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[Music]
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thank you
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[Music]
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phobia is an irrational fear about an
00:00:32
object the objects can vary considerably
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and generally the anxiety generating
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someone makes them so frightened that
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they avoid that object as much as they
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can so it can impact upon people's lives
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in great many ways stopping them going
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out stopping them going to certain
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places someone stopping them going near
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certain things
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day to day like when I'm working is not
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too bad
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it's uh when I go out more than anything
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because when I go to work I go outside
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the door in a car to work inside the
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door I'm fine
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it's pleasure time
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or shopping things like that that is
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difficult to do on my own Rita had a
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severe phobia of birds she couldn't go
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out into the gardens she couldn't look
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at Birds she was constantly Vigilant of
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them looking for them anticipating them
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being around and she would avoid any
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places that she thought Birds might be
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I've I've gone on holiday and I've sat
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on the beach in a tent
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because I just cannot I can't I can't
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have them near me
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hate it I'd like to be able to do what
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other people do be able to get in their
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car go to the town and Shop
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without that worry yeah I would like to
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do that a treatment for phobias
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generally concentrates on helping people
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come to terms with their anxiety
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challenge that anxiety challenge the
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irrationality of that anxiety so that
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the anxiety reduces and they can deal
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with the feared object
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does
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knowing that birds exist out there
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does that alter your lifestyle in any
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way well
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if this was a road and there was a bird
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over there I won't go down there at all
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I'd rather backtrack and
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try and find another route round
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so you would avoid going there I would
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avoid it right yeah okay
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if you come across a bird
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unexpectedly or you can't avoid it
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what will you feel
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I wouldn't be I
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if I was out yeah
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I get terrible palpitations
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feel sick yeah sweat
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and if my husband if my husband's there
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I mean
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I feel that he's my only
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a way around the problem I hide
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anything
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I find being
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outside
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unacceptable
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do you know what that is
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well
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um the the only thing I can put it down
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to was when I was a child my father I
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mean he loved birds all animals in fact
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and but he had his pet
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Jack door
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and here
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seems to take
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a great Delight if this
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well I don't think these birds really
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particularly liked me and it used to
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pack my ankles and
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let's go back to something you said
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earlier you said because you said half
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said a sentence and I wasn't quite sure
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what you were saying
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he talked about your father having this
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pet Jack door
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and you said he seemed to have to have
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great Delight and I wasn't sure well
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because great Delight or your father no
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he I see I think my father thought that
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it was
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um silly somebody being afraid of a bird
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you know because he liked them right why
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should somebody that
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like myself
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be frightened of a bird you know
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so he he thought it was silly what would
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that make him do or what well I think
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he'd make him for sure doing it more
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right so he used to send a bird after
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you really yeah chase you or to pick you
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or whatever
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and what would his response be
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to your response to the bird doing this
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to you
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well
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I don't know whether he thought well the
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more he did that I might accept it more
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or
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or whatever but but was it a bit of a
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laughter yeah it was fun it was fun so
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fun at your expense yes but actually you
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were really quite frightened yes and
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uncomfortable yes right
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I can't have been very easy no I haven't
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because that was every time I was
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indoors
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how old were you
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when the Jack door was alive
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how about
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I suppose up to about the age of 10 11.
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you
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looking a bit distressed I am yeah
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yeah it's all right
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foreign
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tearful and distressed upset
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well because it's a sick I'm a person
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that lies to be in control
