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Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions
Diagnosis & Treatment of Phobias with Cognitive Restructuring Interventions

Section 23
Fear of the Storm: Weather Phobias

CEU Question 23 | CEU Answer Booklet | Table of Contents | Phobias
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs, Nurse CEUs

Weather phobias are the often hidden consequences of severe weather phenomena.
Wind terrified Sandra. At the slightest sign of a storm, the articulate and intelligent mother of five young Fear of the Storm Phobias social work continuing edchildren tuned in to the weather radio and watched the window curtains for a breeze. She called the National Weather Service repeatedly for up-to-the-minute forecasts.

Over several years, Sandra's fear grew worse. She could no longer run errands alone for fear that she might get caught in a storm. She relied totally on her husband and friends for forays outside of the house. Each evening, after quickly cleaning up the dinner dishes, she sat glued to the television, watching the weather reports until bedtime. If forecasters called for a storm, her heart raced, and she labored to take a full breath. Sleep came only with difficulty. During the day, she paced and worried about the disasters that could befall her and her family should the storm hit.

Eventually she sought treatment, and although she faithfully took the various tranquilizers that her physician prescribed, the mere forecast of wind brought on a full-scale panic attack. Sandra was a storm phobic.

More Than Fear
Sandra's symptoms and behavior are typical of the more than eight million people in the United States alone whose reactions to storms are severe enough for a psychiatric diagnosis of storm phobia. Hyperalertness and vigilance are typical phobic responses to storms or storm elements, and they can begin as early as five days before a predicted storm. As the storm draws nearer, the anxiety intensifies, and phobics monitor their NOAA weather radios and The Weather Channel with increasing frequency. The physical symptoms of anxiety, such as accelerated heart rate and breathing, sweating, and nervous pacing, increase. As the storm approaches, they are unable to sleep and begin to tremble, shake, and cry. Many are so profoundly affected that they have stomachaches, vomit or retch, and have diarrhea.

One storm phobic's desperation is illustrated in a case study by Robert Hobson, of the Psychiatry Department at the University of Manchester, England. Hobson's patient, Doris, described her feelings: "I wish sometimes I was deaf, and I've wished I was blind . . . but I have wished it upon myself so I would not be afraid of the thunder and lightning."

After the storm dissipates, most phobics are essentially indistinguishable from anyone else. Embarrassed by their phobic reaction to the storm, they may keep it secret. Typically, only members of the immediate family know the extent of their fear. Phobics are usually shocked to discover that there are others who share their intense fear of storms--they believe that they are the only one in the world with such a reaction. Unfortunately, the knowledge that they are not alone provides little consolation when the next storm arrives, and again they revert to the same panic and phobic behavior.

A description of a patient from one of the first systematic studies of human fears, conducted 107 years ago, illustrates how debilitating such a phobia can be. One of the founding fathers of American psychology, G. Stanley Hall, wrote
A lady . . . has been bedridden for eight years with a rare form of nervous prostration. She mends steadily during cold weather, but sinks away during the season of thunder showers just in proportion as these are severe. Every peal makes her rigid and crampy like a frog with strychnine. Every fall, her state measures the total amount of thunder during the season.

The Road to Phobia
A tornado is clearly a weather event to fear and avoid. But running to the cellar in a panic at the mere prediction of a 10 m.p.h. breeze or the sight of a cumulus cloud is an extreme reaction disproportionate to the risk. This is what distinguishes a fear from a phobia: The reaction is out of proportion to objective risk and causes impairment or disruption of daily life.

The sources of storm phobia can often be traced back through a phobic's experience to a traumatic weather-related event. Sandra experienced the lethal fury of a storm firsthand in her hometown of Wellington, New Zealand. The storm that triggered her fears tore through her town with winds of 133 m.p.h., destroying the area and sinking a ferry in the harbor. All 51 passengers drowned. Although we don't know what thoughts might have gone through Sandra's mind during and after the storm as she learned about the ferry sinking, it is likely that she personalized the tragedy, perhaps imagining what it would have been like had she and her family been aboard the ferry.

According to a study by John Westefeld, at the University of Iowa, 80 percent of storm phobics develop their phobias as a result of traumatic and potentially life-threatening weather-related experiences. For example, Kara developed a wind phobia at age 34 when a hurricane trapped her in a mountain cabin. She was pregnant at the time, and her two-year-old child was with her. Although she and her child hid safely in the basement while 90 m.p.h. wind gusts slammed down huge trees around the cabin, others were not so fortunate. Several people perished in the storm. This experience left her with a severe wind phobia that persisted for 10 years until she sought treatment.

