Something To Be Sneezed At

A worrying report on the use of a nasal spray to treat severe phobias appeared in the media last week.  Dr. Adam Guastella, a psychology researcher at the University of New South Wales, Australia, claims that a combination of two chemicals – oxytocin (a naturally occurring hormone) and an antibiotic called D-cycloserine (DCS) can ‘greatly’ enhance treatments for phobias.  It is important to closely read what the Doctor says, because he is not claiming that these drugs administered by a nasal spray can ‘cure’ phobias, but that combined with behavioural treatments, they make some difference.  The difference they make is questionable, because in one study using the drugs combined with exposure therapy for individuals (he calls them patients) suffering from chronic shyness, the group who got the drug showed a ‘reduction’ in fear compared to those who got a placebo drug (no chemical qualities) and the exposure therapy.  What precisely the reduction was in not made clear.  However, it is no surprise that the administration of the two drugs made a difference.  After all, for years some individuals who are shy and uncertain have used alcohol as a confidence booster.  The difficulties with using any substance – whether alcohol or tranquilizers or the drug combination suggested by Dr. Guastella – are that a tolerance effect builds up so that a higher dosage is required and, even more alarmingly, a dependence on the substance emerges.  There is the added factor of serious side-effects of which no mention is made.  What is astounding is that following questionable results Dr. Guastella is now researching a new use for his concoction to help couples repair relationships that have deteriorated.  It is hard to believe that such a claim can be made for such a complex situation as a troubled couple relationship.

The worry is if Dr. Guastella finds a drug company to market his drug we could be looking at a massive take-up of this so-called ‘new wonder drug.’  Given that a majority of people dread public speaking (social phobia) and thirty to fifty per cent of relationships are seriously troubled, the use of nasal sprayers could become epidemic!  We have had such huge prescription of such ‘wonder’ drugs as Valium and Prozac and Ritalin for children – the psychological and physical fallout from such prescriptions is well documented.

Dr. Guastella describes phobias of heights, spiders, flying, people, public speaking, open spaces, closed spaces as problems.  He sees these conditions as crippling and in need of ‘curing.’  But the question not being asked is why some people develop phobias and others don’t?  After all, babies do not come out of the womb having a range of phobias.  Furthermore, how is it that some ninety per cent of people dread public speaking?  Rather than seeing phobias as conditions, it is wise to see them as creations, necessary defensive strategies developed in order to offset hurt, rejection, humiliation and demeaning of one’s presence.  The fear of public speaking is a creative response to having been put down as a child or compared or seen as a failure.  The cleverness is ‘if I don’t do it, then I can’t fail; if I don’t fail, then I can’t be humiliated.’

It is also the case that phobias are masking deeper conflictual issues that dare not be spoken about.  For example, the phobia of spiders (arachnophobia), which exist in dark corners, may symbolically represent the ‘dark (abusive) things’ that dare not be voiced.  The fear of spiders allows some ‘spilling of the beans’ without threat from those who are feared.  A phobia of flying may symbolically mask a fear of ‘flying off the handle’ (dare not express anger) or a fear of being spontaneous (having to stay in control and on guard all the time).  Human behaviour is both creative and complex.  The attempt to eliminate phobias either by drugs or behavioural methods or a combination of the two misses the intelligence, protective and, often, symbolic nature of the fearful responses.

 It is not then a drug that is needed to resolve a phobia, but a safe relationship that allows the person who is phobic to explore his fear, understand its origins and its creative purpose and to realise the need to become independent of what others think of him.  What underlies many phobias is the addiction to what other people think, borne out of the experience of how hurtful other people’s behaviour can be.  The challenge is to come to the adult place of self-reliance and independence of what others think, say or do.  In the heel of the hunt, it is what you feel about, think about and do for self that counts.  No drug can teach you self-reliance and if you do resort to taking it, it weakens the very thing you need to establish – independence.

Dr. Tony Humphreys is a clinical psychologist and author of Whose Life Are You Living.