Spooked

--Clive Barker

The Eskimo may or may not have 49 words for snow, but there's no disputing that the English language contains an ungodly number of words for fear. Our anxiety takes a thousand forms, from the ceaseless churn of worry to the five-alarm pandemonium of panic. We fret, we freak, we flip. We are traumatized by our terrors and terrified of our traumas.

The events of the past six weeks have illuminated the spooky no man's land of dread in ways we never could have imagined. The naked, screaming terror of Sept. 11, followed by the sinister bubbling of anthrax hysteria, have together shown us that despite our wealth, our power and our technology, we remain prisoners of our own fright.

This Halloween, we decided to take a closer look at the phenomenon of fear. Perhaps our most important discovery is that, down the millennia, fear has actually been useful--critical, in fact--to our survival. "It's as vital to us as oxygen," says Dr. Vijay Shankar, a local psychologist who specializes in anxiety disorders.

Without fear, we would constantly find ourselves plunging headlong into ravines, sticking out our tongues at saber-toothed tigers, flipping off state highway patrolmen and generally indulging in activities unlikely to propagate the species. Fear is nature's way of rescuing us from that other defining human trait--stupidity.

Like all biological mechanisms, however, fear has a distressing tendency to go wrong. Sometimes it rearranges our neural pathways, as in trauma. Sometimes it propels us to repeat rituals a dozen times over, as in obsessive-compulsive disorder. Sometimes it becomes so strong that it overwhelms our very sense of reality, as in paranoia.

If you should feel a chill of recognition reading any of these stories, don' t panic. Anxiety is part of the human condition; the day we stop worrying is the day we die.

--Chris Lydgate

BeLONePHOBiA
fear of needles

On his way home from a short walk in 1996, Pat Risser of West Linn felt an intense pressure on his chest, like a giant squeezing his ribcage.

As a mental-health consultant, Risser--then 44 years old--knew he was having a heart attack. But he could not bring himself to dial 911. "I knew they'd want to come at me with needles," he says.

Intravenous-drug addicts aside, no one enjoys being poked with a syringe. But for belonephobes like Risser, the prospect is unbearable. "My heart pounds," he says. "I struggle to catch my breath. I hyperventilate. I break out in sweat. There's a total sense of panic."

Risser was overruled by his wife, who rushed him to the emergency room at Meridian Park Hospital, where he curled up into a fetal ball while medics inserted an intravenous drip.

Two days later, he underwent angioplasty, a procedure which involves threading a catheter into the patient's femoral artery--located in the groin--and pushing it up toward the heart to unclog the arterial walls.

By standard operating procedure, Risser was given a local anesthetic, plus morphine and Valium. As the surgeon inserted the catheter, however, Risser's belonephobia broke through the drug-induced fog. "Somewhere, deep in my mind, I had some small awareness of a needle," he recalls.

Despite being sedated almost to the point of unconsciousness, he began to thrash around on the operating table, kicking so hard it took a troop of orderlies to hold him down. A few days later his leg turned black and blue from knee to ankle.

Fear of needles has been documented for at least 100 years, or shortly after the hypodermic syringe gained widespread use. Like all phobias, it is marked by an irrational and overwhelming terror out of all proportion to the pinprick. "Many phobias have some rational basis," explains psychologist Ron Kleinknecht, dean of the College of Arts and Sciences at Western Washington University in Bellingham, Wash., who has studied belonephobia and dental phobia for 30 years. "But the response has gone haywire, overriding all rational payoff."

The fear is so intense that dozens of belonephobes have actually died from convulsions or respiratory failure resulting from injection anxiety. Others shun doctors, sometimes for decades, because they cannot stand the thought of a needle puncturing their skin.

Kleinknecht's own research suggests that as many as 7 percent of Americans have shirked medical or dental treatment because of fear of needles or blood. "It's not as though they are weak people," he explains. "But it is beyond their control. That's hard to explain to someone who doesn't have it."

Most belonephobia is linked to traumatic experience, often in childhood. Some people develop belonephobia vicariously, by observing the reaction of others who are injected. Still others have no explanation for their fear.

In Risser's case, the phobia began in early childhood, the result of chronic bronchitis that required frequent shots. "I used to hide under the end table," he recalls. "They used to have to pry me loose to send me to the doctor."

