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Mental Health

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Name: Paul Grobstein
Username: pgrobste@brynmawr.edu
Subject: phobia view, my own and others
Date: Tue Apr 24 15:41:06 EDT 2001
Comments:
The current discussion paper is Daniel Burdick's suggestion, so I'll leave it to him to make give general thoughts. Yes, I have a phobia, for what its worth: snakes.

Some bio 202 student papers on the subject, for additional perspectives and links to other resources


Name: Daniel Burdick
Username: dburdick@brynmawr.edu
Subject: General comments
Date: Thu Apr 26 13:39:57 EDT 2001
Comments:
I've always been sort of fascinated by phobias, probably due to my own fears that I've dealth with most of my life. Most of these, as I learned in part from Kluger's article, aren't actual phobias, though I'm pretty sure a few were. Kluger touches on a couple of topics of interest to me. First is the question of the origin of fears. It seems clear that phobias result from a combination of genetics and/or experience, just like almost any other behavior. It also seems clear that many phobias seem to be unrelated to experience, leaving genetics as the only possible cause. In many cases, that's a perfectly plausible explanation; Kluger describes the evolutionary benefit of having innate fears. And with some fears, this is perfectly understandable -- a healthy fear of snakes or heights could go a long way towards helping you survive. What's interesting to me is the origin of fears that don't seem to have any evolutionary benefit. Why are some people afraid of clowns or electrical appliances or telephones? They're all basically innocuous. What's going on here? My second, and possibly larger, interest is in how we as a society view phobias. Kluger notes the "double dip of psychic pain" caused by the shame of having a phobia. This issue seems huge to me: in my personal experience, I'm almost more afraid to admit to having fears than I am of the things that cause the fears in the first place, and in my mental health volunteer work, I've seen a lot of people who face huge self-esteem issues caused by having phobias. In fact, this issue of self-esteem as triggered by a societal view relates to almost any mental illness. It seems that we've gone a long way in raising awareness about self-esteem issues related to physical appearance; is there any reason why we shouldn't also discount mental appearance as a determinant of self-image? That's not simply a rhetorical question. Perhaps there really is a reason that we as a society should revere those of a certain personality -- where would we be without "fearless leaders"? On the other hand, it seems much more likely that we would benefit from a society in which everyone is confident in him or herself. Part of it relates to the issue of control: most recognize that physical appearance can only be altered with radical steps, but I think many still feel that mental aspects can be controlled and modified to conform to some societal view, at least to a larger extent than they actually can be.
Name: Paul Grobstein
Username: pgrobste@brynmawr.edu
Subject: Phobias, re-viewed
Date: Sun May 6 11:11:21 EDT 2001
Comments:
Thanks to all for a productive/enjoyable discussion. Was good to have "personal experiences", and interesting to me to find that everyone (undergraduates, grad students, postbaccs, therapists) raised their hand when we asked "how many people have phobias themselves"?

Seems to me we developed a pretty strong consensus that phobias could probably originate either in genetic information or in experience. And that, regardless of origin, they could probably usefully be treated by both "talk therapy" and pharmacotherapy. And that, re Daniel's concerns above, that at least part of the phobia "problem" has a cultural component, a "making things worse" for individuals related to cultural norms/expectations. The "cultural issue" slant on mental health continues some conversation from our first meeting. Along those lines, there was a very interesting article in the NY Times magazine this Sunday: Regional Disturbances, documenting cultural variations in "mental illness" and considering why they occur.

Its probably my own interests at play, but I was particularly struck by the conversation comparing pharmacotherapy, "cognitive therapy", and psychoanalysis. From my perspective at least, all three, to the extent they are effective, must be affecting the brain ... but probably in different ways? Drugs, I think we agreed, may well lessen the feeling of anxiety, without necessarily (at least immediately) altering the source of the anxiety. "Cognitive therapy" may (?) help the conscious part of the brain (what I call the I-function) cope better with the feelings of anxiety, but again not alter the source of the anxiety (at least immediately). As noted, one can "understand" a phobia, but that doesn't make the "feeling" go away. This suggests perhaps that, as Freud originally conceived, the source of the anxiety is actually in the "unconscious" part of the brain ... and perhaps that psychoanalysis as a therapeutic technique is unique in directly targeting that part of the brain and the actual source of the anxiety?

More food for thought, at least (yes, it IS the issue of how the two parts of the brain, as characterized above, communicate that it, at the moment, on my mind, for a variety of reasons). Thanks again to everyone for contributing. Hope others took useful things from the conversation too ... and that, in future years, we can build on the foundation of this one.


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