Ask a Therapist: Fears, Phobias & Anxieties with Richard Kneip

WebMD Live Events Transcript


Are you afraid of the dark? Does the mere thought of spiders and other insects make your skin crawl? Are you afraid of heights? Does the fear of leaving the house make you anxious? If so, join Richard Kneip, PhD, as he answers your questions on how to overcome these fears, phobias and anxieties.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome everyone! Today's guest is Richard Kneip, PhD. He will be answering your questions about fears, phobias and anxieties.

loloangel_2000: What is the difference between a fear and a phobia?

Richard Kneip, PhD: A phobia is a very strong fearful reaction to a very specific thing known as a stimulus. Some of the most common phobic stimuli are snakes, heights, and spiders but could be almost anything. People with phobias may change their lifestyles to an extreme to avoid contact with the feared stimulus. Fear, on the other hand, is the normal reaction we all experience to danger or some sort of threat. You can find more detailed information about phobias and their diagnoses and treatments at

crazilynn: How do you conquer anxiety when on a job interview?

Richard Kneip, PhD: Anxiety during a job interview is a normal and expected reaction to a stressful or unpredictable social situation, especially when we are being evaluated or trying to accomplish something that is very important to us. In fact, it has been shown that mild to moderate amounts of anxiety may actually enhance our performance. However, if anxiety becomes too severe, it may interfere with our thinking and lead to responses and behavior that is uncharacteristic. Some common suggestions are doing whatever is possible to minimize one's anxiety prior to the interview, such as staying away from caffeine containing beverages, spending time preparing for the interview by reviewing materials and information you would like to have readily available during your responses to questions. In extreme cases, there are medications that can inhibit the physiological mechanisms that produce anxiety, but these should be used only in extreme cases and only after consultation with a psychiatrist or other medical professional knowledgeable in the administration of psychotropic medications.

sara_3_2_1: What is the best way to overcome the fear of public speaking?

Richard Kneip, PhD: The fear of public speaking is very common and is treatable by using techniques developed for the treatment of phobias. The techniques, known as systematic desensitization, involve first learning to achieve a state of relaxation and then imagining a series of progressively anxiety-provoking scenarios. For instance, a therapist utilizing these techniques would first assist the patient in becoming deeply relaxed utilizing self-hypnosis or relaxation procedures, then might have the patient start by imagining themselves speaking in an auditorium with only one person in the audience. If the patient could tolerate this imagery without an increase in anxiety, then the therapist might move on to a scenario involving two persons, then four, then eight, etc. At the first sign of increased anxiety, the patient would return to the previous level, establish relaxation and then move on. Research has shown these techniques practiced over several weeks will generalize to real life experience.

dthomasc_2000: What is the most difficult fear to overcome?

Richard Kneip, PhD: While I couldn't identify a single fear that we know is the most difficult to overcome, my experience has been in clinical practice that the fears that are extremely difficult to talk about are the most difficult to treat. For instance, fear resulting from prolonged abuse at the hands of another tends to be much more difficult to discuss in therapy than say a fear of spiders. The shame and embarrassment that often accompanies the fear makes it difficult for the sufferer to share the experience with someone else. The sharing is extremely important in the recovery process. There is more information about phobias, anxieties, and their treatment at

rearwindow2000: What is generalized anxiety disorder?

Richard Kneip, PhD: Generalized anxiety disorder, unlike a phobia, is an anxious reaction to no particular stimulus or circumstances. An individual suffering from this will typically report excessive anxiety and worry about a number of events or activities such as work or school performance. They find it difficult to control the worry and usually will report feelings of restlessness or feeling on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension and sleep disturbance.

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