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JR, M.A.
JR, M.A., Mental Health Professional
Category: Mental Health
Satisfied Customers: 184
Experience:  I have a master's degree in clinical psychology and am currently finishing my doctoral degree.
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Since dabbling with some substances as a teen I am left with

Customer Question

Since dabbling with some substances as a teen I am left with a fear of the psychological/physiological effects of various medications. Illicit substances often induced palpitations and I now fear this happening when taking prescribed medications, particularly if I know tachycardia is a known side effect. Moreover, I have developed a fear of not being in control of my body and environment. This is manifest in a recently developed fear of the dentist and of flying.

I need to have a wisdom tooth extracted. I visited the dentist a couple of weeks ago for fillings & became anxious about the effects of the lignocaine used to numb my mouth. When it numbed my nose, making me feel as though I couldn't breathe, I soon began to panic and had to ask the dentist to stop. I did manage to calm myself slightly and allowed her to continue.

My dentist has recommended IV Midazolam sedation but I am afraid of feeling out of control with it. I feel silly because I am a Registered Mental Nurse!
Submitted: 8 years ago.
Category: Mental Health
Expert:  JR, M.A. replied 8 years ago.

It sounds like the CBT techniques have not worked because there is something deeper that you are not tapping into here. From my orientation, CBT is a last resort when other methods have failed. Phobias are essentially symbolic displacements of underlying conflict about deeper issues. Your fear of medicine and fear of fear is somehow preventing you from thinking about more painful emotions. I believe the best treatment for this type of problem is psychodynamic or psychoanalytic treatment. This form of treatment will help you to understand yourself better and may help you overcome your anxiety. Focusing on the symptom (i.e., CBT) is only modestly effective for long-term recovery. I was also trained in CBT and I find it to be less than effective in producing long-term and significant life change. Essentially, CBT is like giving your patient a band-aid and a pat on the head. Dynamic therapy will challenge you and make you face the emotions that you do not want to face. I suggest you seek dynamic therapy if you are ready and willing to face some of those really unpleasant emotions that your symptoms are distracting you from. I'm glad you had the opportunity to witness the futility of CBT. Hopefully, this will encourage you to seek psychodynamic treatment for this problem. Good luck with your treatment. I believe you could make a full recovery.

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