General Question

rexo's avatar

Where does one go when one wants to cure a phobia? a psychologist or a psychiatrist?

Asked by rexo (93points) August 23rd, 2009

i have social phobia, of eating out. i really need help. its interfering with my life. I can’t seem to eat anywhere, when someone is looking at me or with someone new or old friend or when im out.
has anyone has this problem before? whats the cure for it, what helped you over come it?

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38 Answers

YARNLADY's avatar

The difference between the two can be compared to a general practicioner, the psychologist, and a specialist, the psychiatrist. You usually start with the generalist, and if necessary, move on to the specialist. The psychologist can help you make that choice.

drdoombot's avatar

I have almost the same problem and it is a constant struggle. I managed to eat at a korean restaurant with my brother yesterday, but if it was someone else, I know I’d have been in trouble. But even eating out with my brother is an accomplishment and something that was more difficult for me a few years ago. Practice is the only way I’m aware of for getting over it.

I’m interested in hearing if other people have had similar trouble and how they’ve gotten over it.

rexo's avatar

its been a struggle for me when i was younger, but when you’re younger at least thats a good excuse and you eat small amounts. now i need to go out and start my life and find a job, where eventually i’ll be with other people, and need to socialize with them during lunch breaks and celebrations. But even thinking of it, i feel i need to flee, even if im not yet there. in college it was easy to say no to friends, ill just say i need to study thats why im skipping lunch. I badly need help.

MagsRags's avatar

I don’t know enough to give you advice on what kind of therapy might be helpful, but in the large medical group where I practice, psychologists, psychiatric nurse practitioners and psychiatric social workers do pretty much all the counseling/therapy. The psychiatrists generally don’t get involved unless the client needs psych medication management above and beyond simple antidepressants.

rexo's avatar

I wish I can receive more answers…

Icky's avatar

generally, psychologists figure out why you have a phobia; psychiatrists prescribe you a medicine for it

psychologists are not medical doctors, but psychiatrists are

ninjacolin's avatar

Medicine?! No way. The cure for phobias is exposure.

What you have to do is go out to eat for the purpose of curing yourself. go out to eat for intentional practice. Do not wait for the next random opportunity to go out to eat! You have to go out as a mission to improve yourself. Just like going to school. Call a friend and tell them what you’re dealing with and invite them to help you go out and get eating in public done! You’ll want to use different friends and sometimes more than just one friend.

Learn to eat sloppily in front of people as an extreme. Have fun with it. Laugh and keep going.

What you need is practice. Lots of practice. Practice and the creation of Great memories of successful public eating adventures will cure you.

rexo's avatar

Thats a good idea.
I’ve been house bound for a very very long time.
It means I need to tell the friend my certain problem. I don’t know if I can do that and confess to them my problem.

ninjacolin's avatar

you can do anything you want.
but be warned.. you will only do what you ultimately prefer.

ninjacolin's avatar

don’t think of it as such a big deal. it’s just a series of small steps, k?

so, tomorrow (or right now) instead of thinking about the whole big staircase, just think about each simple little step… and only 1 step at a time. It’s just like going to the store, you don’t have to see the whole path.. you just drive/walk down one street at a time and eventually your goal manifests itself. so..

Step 1: Pick up the phone. (easy as hell! think of nothing more.)

in fact, you may as well stop reading right now actually. when you’ve got the phone in hand then you can come read step 2. and so on and so on..

Step 2 is just thinking of a friend’s name and number. (that’s all)

Step 3 is simply dialing that number, one key at time.

Step 4 is reading this line: “Hey friends name. You’ve been a wonderful friend to me. I would be honored if you could make some time this week to grab a bite with me. I’ve come to realize that I simply haven’t had enough practice eating in public to date! While most others have had maybe 10 – 20 public eating sessions per month, i have been having maybe less than 1 per month! strange huh? So, you see, I want to increase the number of public eatings that I do per week. Can you help me? What day is good for you?”

