Button phobia treatment

Phobias (from the Greek word for fear, Phobos) are categorised as anxiety disorders. While anxiety is a normal response to the possibility of the existence of danger, its 'fight or flight' mechanism can also spiral out of proportion to a presenting, or even imagined, threat.

Simple or specific phobias (concerned with objects or situations) are often developed in childhood, and linked to negative experiences or learned responses. Complex ones (like agoraphobia and social anxiety) usually develop during adulthood.

Symptoms of phobia induced panic attacks

The distressing physical symptoms of phobic panic include:

• sweating
• shaking
• choking
• having difficulty breathing
• feeling pain in the chest
• a rapid heartbeat
• feeling sick
• feeling faint, confused, or disoriented

Fear of buttons: what are the signs?

Koumpounophobia (fear of buttons) is one of the more difficult specific phobias to understand or rationalise. It is believed that an exaggerated and debilitating reaction to being in the presence of buttons could be caused by:

• stress
• a harsh word or traumatic experience
• an aversion to germs
• fear of ingestion
• anxiety replacement
• learning from others
• a genetic disposition

It could be one or a combination of these factors, and a person may also suffer from several other phobias at the same time. There may be no understandable reason for a phobia to develop, but explanation or not, koumpounophobia affects around 75,000 people in the world today. The most famous of these was Steve Jobs, whose phobia has shaped our modern world. His aversion to buttons led to his invention of the button-free 'pro mouse' and the touch screen, two of Apple’s most remarkable successes. But most people are not in a position to change the world to accommodate them.

How to tackle button phobia

So what to do with a child who is faced with the imminent prospect of dressing to go to school? Or how to help a student moving up a grade that requires a uniform that involves buttons? What about adults who panic when they're too close to someone wearing buttons? There are several avenues to explore; the most recommended ones are:

• cognitive hypnotherapy (which involves modulating thought processes)
• exposure therapy with progressive desensitisation
• relaxation techniques, including hypnotherapy and mindfulness
• the neurolinguistic programming (NLP) fast phobia rewind technique
• medication for anxiety (anti-depressants, tranquillisers, beta-blockers)

Not included in this standard list, however, is eye movement desensitisation reprocessing (EMDR) therapy, an approach more than worth mentioning.

What is EMDR, and how can it help with Koumpounophobia?

EMDR is an evidence-based form of psychotherapy, based on research published by Francine Shapiro in 1989. Since 2004 it has been recommended as an effective treatment for trauma in the practice guidelines of The World Health Organisation (WHO), The International Society for Traumatic Stress Studies, The American Psychiatric Association, and, in the UK, by The National Institute for Health and Care Excellence (NICE). Although it was originally developed to treat adults, it is also now used to treat trauma PTSD and phobias in children and adolescents.

The goal of EMDR is to reduce the long-lasting effects of distressing memories and relieve presenting symptoms. The method utilises a specific eight-phase approach which includes having the client recall distressing images, while simultaneously receiving one of several types of bilateral sensory input. The bilateral stimulation could be side to side eye movements produced by following a finger, object, or light. The stimulation can also be produced by listening to a bilateral sound or experiencing bilateral touch (left and right knees or hands, for example, being alternatively tapped).

In brief, the eight phases, according to Francine Shapiro, are as follows;

• Phase one: History taking, identifying possible targets and developing a treatment plan.
• Phase two: Helping the client create a 'safe state or place' of calm, relaxation and self-control so they can handle emotional distress
• Phases three-six: Identifying and processing the target using EMDR procedures and bilateral stimulation
• Phase seven: Debrief and closure
• Phase eight: Examining progress and moving forward

There has been controversy as to how or why EMDR works. The prevalent view is that the process artificially creates a natural process that was interrupted, ineffectively processed, or perhaps has relegated a memory to the 'wrong' part of the brain. Since initial controlled studies were published in 1989, hundreds of case studies and several controlled outcome studies have been published.

Despite debates on how it is practised and questions about its efficacy, the results have often been astounding. Whereas CBT was primarily promoted for phobia treatment (using graduated exposure), EMDR serves to uncover traumatic connections, resolving the trauma and thus the resultant phobia. In one to five sessions, EMDR can make life-altering changes.

One could ask what would have happened in the IT world if Steve Jobs had sought EMDR help for his button phobia? For today’s children and adults alike, it is wondrous to know that they no longer need to be paralysed by the fear of objects or situations. Goodbye to button phobia, and goodbye to all phobias!