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to be uncontrollable
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I don't find
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well
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seems silly really doesn't it
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you've used that word silly a lot well
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because other people keep saying it's
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silly
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you know well I think but I don't really
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find it is at all yeah I guess people
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say it's silly because they don't
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understand
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but clearly you're frightened
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I I think there are things that we can
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do to help you with your bird phobia
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but we need to come back and meet again
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another time to discuss what that will
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be and what that will entail and to talk
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to you about how you feel about that
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okay because I'll explain a little bit
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more what that will entail
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um and
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if you're then happy to do that we we
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can proceed from there okay but we'd
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really need to meet again to do that
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would you be happy to do that yeah okay
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well we'll arrange another appointment
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and uh I'll see you then okay okay
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uh treatment for phobias generally
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concentrates on helping people come to
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terms with their anxiety challenge that
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anxiety challenge the irrationality of
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that anxiety so that the anxiety reduces
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and they can deal with the feared object
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you said you'd had nightmares
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yeah and I've been dreaming about all
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the time same dream or no right no just
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on my mind all right
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have you been they've been more on your
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mind during the day as well
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in what way what how will they have come
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to mind
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how have you thought about them well I
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got the nearest I did to a bird
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yesterday then and that was
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it was done
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I told you I was in my garage and
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sorting things out that came out the
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carriage and we've got this patio wall
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and I was walking past that wall and at
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the end of it there was this
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dove
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all right Bang there
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bubbles up a tree
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I'm screaming showering
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and um
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well it did Fly Away
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a nice Valley nearest how difficult to a
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bird
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how are you feeling right now as you're
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telling me stressed stress what do you
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mean by that well I'm shaking I'm
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shaking
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what do you feel inside
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Tara I just feel frightened okay
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and on a scale of one to ten
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how frightened would you say you fell
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you're 10 out of 10. right now even just
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talking about it okay
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what physiological physical
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um symptoms do you feel do you can you
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feel your heart your blood tensing your
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heart's racing what else tell me what
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else you can well I'm tensing out
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and
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well
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I'm shaking
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what's happening to your breathing well
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it's getting shallow right
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okay because that's something I want to
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concentrate on today relaxation can play
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an important part in the treating of
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phobias because relaxation is aimed at
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helping someone reduce their autonomic
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arousal so reducing the physiological
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response so that they feel more in
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control of their body which means
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they're more likely to feel that they
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can more in control of the situation
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okay I want you to just concentrate on
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your breathing
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take your mind and focus on your
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breathing
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and breathe in
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and breathe out
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in a calm
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rhythmic
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train I find it very difficult to relax
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yeah
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I don't often yeah
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so it would be quite good for you to
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learn this in any case
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foreign
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[Music]
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sometimes again it helps to have your
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your eyes shut but in your mind try and
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take yourself to
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favorite place
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favorite
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situation could be anywhere it might be
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a beach it might be a
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indoors it might be outdoors
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but take yourself your mind to a place
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that you know you're happy
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feel relaxed
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a place you enjoy
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now in your mind go there
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try and imagine you're there
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notice the things about the situation
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the place
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that makes it enjoyable
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a patient's motivation is significant in
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the efficiency of treatment Rita was
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extremely determined to overcome this
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and this went a great a long way to
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helping her speed through the process
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notice how
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bodies relaxed
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and calm
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people have phobias for a number of