Step 5: Is hearing them agree to it! Maybe you can even agree to simply eating at their house for starters.

So on and so on.. one step at a time.. you only ever have one thing to do. :)

and yes, you really can just read that out. you can write your own if you want, but why procrastinate? you can even tell them that you’re reading it. nothing matters, people just feel honored to be asked to be helpful!

rexo's avatar

I’ll try that too.. even reading your answer i’m hyperventalating

ninjacolin's avatar

the idea behind exposure and practice is that you gain experience. it’s like playing an RPG video game and gaining experience points.

in everything you do.. the first time will be shakey and hyperventalation-worthy. enjoy those moments while you can because as humans we tend to form habits where, with enough practice, you actually lose the ability to be so worried about it anymore.

first time you ride a bike you experience fear, bumps, scratches and potential broken limbs! the 500th time however, you’re jumping on the bike in a flash and taking off and doing cat walks. “practice makes perfect” isn’t just a cute line. it’s the way we function as humans.

change is abrasive. and change is the portal that takes you from who you are now to the new version of yourself.

rexo's avatar

I did, I did try to push myself out there. But I ended up having bad experience, and having more and more bad experiences. I keep on remembering those instances and experience that I have. When I go out with friends, who don’t know I’m really nervous about it, I always end up not being able to function well(eat). Now I’m running out of friends who have not seen me eat nervously. The memories are recurring and recurring now even when I eat alone because I remember that, or when I need to eat with someone

rexo's avatar

Sometimes I would say ‘No’ to an invitation, then a friend will get mad at me for not coming.
I want to go so much, and I don’t want to let down a friend.

There was also an instance when, a friend(a different friend) wanted me to accompany him to dine. then he commented by saying “oh eating, your favorite thing to do”
I was really sad he commented that to me.

ninjacolin's avatar

By the way, psychologists are great for this stuff. You should see one!

Yea, our memories are so important. Of course, if you only remember bad things about an activity it will taint your opinion and comfort with that activity. That’s why I was encouraging you to create and mentally dwell on new positive memories about dining out.

See, your friends simply have more experience than you. You have some catching up to do, that’s all. Yes, take every opportunity to dine with them.. but practice when those opportunities are not available. You just have to catch up to them in good memory associations with dining out. :)

When people make jokes like that, smile and be grateful that they are trying to use humor to help you. You seem to have a phobia of eating AND a phobia of dealing with the reality of the phobia. Your friends seem good at letting you know that it’s not a big deal to them. They accept you for who you are and obviously continue to invite you out!

ninjacolin's avatar

Watch movies about food and socializing. Learn how people interact with food. Read magazines about food and dining out. Learn about the art of dining atmospheres. Get into the architecture. There’s so much to appreciate about the whole experience. Learn why people like to dine out. Learn why people like to eat with others. Ask people, in person, what they like about dining out.

You’ve spent so much time dwelling on negatives. You need to now dwell on all the positives. Double time! :)

rexo's avatar

Actually when he commented that he was not joking, he was annoyed at me. I’ll try to accept it as if he was just joking, makes it less hurtful.

So its a psychologist then, not a psychiatrist? Will they be able to pin point the exact reason for it? Or will just prescribed a medication, thats a psychiatrist(as other people answered)? if its a medicine, I’m really curious how it will directly go towards those bad memories of eating out.

regardless, you really gave me alot of answers on how to overcome it, i really like your answer where i should focus on the positive of dining out. and ask people why they like to dine out with people.

ninjacolin's avatar


people get frustrated when they see a good thing going to waste. their annoyance is a sign of their desperation to enjoy themselves with you. :) you’re loved. and loved people are the ones who can really get under our skin. ;)

the “reason” why you don’t like dining out is a mixture of things:
– you believe you have “bad experiences” with the activity
– you may have some misunderstanding as to how humans relate to one another
– you are under-practiced with the activity of dining out
– you are under-practiced with the activity of socializing.

