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  • If the state is beyond self-help, then much can be done by consultation with a competent family doctor with experience in these matters and some appreciation of modern relaxants and anti depressants.

  • If self management is ineffective, and the problem seems very complicated, then specialist medical help should be sought. The most effective course is likely to be intensive psychotherapy aided by medication. But a number of sessions are usually necessary in order to liberate hidden conflicts.

  • Behaviour therapy also has many advocates. An important part of it and one that is a matter of much argument is that those who practise it deny the existence of the unconscious, and deal with symptoms as they show themselves without delving further into a person's personality. One method used by behaviourists is desensitization, in which, by getting the sufferer to imaging a feared situation or by introducing him or her to what is feared, the anxiety is lessened by degrees. For example, if a person has a phobia about spiders, this could be tackled by first producing tiny paper spiders, gradually working up to real spiders. Another type of therapy is aversion treatment in which the symptom becomes related in the person's mind to something unpleasant e.g., in someone who drinks too much, when the urge for a drink comes, it would be accompanied by a mild electric sock. Flooding is also used by behaviourists; the individual is directed to submerge himself in his anxiety until he or she, as it were, uses it all up.

  • There are numerous medical preparations that can help. Propranolol is especially useful where there is involvement of the heart and arteries. The benzodiazepines are the tricyclic preparations if there is also depression.

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