Like Sandra, Kara was an intelligent, capable, and happy person--until a breeze came up. Then the phobia took over. Under the right circumstances, we are all capable of forming such associations. To escape the dangers of a storm is a response that is a fundamental survival mechanism in the animal kingdom.

About 15 percent of storm phobics acquire their fears more indirectly, some by vicariously experiencing others' traumas. For example, Lars-Goran Öst, from the University of Stockholm, described the case of one woman who learned her fear from her mother. When she was a child, a whirlwind pummeled her house with pebbles, while her mother shouted hysterically, "It is doomsday!" Parents can pass on fears and phobias to children through this process of psychological contagion. Although less common, some acquire fears through observing the plight of others or seeing the violent and destructive power of storms on television or in the movies.

A few, about 5 percent, have no recollection of when or how their phobia started. They cannot recall a time when they did not suffer their extreme fears. We presume that these began in childhood, as do most phobias. However, the "onset experience" is long forgotten and perhaps was never fully recorded in conscious memory. The fear lingers in nonverbal parts of memory, eluding conscious recall yet reflexively activating when a storm threatens.

Although it appears clear that phobia development is associated with frightening experience, such associations do not tell the complete story. If exposure to severe weather were the only factor necessary for a phobia to develop, then everyone who experiences the destructive power of weather would be affected. Additional factors must be necessary to cause a phobic reaction. Certainly, prior positive experiences with storms can buffer a person from developing a phobia when "the big one hits."

Evidence now strongly suggests that people differ genetically in ways that make them more or less vulnerable to the emotional effects of trauma. Although weather phobias are not directly inherited (nor are other phobias, for that matter), it is probable that certain people have a genetic tendency toward developing phobias if they are exposed to painful and frightening experiences.

Who's Afraid of the Storm?
Epidemiological studies suggest that approximately 3 percent of adults exhibit a storm phobia. Although storm phobia is not the most prevalent phobia, it does rank among the top five or ten fears in most studies. Ranked higher are fear of heights, deep water, and small, crawly animals, such as snakes. However, one study of children found that, while storms were not the single most prevalent fear, they were the most intensely feared.

In childhood, when most storm phobias begin, fears of wind, thunder, and lightning are quite common. Fortunately, most children lose these fears as they mature and gain knowledge about the natural world. Those that do not abate during childhood are likely to run a protracted course into adulthood. Kazuhiko Abe, of Osaka City University Medical School in Japan, conducted one of the few longitudinal studies of childhood phobias. He found that 33 percent of children identified in grade school as storm phobic remained phobic when contacted an average of 27 years later. This general pattern is evident for other fears as well: Where perhaps two-thirds of early childhood fears dissipate with age and experience, the remaining one-third persist into adulthood.

According to a study headed by Karen Bourdon at the National Institute of Mental Health in Bethesda, Maryland, female storm phobics predominate over males by a ratio of 3.6 to 1. This gender difference is documented in numerous studies from countries as diverse as the United States, Japan, and Scandinavia and as far back as data exist (the late 1800s). However, there remains very little agreement on how to explain this consistently observed difference. We simply do not know whether the difference is due to how boys and girls are raised and socialized or to yet undiscovered biological factors.

Learning and Unlearning Fear
Treatments for phobias are relatively straightforward and quite effective if executed in a systematic program. Unfortunately, few storm phobics avail themselves of the treatment. Few dare to share their secret even with their physician. Consequently, this and most other phobias often go untreated until some change in life circumstances forces the issue. In some cases, that could be moving to an area where wind and thunderstorms are prevalent, so that life becomes severely disrupted by the phobia.

Although there are several phobia treatments, the most effective ones assume that the fear reactions are equivalent to classical Pavlovian conditioned responses. At the beginning of the twentieth century, Russian physiologist Ivan Pavlov conditioned dogs to associate the sound of a bell with food by continually exposing them to the bell immediately before giving them food. After repeated exposure, the dogs drooled at the sound of the bell, even if there was no food. They had been conditioned to respond physiologically to an otherwise arbitrary stimulus.

In phobics, the simultaneous exposure to both an aversive state of affairs, such as fear or pain, and some other stimulus, such as a child's mother screaming while a storm pummels the house, results in a conditioned reaction of fear. Subsequently, when the specific stimulus recurs, or when the phobic merely believes it may recur, the fear reaction automatically reactivates from memory. The person learns, or becomes conditioned, to expect that one stimulus such as wind will be followed immediately with another stimulus such as fear, pain, or threat thereof, as it was on the initial occasion. If intense enough, the emotion evoked during the initial contact can leave an indelible memory of the association.

