A panic attack ignited by a severe phobia has no equal in the realm of human fear. Being mentally and physically paralyzed in a split second, your involuntary functions – breathing, blinking, even thinking – are stunned into incapacitation. At the same moment, however, you know that you’re overreacting, that you’re making a fool of yourself, that you’re not at all in the kind of danger that would warrant such an extreme reaction. But reality is now relative, and none of that matters. You’re caged inside a horrific out-of-body experience that renders you simultaneously rational and irrational. And you have no idea why you’re triggered by something that most people around you are indifferent to; it’s just your phobia.

Of the 19 million Americans who have a phobia ranging from mild to severe, 1 in 5 will go through their lives accommodating the level of impairment described above. Only 1 in 10 people with phobias go on to receive treatment, and the rest avoid their triggers at all costs. What’s interesting is, there’s actually a therapy with an 80% to 90% success rate at curing phobias: exposure-driven desensitization. And yet, people with severe phobias aren’t inclined to avail themselves of it. Why? In tragic irony, that therapy is abject terror itself. So, how can these poor souls get started down the path toward better mental health? One way is to accept all-natural, legal assistance from the (redundantly named) beverage kava kava, which has been proven effective at enhancing exposure therapy.

What Is a Phobia?

As summarized by Johns Hopkins Medicine, a phobia is “an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity.” Citing the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), PsychCentral identifies the criteria for a phobia diagnosis:

  • You have a persistent fear that is excessive or unreasonable toward specific objects or situations.
  • Exposure to the object or situation causes immediate anxiety.
  • Your fear is greater than the actual threat.
  • You avoid the object or situation at all costs.
  • The phobia interferes with your daily functioning (routines, relationships, work, school, etc.).
  • The phobia has been present for at least six months.
  • The phobia is not due to another mental health disorder or medical condition.

Once diagnosed, a phobia is described as either specific or complex. Specific phobias center on a particular object, animal, situation or activity. The afflicted person might have an extreme fear of spiders, heights, dentist visits or blood, for instance. By contrast, a complex phobia is a deep-rooted fear associated with a particular situation or circumstance, and is typically more disabling than a specific phobia. The two most common of these are agoraphobia (fear of being unable to escape) and social phobia (fear of social situations). Given that both specific and complex phobias are treated with exposure therapy, this article doesn’t dwell on the distinctions.

A person afflicted with social phobia will avoid interacting (remotely or in person) with other people due to exaggerated concerns about doing something embarrassing, being watched and judged, or many other possible but improbable outcomes. Photo Credit: Sebastiaan ter Burg via Creative Commons by 4.0

A person afflicted with social phobia will avoid interacting (remotely or in person) with other people due to exaggerated concerns about doing something embarrassing, being watched and judged, or many other possible but improbable outcomes. Photo Credit: Sebastiaan ter Burg via Creative Commons by 4.0

Phobias can emerge during childhood, but they are usually first detected when someone is between the ages of 15 and 20. Some can be created by a traumatic event; others can be acquired as learned behavior from a parental figure who has a certain phobia. More often than not though, the cause is indiscernible. Moreover, as the Mayo Clinic observes, “Knowing the cause of a phobia is less important than focusing on how to treat the avoidance behavior that has developed over time.” If left untreated, the phobia can become more severe, ultimately interfering with the person’s day-to-day life, causing the person to associate intense feelings of dread with places or activities they once enjoyed, and inducing depression.

What Does Exposure Therapy Entail?

A patient undergoing exposure therapy is forced to confront and experience their fear at increasing intervals of time and intensity. For instance, someone with aerophobia (fear of flying) might begin therapy by looking at photos of aircraft cabins, gradually working toward an in-cabin experience via virtual reality. The objective is to desensitize the person to the phobia by breaking their pattern of fear and avoidance so that the phobia can’t be triggered anymore.

Exposure therapy sessions are led by a psychologist who gives the patient an environment in which they can safely be exposed to the objects, activities or situations that they fear and avoid. The exposure can be in vivo (e.g., using real snakes to treat someone with ophidiophobia), imaginal (i.e., having the patient conjure the fear in their mind), in virtuo (i.e., using virtual reality), or interoceptive (i.e., causing the physical sensations the person fears). Whatever the variation of exposure, its pacing can be tailored to the patient as well. (Click here to read the American Psychological Association’s explanation of pacing approaches.)