Belonephobia can be treated with a technique known as progressive desensitization--gradually exposing the patient to needles, until the anxiety is extinguished. Although not all belonephobes who seek such treatment overcome their fear, Kleinknecht says most improve. "Our goal is not to make them happy with needles," he says, "but to do what they have to do."

Right now, however, Risser would prefer to be left alone. "I panic at the thought of getting close to needles," he says. "Desensitization means needles. I don't want treatment. I don't want anything to do with needles. I do realize this is an irrational fear--but when the panic kicks in, I don't have a lot of control over rational and irrational."

What if he suffered another heart attack? "I don't know," he says. "I might not call. I'm less afraid of dying than I am of needles."

--Chris Lydgate

For more on belonephobia, check panicdisorder.about.com/cs/needlephobia.

Delusory Parasitosis
fear of parasitic infestation

No one is going to accuse you of arachnophobia if, upon sauntering through an unseen spiderweb, you sputter and flail at the gossamer facemask. No one is going to call you a freak if you wince at the skitter of cockroaches retreating from the flick of a kitchen fluorescent. We are all allowed to be leery of the bug kingdom--so numerous, so tiny, so exoskeletal.

Perhaps you have, some sleepless summer night in an unscreened room, even leapt up, turned on the light, torn off the sheet, and searched for the bed bugs you were certain were bedeviling you, only to find nothing more sinister than lint.

That fevered hunt for the bugs robbing you of sleep and sanity is a small taste of what life is like for those who suffer from delusory parasitosis.

These unfortunates live with the unshakable conviction that they are infested with parasites, burrowing, munching and breeding in their skin. Of course, most sufferers do not agree that their complaint is delusional (it doesn't help that parasitic infestation does sometimes occur), and they refer to what afflicts them as "unidentified skin parasites."

There are Web-based support groups for such people, and the agony of their plight is palpable in their postings:

"Nothing seems to work anymore. They are intelligent and become resistant to treatment very quickly. Now, I'm feeling things move IN my head, not just under the scalp."

"Anyone know where to get the shampoo or whatever it is that makes lice glow under a black light? I know my things are on the surface at times, and I feel a tickle, clawing or hop as they move, but I can never see anything."

Dr. Annalisa Gorman, a dermatology resident at OHSU, sees a case of delusory parasitosis about once a month. "None of these patients is floridly psychotic or schizophrenic," Dr. Gorman says, "so I try to rule out all possibility of actual parasites before making a psychiatric referral."

One telltale symptom is the "matchbox sign," so named because the patient may bring a matchbox to his or her doctor containing a sample of the perceived parasites, its eggs or other evidence. Microscopic examination usually reveals the sample to be made up of lint, scabs and household dust.

Because patients with delusory parasitosis usually pick at themselves in an attempt to find and extract the parasites, they often develop skin lesions--which in turn confirm the central delusion.

Gorman makes clear that the pain and suffering is real. She compares patients to amputees who still feel pain in phantom limbs: "Certain parts of your brain can tell you that you are feeling pain, and who am I to tell you different?" she says. "Pain is all in your head. For all of us."

Delusory parasitosis is also associated with alcoholism and drug abuse, according to Dr. Jim Thayer, medical director at the Hooper detoxification center. Alcoholics may suffer from temporary bouts of parasitic delusion as a result of delirium tremens, Thayer says, while speed freaks or cokeheads may develop a permanent obsession.

It is a fear that's not hard to understand. Who hasn't lost all composure, swatting maniacally at a bug that flew into one's hair? But what if you swatted and picked and deloused and scraped and you still itched?

The next time you drop a rubber spider on a friend's shoulder and chortle at his shudder, think of this anonymous posting on the National Unidentified Skin Parasite Association website (www.skinparasites.com):

"I pulled out another thing this afternoon by way of suction and tube. This one was wider than most. I'd say around it was 1/2 inch to 3/4 inch and about 3 inches long.... I took a pair of small scissors and snipped open to expose the insides.... I have it in water right now to try and leach as much of the blood as possible to see if I can see anything like guts.... Every time the pathologist looks at one of these samples he says it's just a blood clot.... I bet if I went and planted a fresh one on one of their foreheads, they wouldn't say blood clot."

--David Shafer

AiLURoPHoBiA
fear of cats

Cat. The single man's confidant on a lonely Friday night. The spinster's companion, pampered with squeaking toys and scratching posts. The toddler's elusive playmate.