When this form of conditioning is responsible for the phobia, psychologists can treat their patients with certain techniques known to reduce the strength of a Pavlovian conditioned response. It is, in essence, reverse conditioning. The phobic person is exposed to the associated stimulus--sounds of thunder or wind--without resulting effect. On initial presentation, the patient experiences a typical fear reaction. This fear will rise, peak, and then diminish over time. Subsequent exposures show some recovery of the reaction, but that too diminishes progressively with continued exposure. When systematically programmed, this procedure works well, particularly if several important elements are included.

Fighting Fear with Fear
Perhaps the most efficient means of extinguishing a storm phobia is the procedure called "flooding," in which the phobic is exposed directly to the maelstrom and not allowed to escape. When no injury occurs, the fear subsides within an hour or two. Flooding can be harsh, and few would stand for it in this rude form. However, a more humane and common variant is also effective. With graduated exposure, the stimulus is presented in increments of increasing intensity, allowing the person to habituate to one level before the next, more intense element is introduced. Many phobics can be treated in a single, extended session using this modified incremental exposure procedure.

Live storms or their individual elements are difficult to conjure up on demand. However, storm simulations are quite effective and in some cases are better because a therapist can present them in increasingly strong and vivid increments. For example, an audio recording of thunder can be presented at a low volume until it evokes no fear. Then the volume can be progressively increased until it is eventually taken at full intensity.

Similarly, static electricity can simulate lightning. Generators such as a Tesla machine produce small, controlled flashes, and large generators, such as the huge Van de Graaff generator at the Boston Museum of Science, can simulate larger, more realistic flashes. As a final test, the phobic could be suspended in the museum's faradic cage with lightning shooting around.

Most recently, psychologists have developed virtual reality programs for treating phobias of many types. With virtual reality technology, phobic patients can experience a computer-simulated storm through their eyepiece in manageable increments so that they are able to interact with it at their own pace.

An additional treatment component focuses on helping the phobic believe that he or she can tolerate the feared stimulus. The extent to which the phobic believes that he or she will be able to withstand the stress of exposure to the storm is referred to as self-efficacy. By definition, storm phobics believe that they are unable to tolerate a storm. However, once they have tolerated a minor version of a storm, they typically will agree that they could probably take a little bit more intensity. Their self-efficacy is enhanced with respect to their ability to handle an increased stress load. As they succeed in handling the storm in small increments, they progressively gain the confidence to tolerate the entire storm or its simulation at its full fury.

Begging and cajoling someone or administering tranquilizing drugs, however, are typically ineffective. The situation must be arranged so that they demonstrate for themselves that they can tolerate some degree of the storm before believing that they can move on to the next level.

A final element of treatment comes from the fact that most fearful people have very little (or mistaken) knowledge of weather and storms and consequently have quite exaggerated conceptions of the risks associated with them. Providing phobics with knowledge of how storms develop and progress and how they can avoid and prevent injury and damage can help them assess the true risk of injury more realistically.

Education about weather phenomena can serve as phobia prevention. For example, children educated about and exposed to the elements in a positive manner are less likely to develop phobic reactions later when they experience severe weather.

Although we are still unable to control the weather, we do have sufficient knowledge to prevent and treat the emotional consequences of severe weather phenomena. Sandra's phobia was successfully treated by A. J. W. Taylor, a psychologist from the Victoria University of Wellington, New Zealand. She has since resumed her previous, busy life and can complete errands and accompany her family on weekend excursions. Similarly, Kara's successful treatment enabled her to return to her mountain cabin for vacations. Amazingly, she was able to remain relaxed during a storm with gale-force winds. Today, no one has to suffer from storm phobia or miss the opportunity to marvel at Mother Nature's boundless power and beauty.

Help is available for those with weather phobias. The Anxiety Disorders Association of America (www.adaa.org) and the Association for Advancement of Behavior Therapy (www.aabt.org) provide resources on their Web sites for finding qualified behavioral health professionals.

Specific Weather Phobias

  • Aerophobia/Anemophobia          Wind and drafts
  • Astraphobia                                Lightning and stars
  • Auroraphobia                             Northern lights
  • Brontophobia                              Thunder
  • Chionophobia                             Snow
  • Homlichophobia                          Fog
  • Hygrophobia                              Dampness and moisture
  • Kyklonasophobia                        Tornadoes
  • Kryophobia                                Cold
  • Ombrophobia                             Rain
  • Pymmyraphobia                         Floods
  • Thermophobia                            Heat
  • Trikymia/Kataigidaphobia           Severe storms
- Kleinknecht, Ronald A.; Afraid of the Weather?;  Weatherwise; No/Dec 2002; Vol. 56, Issue 6

Personal Reflection Exercise #9
The preceding section contained information regarding weather-related phobias.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 23
How might lightning be simulated to help clients overcome their fear? Record the letter of the correct answer the CEU Answer Booklet.

 
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