High Reward, High Risk

Even though exposure therapy is touted as the “gold standard for treating phobias” and has the aforementioned success rate of up to 90%, it’s an emotionally grueling procedure. In fact, it’s so intense that patients are trained in relaxation techniques (e.g., deep breathing, guided imagery) before they can begin their first session. In addition to equipping them for the training, this initiates the process of learning how to better manage responses, thoughts and feelings overall – the heart of exposure therapy.

Relaxation techniques are taught to patients before they begin the process of exposure therapy so that they can make it through the therapy. Photo by Natalie Bond /pexels.com

Relaxation techniques are taught to patients before they begin the process of exposure therapy so that they can make it through the therapy. Photo by Natalie Bond /pexels.com

But what if those techniques aren’t enough to get them through periods of sustained, maxed-out fear? After all, up to 27% of the people who start exposure therapy drop out, so something needs to give those people some extra help. Of course, there are drugs for that – three kinds in particular for exposure therapy, in fact: antidepressants, sedatives and beta blockers. However, given that phobias have a high comorbidity rate and often occur with substance abuse disorders and other anxiety and mood disorders, those drugs likely aren’t practical for many patients. What then?

Kava Kava to the Rescue!

Kava kava, like the three pharmaceuticals cited above, is used to reduce the anxiety and panic symptoms felt from thinking about or being exposed to the object of a person’s phobia. It can be imbibed before, during and/or after exposure therapy sessions.

Being a 100% plant-derived beverage and not a chemical concoction, kava kava has no evidence (as of June 14, 2023) of causing addiction or withdrawal. Also, unlike other herbal treatments, such as cannabis, kava kava can easily be obtained since it’s not a controlled substance in the United States. (Click here for comparisons of kava kava with cannabis and CBD, incidentally.) Thus, those who can’t use Valium, Prozac or other such options to endure exposure therapy have an alternative. And for people who struggle through life with a severe phobia, this can be a lifesaving alternative, at that.

Of all herbal medications that treat anxiety disorders, kava kava is the most widely studied. Consequently, much – albeit not all – is known about how to administer it effectively. Its anxiolytic and muscle-relaxing properties (kavalactones) are routinely packaged in over-the-counter capsules, but kava kava’s genuine form is the traditional beverage of the same name. This drink, originating in Polynesia, is prepared via the cold-water extraction of the ground organs of the plant Piper Methysticum. An article by Flavor Fix breaks down how this tea-like drink is prepared.

Kava kava is traditionally served in hollowed-out coconuts at bars that specialize in this drink. Photo via Creative Commons/Public Domain

Kava kava is traditionally served in hollowed-out coconuts at bars that specialize in this drink. Photo via Creative Commons/Public Domain

But First, Consult Your Physician!

A study proposing a plan for standardizing kava kava’s use in treating anxiety recommends consuming no more than 250 milligrams of it per day. This can be done for up to six weeks, according to the lowest maximum timeframe put forth by researchers. The risk of taking it beyond that is influenced by many factors, and is not a guaranteed outcome, but is quite serious: hepatoxicity (liver injury).

This should not be misinterpreted as a foregone conclusion though, as numerous other studies found no instance of serious side effects or liver damage. In those clinical trials, nausea, headaches and dermatitis were the most common side effects. Moreover, most of those ceased once the participant stopped consuming kava kava. And in other clinical trials, there was no mention of liver failure of any kind. So, although it’s certainly necessary for informed consent, the prospect of hepatoxicity ought not to be an instant deal-breaker for people cramming their lives into spaces free of their phobia triggers.

Another thing to be aware of is the lack of standardization in the kava kava industry. Like cannabis, kava kava is available in different preparations and strains. However, unlike cannabis, these aren’t tested and labeled with the precision needed for assured safe consumption. Consequently, it becomes harder for a person to gauge the right dosage or even the right manufacturer. Guidance can be provided by the psychologist running the exposure therapy.

Consult your physician prior to consuming any kava kava, whether it’s the original beverage or an over-the-counter substitute. Equally important, consult your physician prior to signing up for exposure therapy. Your medical doctor and your psychologist need to be in agreement on your proposed plan for phobia therapy, lest it have the opposite effect overall. You deserve to live free of the tyranny of phobias, but be a responsible rebel and take down your phobia armed with knowledge and the concurrence of those who know best.

Assuming your doctors are on board with it, let’s raise a kava kava coconut to toast a future free of irrational fear! Hear, hear!

Kathleen Hearons is a writer, editor, linguist and voice over actor from Los Angeles. She specializes in creative writing and research-intensive analysis and reporting.  





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