Health News

July 10, 2000 -- Are you unrealistically frightened of dogs? Or the dark ... or crowds? Have no fear: new research from Britain seems to point the way toward help ... and it's pointing -- and clicking -- right at your computer screen.

Isaac M. Marks, MRCPsych, a British psychiatrist renowned for his work with fears and phobias, says a computer-based program can help people with these problems. In fact, he says computer programs can help people overcome a variety of problems, from obsessive-compulsive behavior to anxiety disorders.

Marks, a professor of psychiatry at Bethlehem-Maudsley Hospital and the Institute of Psychiatry in London, presented in late June the results of his studies using a computer program named "Fearfighter" at the Federation of European Neuroscience Societies (FENS 2000) meeting in Brighton, England.

The American Psychiatric Association defines a phobia as an intense, unrealistic fear of an object, an event, or a feeling. Phobias can be a fear of nearly anything -- animals, driving, elevators, closed spaces, or even open spaces. Often, there is no explanation for the fear. Sometimes the person can readily identify a frightening event that triggered the phobia. However, experts don't know why some people who experience such an event develop a phobia and others do not. Many psychologists believe the cause lies in a combination of genetic predisposition mixed with environmental and social causes.

The National Mental Health Association estimates that phobias afflict at least 12% of all Americans. They are the most common psychiatric illness in women and the second most common in men over age 25.

When people with phobias are confronted by the thing they fear, they will often begin to breathe rapidly and experience a pounding heartbeat and sweaty palms. Phobic disorders are classified as part of the group of anxiety disorders, which includes panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder. Several drugs regulated by the FDA are now being used to treat phobias and other anxiety disorders.

Marx tells WebMD the personal computer-based Fearfighter system takes the user through the stages necessary to treat their phobia using behavioral principles, which teach sufferers slowly over time that there is no real danger from the thing that they fear.

"The nine steps to recovery can be completed over several weeks," says Marx. Initial sessions educate the user about the nature of anxiety, then the software gathers and stores information about patients and their particular problem, which it can use to graph their progress. Subsequent steps help the user identify triggers that produce the fear and create and assign "homework" tasks. Homework diaries are printed out with details of a "personalized exposure plan." Difficulties that may arise later in treatment are anticipated and dealt with in a troubleshooting section.

Marks says that when working with 60 people with phobias at the Self-Care Clinic in the Maudsley Hospital, the system saved clinicians up to 67% of their time without hindering their patients' improvement. Results suggested that if adjusted, the system could be used more easily by a wider range of phobias.

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