you may be under-educated on the matter of socializing as well. do you think this is the case?

ninjacolin's avatar

the only thing you can do about bad memories is over-shadow them with new positive memories. you will never forget what you’ve experienced, but you can drown them out with positive and more significant memories.

rexo's avatar

I really think its the bad experience that really made it worst. Not to mention, when I’m with people I eat with, I’m always being put down.
I think I have a good relationship with others. People find me friendly and good to talk with. Especially in class. But when it comes to eating with them, thats the time a flee. Makes me feel sad, because I know I had a good relationship with them before we had to eat.

ninjacolin's avatar

hmm.. what are they putting you down for? what are they picking on exactly?

What does a bad dining experience look like exactly? What goes wrong?

janbb's avatar

I would definitely go see a pshychologist. There are ones who are specially trained to work on phobias and have very effective methods for it. Don’t wait; it sounds like this is making you quite unhappy. If you are at college, maybe start by going to your school’s counselling and health center for a referral. I know in the Boston area there is a specialist who has pioneered work on phobias.

Quagmire's avatar

You see, I don’t understand, if you are fine sitting with 5 people talking, what’s different if they have a soda in their hand? If you can (no pun intended) deal with THAT, then what’s different if they also have a hot dog in their hand?

A Psychologist will start you out and diagnose what your problem is without medication.

I know someone who was uncomfortable with people seeing him eat, especially at buffets, because he was morbidly obese. For him, the solution was to lose weight.

marinelife's avatar

I think that you might find this site about social anxiety and social phobias helpful.

Good luck.

casheroo's avatar

I saw psychiatrist to get over my agoraphobia/social phobia. I went to the University of Pennsylvania, and saw a fantastic doctor. I picked U of Penn because of their reputation and because of being sick of my phobia holding me back in life, affecting my relationship and family.
It was basically exposure, forcing me into panic attacks, talking A LOT of things out…more in depth than any therapy I’ve ever had. Usually psychiatrists give out medicine, but I was pregnant and refused medication so they had to do intense therapy multiple times a week. It was expensive, because of the copay…but I have been medication free, and panic attack free since my treatment. I do still get anxious and sad, but I now recognize that these are normal feelings and can cope.

Judi's avatar

If you see a licensed therapist, be it a counselor, a psychologist, or a psychiatrist, they will probably be better than us at determining what course of treatment will work for you.
I know that there are medications. That practically cure OCD now, and they may have something that can take the edge off of a social anxiety.
Were all rooting for you. Help is available, you just need to reach out to the pros and do the work.

JLeslie's avatar

Seems like you need to figure out what really bothers you about eating out and then maybe you can deal with it. Are you afraid of people watching you eat? Can you have a coffee out with friends, its just specifically the act of eating that troubles you? A psychologist is talk therapy, a psychiatrist mostly is there to prescribe meds. If the psychologist feels you need medication she will recommend a doctor/psychiatrist. It is fine to see a psychiatrist right off the bat, but good to know they will be inclined to prescribe.

casheroo's avatar

I just want to say, people keep saying psychiatrist are for meds….but I find they are the best therapists to have. They do it all, you don’t have to bounce from one person to the next, so this one person gets to know all about you and how you react to medications as well. It’s much more personalized, and I wish I had gone to one sooner, rather than going to a large practice.

JLeslie's avatar

@casheroo Glad you wrote your last statement, I agree that psychiatrists can be one stop shopping, especially for phobia related needs, for other problems I might be less inclined to agree. I hope my statement did not come across like I was leaning away from seeing a psychiatrist, but I think the way I worded my response it might have seemed that way. The most important thing I think is to get treated by someone who has experience with phobias specifically. There is quite a bit of reserach on successes with phobia’s and you want to see someone who is familiar with the different forms of treatment,

wundayatta's avatar

Also, if therapy isn’t helpful, and you can’t do what @ninjacolin suggests, there are a lot of meds that can help. See a psychiatrist to get help. Social Phobia is a result of differences in brain chemistry. You can change your brain chemistry using techniques such as @ninjacolin suggests, but also with meds. You don’t have to do it all on your own. Meds are just another tool—usually much more efficient than psychotherapeutic tools. Although I think it is best to use both.

