Phobias can develop any time – but they don't have to rule your life

I am on a beach watching a fish jump out of the sea. Then my mind wanders off somewhere deep in my subconscious. When it returns I am in Brazil and I can see butterflies.

Moments later, my eyes blink repeatedly as I am stirred from a deep state of relaxation by the clinical hypnotherapist and personal development coach Yvonne Morgan.

The session has lasted a matter of minutes but, in that time, Morgan has taken my overactive mind on a calming journey.

Relaxing me is the first step in a process of five one-hour sessions to help me conquer my fears of snakes and heights.

While I consider my fears rational - they are easily avoided - for others fear can transform into a full-blown phobia, an anxiety disorder that causes an overwhelming need to avoid all contact with the source of the phobia.

This is the reality for the 11-year-old Joe Thompson, whose story has gripped the UAE over the past few weeks.

Joe's family has moved back to the UK after living in the UAE for several years, but Joe and his father Tony, a quality manager at a private hospital, have yet to join them because the youngster has developed a debilitating fear of flying.

Despite travelling long-haul regularly in his short life, Joe and his family have no idea why his phobia suddenly developed in March. Repeated attempts since then to board a plane have failed despite help from therapists and the use of sedatives.

His father describes Joe's reaction as "like the flick of a switch". One moment he is fine but the moment they enter the terminal his breathing changes and he starts to cry and get anxious.

Joe told The National last month: "I feel terrified. I don't know what to do. I just can't do it."

Indications of phobias include a feeling of panic or dread and physical symptoms such as shaking, sweating, a rapid heart rate, breathing difficulties and nausea.

But what causes a phobia is more difficult to define.

"There are a variety of reasons," says Morgan. "The patient may have had a sensitising event, so they might have had a dreadful long-distance flight or bad turbulence. While most people will just think it was an awful flight and forget about it, for others it's almost as if the memory gets lodged by the unconscious mind as a warning.

"The unconscious mind will then be on the lookout for any other situation or experience that could match that experience. It goes into red alert."

Phobias can also arise if relatives have fears that the sufferer effectively inherits.

"Immediate family members of people with phobias are about three times more likely to also suffer from a phobia than those who do not have such a family history," says Dr Raymond Hamden, a clinical and forensic psychologist at the Human Relations Institute in Dubai. He says phobias account for 20 per cent of the cases his clinic treats. "People whose parents either were overly protective or were distant in raising them may be at more risk of developing phobias."

Dr Hamden says there are three types of phobia: social phobia, such as a fear of public speaking, meeting new people or other social situations; agoraphobia, a fear of being outside; and specific phobias, such as a fear of particular items or situations.

Morgan says the most common phobias she deals with at her Dubai office are a fear of giving presentations, fear of the dentist, fear of getting ill and a fear of flying.

While they are all potentially avoidable, people living in the UAE will struggle to avoid flying, which is why Joe and his father are now staying here while Joe's anxieties are treated.

While there were plans to drive overland to the UK, these were shelved this week after Joe's fears extended to all forms of travel.

But the youngster is not alone.

For even frequent flyers can fall victim, such as Bobby Singh, 30, a Dubai resident who flew up to eight times a week for his job running an executive search business.

"I had responsibility for offices in Kuwait, Bahrain, Qatar and Oman, so I would start flying on a Sunday morning and return on a Thursday afternoon.

"I was flying so much that I became paranoid and stopped enjoying it. I'd panic, thinking, 'What if, what if, what if?' So I turned up to work one day and said: 'I'm not doing it anymore'."

While Singh struggles to understand why he developed his phobia, Morgan explains that a sudden fear might not be as random as it seems.

"There will always be an underlying anxiety that might manifest itself as a fear of flying but could easily manifest itself as a fear of anything else," she explains.

"A patient I'm seeing at the moment had a panic attack driving back from Abu Dhabi to Dubai. Prior to that he had the same kind of experience on a flight. What often happens if you have a panic attack on a flight or on a motorway is that you will automatically attribute it to that situation but it could be random. That panic attack could have happened at the same time on the same day [while the patient was] doing something else.

"People are always looking for an explanation and, instead of stepping back and thinking 'I am very stressed at the moment', they wonder what is going on."

