Sage: Finding cause vs. treating symptoms

[Kim Parnell]

Sage: In your professional opinion and experience, how important is it to try to discover the underlying cause of this phobia during therapy? I understand that you knew why you developed this phobia, and that helped a great deal in your cure, but many people don’t. Myself included. How much time of therapy should be spent on trying to find the cause vs. fixing the problem? Do they have to go hand-in-hand? My therapist seems to be spending a lot of time trying to make me remember my childhood and I am getting impatient that we aren’t doing anything to make me feel better. I know I probably need to communicate my impatience with her.

Thanks so much for your help!

[sage]

Different therapists have different ways of operating. Sometimes getting at the root of problems, especially examining the family system (your childhood) is most enlightening (for both you AND your therapist). Having said that, I would wonder what difference it makes to the treatment. Actually, the treatment for phobia is pretty standard, regardless of the cause. So you might want to ask your therapist what his or her plans for treatment are, and if they will change depending on what caused your phobia. Discuss with the therapist your concern over the direction therapy is going, and ask their opinion on the method they're using. You have a right to know, and to actually take charge of your own treatment program. My therapist always used to say "you're in the driver's seat"...and so it should be.


Phobias are not caused by any one thing anyway. Several factors must be in place to add up to a phobia. Genetics is not enough. Trauma is not enough. Family process is not enough on its own. A lot has to do with chronic anxiety level in the whole family, including grandparents and aunts and uncles-systems. So in other words, even if someone vomited on you once when you were in hospital or if you vomited once and choked on something...you wouldn't necessarily develop a phobia because of it. There would have to be something else such as how your parents reacted to the incident, or even how they were reacting to other factors in the family at the time (deaths, conflict, divorce, etc.) It's complicated.


Short answer is...knowing the cause(s) helps a lot, because it helps overall with therapy. But the cure is the same - changing flawed thinking, learning to manage anxiety, gradual exposure to the stimulus, a good relationship with the therapist.


Hope this helps!