But some people find the unblinking eyes and hacking furballs, well, a bit freaky.

Ever since she can remember, Michelle, a 31-year-old civil engineer, has feared felines--specifically, black cats--because she believes them to be the reincarnation of malevolent spirits.

Growing up in Louisiana, her older sisters taught her to spit on the ground whenever an ebony cat crossed her path. "Spitting is very cleansing," she explains, a hint of Cajun in her voice. "It extinguishes the bad juju."

If she is driving with friends and a black cat crosses in front of her car, she rolls down the windows and makes everyone spit on the ground. "It's points against your karma if you don't spit," she says. "You do the best to save the people you are with."

Historically, cats have been a contradictory symbol of good and evil. Ancient Egyptians considered them good luck and even worshipped them, but sometime during the Middle Ages felines crossed over to the Dark Side. Superstitious medievals believed that black cats had supernatural powers. After seven years of serving a witch, cats became witches themselves--and if a black cat crossed your path, it was a sign that Satan was taking an interest in you.

The association between black cats and black magic is so strong that many animal shelters, including the Multnomah County Animal Control Division, will not give them up for adoption during the month of October. "We want to make sure the animals are protected," said a spokesperson at Klamath Falls Humane Society. "We're scared of people sacrificing cats for fun."

To Michelle, there's nothing fun about black cats' power, though she wouldn't mind getting a taste of it. "One day I would like to be reincarnated as a black cat," she confesses. "So I can wreak havoc on others, too."

--Marianne Reid

MiSoPHOBiA
fear of contamination by germs

I grew up in a family of germ-phobes. Long before AIDS or anthrax, we were creeped out by public restrooms and crowded subway cars. From an early age, I remember my dad, an accountant, teaching us never to soak in hotel hot tubs and to scrub each soda can before drinking. We were the Partridge family of clean freaks: We could have taken our hand-washing act on the road.

My mother insists this trait stems from my dad's genes. My paternal grandmother was a world traveler who suspected tuberculosis in every cough and was so wary of out-of-town water that she brushed her teeth with whiskey--even though she was a teetotaler. Even back home, she covered her car seats in plastic and lectured us on the fine points of germs lurking in public places.

Through the years, this idiosyncrasy has manifested itself in strange ways throughout my Irish-Catholic family. My sister, Elizabeth, washes her dishes with paper towels because her roommates use the sponge to wipe the kitchen counters. My older brother Don steers clear of buffet lines--they involve reusable tongs--and never handles a pay phone. My other brother, Chris, washes his hands up to 20 times a day. My cousin Joe never touches a public bathroom door. Usually, he'll kick the door open like a ninja; he has even been known to use his head when he couldn't perform his karate moves.

My aunt Claire can't stand the thought of shaking hands at church and looks forward to cold weather so she can wear gloves again. Her son Tim also tries to avoid handshakes. When business protocol demands hand-to-hand contact, he dashes to the nearest restroom as soon as possible to rinse off the germs.

Every family has strange habits, but are we pathological? Is it weird that we all shudder at the phrase "hotel bedspread"?

Overwhelming fear of germs is a common symptom of obsessive-compulsive disorder--an anxiety disorder under which a person performs ritualistic actions over and over again to keep unpleasant thoughts at bay. But according to clinical psychologist Dr. Ricks Warren, director of the Anxiety Disorders Clinic in Lake Oswego, our particular brand of germ phobia would not qualify as full-blown OCD--just the "subclinical" variety.

"Subclinical people have some protective behaviors, such as avoidance and aversion techniques," Warren says. "Their habits, however, do not significantly interfere with their lives as they do for OCD patients."

A true OCD sufferer checks the locks before going to bed not just once or twice, but a dozen times. He'll wash his hands a hundred times a day; he'll hit a bump in his car, wonder if it was a pedestrian, and circle back a dozen times to make certain it was not.

As for my own phobia? I can't stand to put my bags on a bathroom floor. I go to great lengths to juggle them or stack them on the door hook--surely exceeding the weight limit for that flimsy hardware. I perform my circus act, of course, while hovering over the toilet so as not touch it with any exposed body part.

Some people may consider this strange, but to me, it's just a way of life.

--Marianne Reid

SoCIaL PHoBiA
fear of humiliation

Lee was never a shrinking violet. In high school, he was the class clown. After he graduated, in the early '70s, he played keyboard for a local rock group. He never felt uncomfortable meeting strangers at parties.