Singh certainly understands that the stressful life he was living before the onset of his phobia could have been a factor.

"Maybe it wasn't the actual flight but the whole process - working too many hours, flying so much and being away from home - but my mind blamed it on the physical process of the flight."

Singh avoided dealing with his fear for almost three years, partly because the onset coincided with the global economic crisis and the closure of regional offices.

But after the British company boss and his wife booked a flight home for a wedding in December, he panicked and struggled to sleep as the flight loomed nearer and nearer.

After a friend recommended trying a hypnotherapist, he contacted Morgan, paying Dh400 a session for five sessions.

Morgan uses a variety of techniques, drawing on classic hypnotherapy, which allows the unconscious mind to respond to positive suggestion; neurolinguistic programming, which offers tools to help patients redesign their thinking; and cognitive behavioural therapy, a psychotherapeutic approach that uses exercises to help patients understand the thoughts and feelings that influence behaviour.

"We get people relaxed and find out what's going on in their life that could be contributing to any residual anxiety. This can be stress at work, at home or even something as simple as not enough sleep or an imbalance in their diet such as too much caffeine or sugar, and those are easy for people to start modifying," says Morgan.

"For any kind of fear or phobia to be activated, there needs to be an existing stress and, of course, the unconscious mind - which is the place where phobias are held, if you like - won't respond to any kind of change work until it realises you are relaxed."

Once Morgan has established what the fear is, she uses visualisation and rewind techniques to help patients think about the experience more positively.

"If I had a client with a fear of heights who was wanting to go up the Burj Khalifa, then I'd get them to imagine having come down, having taken lots of pictures and feeling comfortable, knowing that they are here quite safe in my office."

By working backwards through the experience while the person is completely relaxed, it effectively scrambles a person's memory of an experience or event and minimises the impact.

"It's all about diffusing the anxiety and changing the template and normalising something," Morgan adds.

The process certainly worked for Singh, who says his flight back to the UK was absolutely fine.

"I'd happily go and jump on a flight now. I've flown frequently since and would say I am cured."

At the Human Relations Institute, Dr Hamden also uses cognitive behavioural therapy, but says those who don't respond to traditional psychological techniques can receive medication from a doctor. Treatments include antidepressants and tranquillisers.

Then there's a more controversial self-help method favoured by some: facing your fear head on. While a qualified therapist is unlikely to recommend such extreme treatment (many believe it can only heighten levels of anxiety), for Abed Rafiq, 26, a public relations manager, the best way to treat his fear of heights was to go skydiving.

"It was a spur of the moment thing," he explains. "I saw the ad and thought, 'This might just work'. I've always had a fear of heights. I remember about 12 years ago I went to an old castle in Syria. I climbed the tower and when I came out there was no ledge at the top. I was so terrified I couldn't even get my head out of the staircase; I froze up, could feel my stomach churning and felt dizzy.

"I wouldn't say my fear was inhibiting my life but it had reached a point where I couldn't take it anymore and needed to fix it."

On the day of his tandem skydive jump, in May 2010, Syrian Rafiq forced himself to go through with it, fighting his anxiety at every stage.

"I was frozen and couldn't jump so the guy tied to me had to push me out of the plane.

"Ten seconds later it hit me that I was literally falling. The ground was coming closer and my brain started freaking me out and then I thought, 'This actually isn't too bad'.

"Landing was one of the best feelings of my life. Something in me had changed."

Since then he has done three more jumps and now wants to get his skydiving licence.

However, Rafiq would not describe himself as 100 per cent cured.

"If I stand too close to the edge of a ledge I'd probably get dizzy, but it's not as bad as it used to be. I also have a fear of spiders. It's nothing chronic but I'm not going to have an up-close and personal session with a spider any time soon."

arayer@thenational.ae

Common phobias

Ablutophobia Fear of washing or bathing

Achluophobia Fear of -darkness

Acousticophobia Fear of noise

Aichmophobia Fear of -needles or pointed objects

Chiraptophobia Fear of -being touched

Chrometophobia Fear of money

Dentophobia Fear of the dentist

Hypsiphobia Fear of heights

Nosophobia Fear of -becoming ill

Tachophobia Fear of speed

Xenophobia Fear of -strangers or foreigners

Zoophobia Fear of animals