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different reasons in Rita's case I think
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there were specific triggers and
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specific causes that go back some way
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into her past
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once these have been identified it was
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easy or easier to work with her on these
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particular issues
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but these were issues she didn't
00:13:25
particularly want to talk about on
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camera
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let me check would you go out into the
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garden normally would you go beyond the
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patio doors normally no not too far I
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used to sit just outside the patio door
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right
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and you went beyond that I went beyond
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that and sat right which roughly how far
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beyond
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um oh about
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20 feet 20 feet so quite some way away
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from the passenger door yeah yeah right
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and that's not what you'd normally do no
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not to sit right no I might wandered
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around there might you yes but not to
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sit no
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what do you think enabled you to do that
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well I thought I'm I've got a
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conqueror
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parts of
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this and try
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so I thought I'd see how I'd get on
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if I show you a picture of a bird
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will you just look at it
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and tell me what it makes you feel and
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think
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okay now I want you to just remind
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yourself this is just a picture
00:14:51
that you're in control
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learn to breathe and calm yourself
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okay so try and relax yourself before we
00:15:00
do this
00:15:07
can you see that
00:15:09
yeah
00:15:13
how do you feel when you see that
00:15:17
I'm all right so I know it's over there
00:15:18
okay
00:15:20
I can breathe take control of your
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breathing
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try and relax yourself
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take the eyes off it now
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okay I'm quite relaxed now okay
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okay could you take me
00:15:42
yeah
00:15:43
calendar okay what is it a swallow
00:15:50
sure actually
00:15:52
it is is it
00:15:55
flying across water very low level
00:16:07
all right how's it feel now
00:16:10
I feel right if you touch that picture
00:16:13
yes I could try
00:16:22
initially when I got the picture out
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you sort of sat back a bit and said okay
00:16:29
whilst it was over there and you've gone
00:16:31
from there to
00:16:33
to holding it to touching the picture
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you've gone from worrying about a
00:16:39
picture you didn't know what it was
00:16:41
going to be like just seeing it a
00:16:43
distance to holding the the calendar to
00:16:48
actually
00:16:49
whoops touching the um the picture
00:16:54
yeah generally the confrontation is seen
00:16:57
as being the
00:16:58
um the major component nowadays what one
00:17:02
is doing is exposing the patient to the
00:17:04
anxiety that will arouse the anxiety the
00:17:07
relaxation and other techniques are
00:17:09
there to help the patient manage that
00:17:13
anxiety in in a better way
00:17:15
the speed at which the patient
00:17:18
progresses through the exposure the
00:17:22
confrontation depends to some extent on
00:17:25
the severity the complexity of the the
00:17:29
patient's difficulties and I guess might
00:17:32
vary from practitioners to practitioners
00:17:39
this is no different from the others no
00:17:43
but it looks more
00:18:01
hold on
00:18:11
foreign
00:18:25
patients come along already on
00:18:28
medication either prescribed by GP or by
00:18:30
their psychiatrist this is often where
00:18:34
the anxiety is so significant that they
00:18:36
need something to to begin to calm them
00:18:38
down in the first place gradually as the
00:18:40
treatment program might develop we would
00:18:43
look to try and reduce the need Reliance
00:18:47
on medication and generally that's
00:18:50
without significant effect
00:18:58
just stand here
00:19:01
but we're just going to go outside okay
00:19:05
this is something that you do at home
00:19:07
you've been doing during the past week
00:19:09
okay so let's
00:19:13
it's nothing new to you
00:19:15
so we're just going to go outside and
00:19:17
just get used to being outside of this
00:19:19
building okay
00:19:20
[Applause]
00:19:23
okay
00:19:32
deep breaths
00:19:42
how high did that go up how about four
00:19:48
good
00:20:07
and just gradually stand back as far as
00:20:10
you feel comfortable and safe make sure
00:20:13
you're relaxed
00:20:16
keep on top of your breathing remind
00:20:18
yourself
00:20:19
they're not going to harm you that
00:20:21
you're in control and do all of the
00:20:23
other things that we've been we've been
00:20:24
through
00:20:25
and then slowly just just perhaps a yard
00:20:28
at a time move a yard forward stop
00:20:32
compose yourself
00:20:36
and then use another yard okay so you
00:20:39
just gradually expose yourself to the
00:20:42
birds because that way you'll find and
00:20:45
you'll prove to yourself that in fact
00:20:47
they always fly away
00:20:49
down to the past as well hey
00:20:54
we'll leave it for this week let's do
00:20:56
that for him okay do you want to throw
00:20:58
those to the birds
00:21:00
so
00:21:16
so
00:21:18
um it's a big moment now what's been
00:21:20
going through your mind
00:21:23
oh I've tried to prepare myself
00:21:27
for this moment so I've been doing some
00:21:30
breathing exercises
00:21:32
and
00:21:33
I am quite looking forward to it
00:21:44
now these feathers all right you want to
00:21:48
get on the floor but you can't get on
00:21:49
the floor tom these feathers are very
00:21:51
fluffy feathers they're not like
00:21:53
feathers like especially some of the
00:21:55
things like the Jack doors and the crows
00:21:57
they got quite harsh over something on
00:21:58
them so good
00:22:01
take your time
00:22:04
if you want a chair over here we'll
00:22:05
bring a chair no okay you have a little
00:22:08
feeling there are these feathers don't
00:22:10
feel like ordinary feathers they're very
00:22:11
silky soft feathers well done I haven't
00:22:14
touched it yet
00:22:16
well done well done
00:22:21
see they move their head so fast don't
00:22:23
they she's a very friendly self this one
00:22:25
she's an old lady well done you don't
00:22:27
get out of the world brilliant brilliant
00:22:29
yeah but their heads move so fast
00:22:35
she can't flap she can open her wings
00:22:37
because I'm holding him still if you
00:22:39
want to stand to stand next to me so
00:22:40
how's the best way
00:22:42
because you can't open the wings but
00:22:44
I'll be here all right
00:22:46
just stand next to me like this and I
00:22:48
won't pass over for a minute just to get
00:22:50
used to standing next to me
00:22:53
well done
00:22:57
I am quite nervous doing this but I'm
00:23:00
here with you all the time
00:23:02
that is great absolutely brilliant
00:23:05
you're doing so well very very good
00:23:08
how's that feel in your hands now
00:23:11
let go okay love you because I'm going
00:23:15
to do it on my uh I am going to do it so
00:23:18
well very good he's well done absolutely
00:23:20
brilliant
00:23:24
yeah they're absolutely brilliant so so
00:23:27
good okay love you
00:23:30
well done with excellent
00:23:32
[Music]
00:23:35
just take your time just carry on
00:23:37
stroking first rather than try and pick
00:23:38
him up just a stroke that stroke his two
00:23:40
that's great well done that's it great
00:23:43
now he wants to step up on your finger
00:23:45
that's why now keep your finger low down
00:23:47
so he doesn't like that should I hold
00:23:49
your hand with you yeah please okay is
00:23:52
that all right yeah okay fine that's it
00:23:54
puppy go snowy come on Snowy snow is
00:23:56
this way darling pass it up go that's it
00:23:58
Well Done Rita look at that cranky
00:24:02
tradition assistant looking at her
00:24:03
wonderful
00:24:05
how do you feel about
00:24:07
that
00:24:07
in Rita's case we were very fortunate to
00:24:10
be able to have her handle such
00:24:13
magnificent Birds normally we wouldn't
00:24:15
be in a position to do that but seeing
00:24:19
the turnaround in Rita from someone who
00:24:21
wouldn't walk outside her
00:24:23
um into her back Garden wouldn't go on
00:24:25
holiday to be able to stroke and indeed
00:24:28
enjoy Birds was a tremendous boost
00:24:32
that's the pleasure part of the pleasure
00:24:34
that one gets from that
00:24:38
foreign
00:24:40
[Music]
00:24:57
[Music]
00:25:06
it's really the best thing that ever
00:25:09
happened to me it really is
00:25:11
foreign
00:25:16
[Music]