But one day in 1976, during the first class of the semester at Portland State University, his professor asked students to go around the room and introduce themselves. Although Lee had been in similar situations many times before, he panicked. By the time it was his turn to speak, his heart pounded, his hands trembled, and he couldn't catch his breath. "It was overwhelming," he remembers.

Over the next two decades, Lee, now a 49-year-old manager at a local high-tech firm, suffered attacks of acute anxiety when he introduced himself before groups of strangers. "When I was giving a report, I didn't seem to have a problem," he says. "But if I was required to express my feelings, I would just go into the spiral."

Twenty years ago, social phobia--also known as social anxiety disorder--was an obscure backwater in the swampy meridian of fear, seldom diagnosed and little understood. Today it's considered one of America's most common psychological problems, afflicting roughly 7 percent of the U.S. population at any given time.

Psychologists say the dramatic increase reflects not an epidemic of shyness, but a better understanding of the myriad disguises the disorder can take.

The central fear of the social phobic is a dread of embarrassment or humiliation, according to Lake Oswego psychologist Dr. Vijay Shankar, an expert in anxiety disorders. This phobia can take a bewildering variety of forms, however: Some social phobics refuse to sign their name in front of others, lest their awkward script be judged a sign of weakness; others tremble at the thought of public speaking, job interviews, birthday parties, meeting people, making a telephone call, holiday dinners or even swallowing in public.

Because social phobia is, at heart, an anxiety about how others judge them, social phobics are acutely self-conscious about their own distress symptoms. The trembling hands, the sweaty armpits, the cottonmouth, the dreaded blush--for the social phobic, these are like neon signs advertising their own inadequacy. In this sense, Shankar says, social phobia becomes a sort of meta-anxiety: the fear of fear itself.

Although pharmaceutical giant SmithKline Beecham, the maker of Paxil, has taken the lead in popularizing social phobia, research suggests that the most effective treatment is something called cognitive-behavioral therapy, which consists of analyzing the anxiety, studying its internal (il)logic, and exploring strategies to combat it.

Lee and Shankar, for example, videotaped role-playing sessions to simulate awkward encounters. On playback, Lee was surprised to discover that "I looked nowhere near as nervous as I felt."

Then they analyzed the thoughts that automatically flew through his mind whenever he was in a stressful situation, which ran something like, "Oh, jeez, here it comes again. I'm going to have a panic attack and make a fool of myself." In fact, Lee realized, an increased heartbeat did not necessarily herald an impending anxiety attack. Finally, they crafted a "rational response" to the signs of stress: the insight that "it's OK to appear a little nervous."

After a year of therapy, Lee does not consider himself cured. But, he says, "it's amazing how much that has helped." Now he actively searches for chances to put his newfound knowledge to use. "I honestly look forward to opportunities that used to cause me fear," he says. "Of all the things I've done in my life, this is one of the ones I'm most proud of."

--Chris Lydgate

For more information on social phobia, check out www.socialphobia.org. You can contact the Anxiety Disorders Clinic at 635-8710. FeARs of FaMOuS PoRtLaNDeRS

* Theatrical impresario Howie Baggadonutz: Bats

* Gallery owner Charles Froelick: Burning. Drowning. Needles.

* Mayor Vera Katz: Flying.

* Quadriplegic cartoonist John Callahan: Possums. Electricians.

* WW music critic John Graham: Answering the telephone.

* Actor C.W. Jensen: Snakes.

* KNRK diva Daria O'Neill: Michael Jackson

* Gender-bender Darcelle: Snakes. Heights.

* Dancer Linda K. Johnson: Mice. Rats.

* KOIN anchor Jeff Gianola: Poodles.

* Metro council president David Bragdon: Clowns.

* Multnomah County Sheriff Dan Noelle: Nothing.

* Car king Scott Thomason: "I guess that I'm fearless."

* Biweekly news mogul Rev. Dr. Bob Pamplin: "I don't really have any phobias...There are things that I don't like...I don't like buttermilk...."

* Port of Portland honcho Bill Wyatt: "I'm terrified of shallow water--anything under 43 feet." (The port wants to dredge the Columbia River.)

* GOP gubernatorial hopeful Ron Saxton: "Another eight years of business as usual in the governor's office."

* Demo gubernatorial hopeful Ted Kulongoski: Willamette Week.

WWeek 2015