Judi's avatar

I was just thinking about this question and realized that with the current healthcare system in America, a person goes to their insurance company and sees whoever they allow them to see and gets the limited service they allow them to get.

YARNLADY's avatar

@Judi Insurance companies do not ‘allow’ the services. They only tell you what they will pay for, and you are free to pay for any additional services you want.

Judi's avatar

At $80—$150.00 per hour, I wouldn’t consider it a choice for most people, especially considering how much therapy will be required. Once a month won’t fix his problem.

YARNLADY's avatar

Many therapy providers will have a sliding scale for people with inadequate coverage. When I used the services of a counselor, she charged the regular fee, and then discounted two-thirds of it, and I only paid $25 per session. She got a tax write-off for the difference.

drdoombot's avatar

Being unemployed when my panic attacks started, I had no money to pay for a therapist. Thank god for Medicaid.

Buttonstc's avatar

Regardless of the formal title of whom you see, what you specifically want (and should request) is a behaviorist And most especially one who has experience treating phobias.

I didn’t have the exact same phobia as you but it was not any less crippling.

The primary treatment method used is called systematic desensitization. What this basically means is that it’s done in small baby steps starting with imagining various parts involved in your phobia. It then gradually over a period of weeks and months, progresses to the point where what you couldn’t even imagine as being possible gradually becomes doable.

Some of the steps involve what Ninjacolin was talking about but Very very gradually.

This is also combined with developing what is termed a relaxation response. The reason being that physical relaxation is incompatible with the feelings of stress and panic (as you described earlier at just thinking about being able to eat with someone else)

Logically, I realize that you probably think that it couldn’t possibly that simple and absolutely can’t picture yourself being ever free of this but it really is.

I felt the same way at the beginning so I know. But at the end of three months I was indeed doing the unimaginable.

If your finances are slim and you want to get a head start on things and shorten the time you need the aid of a therapist you can get a book called “The Relaxation Response” by Benson. Don’t just read it but start doing the exercises and begin training your body. It certainly doesn’t hurt in any way and the main drawback is the repetition if you get bored easily. But it will get you partway there because this is the part that doesn’t require a therapist to learn. Anybody who can read can do it.

You can also Google the term “systematic desensitization” and read about why this works.

I wish you the best in tackling this. I know it’s hard to imagine that you could ever comfortably sit down for a meal with someone but it is indeed within reach for you. You sound highly motivated to tackle this and that’s what you need to begin. It will not take as long as you probably think.

If you have any other specific questions about my experience feel free to PM me.

Good luck.

rexo's avatar

Im sorry I wasn’t able to reply sooner, especially to ninjacollin, who asked me a direct question. I was even delighted with the flow of our conversation regarding my problem.

Putting me down:
When I was a child, we will have family gatherings, or will have guests over. I remember already being anxious to eat with them. But like I said, it was more acceptable to act that way when you are a kid. Though I’ll always remember, when we have the small talks when we eat, I’m always put down by my parents. Because when people ask about your kids, and how are they in school, ofcoarse, they say all the accomplishment their children had. When it came to me, they’ll always say nothing. Or in a way, that less focus on my other child.

A bad experience would be not being able to swallow what i’m eating. before I would use my drinks to slide it down. But now, even drinking my drink its even hard to swallow that.

ninjacolin's avatar

wow, i wasn’t expecting that kind of symptom at all. not being able to swallow.. that’s some kind of reflexive issue. do you remember a time when you used to be able to eat with people without a problem? perhaps when you were younger?

be sure to let your doc know about this!

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