High anxiety: Bridge phobia crosses into world of panic

  • Article by: KIM ODE , Star Tribune
  • Updated: August 10, 2007 - 11:40 PM

Fear of bridges is real, but it's more about feeling trapped than fearing that it will collapse. Experts say treatments have a high success rate.

The goal wasn't so much to drive across the bridge without fear as it was to make the crossing seem mundane. And so psychologist Thomas Hicks sat buckled in as his client accelerated across the Hwy. 77 bridge, its slim lanes elevated on piers across the broad valley of the Minnesota River.

South over the bridge to the first exit, backtrack and go north. South and north, back and forth, Bloomington and Burnsville for 45 minutes -- until an act that for years was unimaginable became, of all things, boring.

It's called gephyrophobia, (JEFF-i-ro-FO-bee-uh) or the specific fear of crossing a bridge. Psychologists say that the anxiety isn't so much that a bridge will collapse, as the Interstate 35W bridge did, but that it offers no escape. It's similar to a fear of flying, said Vern Devine, a clinical psychologist in St. Louis Park. People are more afraid that they're going to panic in a plane's confines and "crash" more than the plane itself.

Granted, the idea that a bridge could collapse "would seem, until last week, kind of unusual," Devine said. But it's the idea of suffering a panic attack with no means to pull onto the shoulder or to step off into the ditch that makes bridges a special hell for some.

It's hard to say how many people fear crossing a bridge, although that number has no doubt increased since last week's tragedy. Psychologists distinguish between a general anxiety about bridge safety that may ease with time or simply be met with a certain daily fatalism, and developing a specific phobia that proves debilitating. One indication of the latter comes from those who manage the 4-mile-long Chesapeake Bay Bridge in Maryland. Each year, about 4,000 people pay $25 a trip for someone to drive them across.

Whether it's bridges or need- les or circus clowns, experts say that at least one in 10 people will experience some sort of phobia in their lifetimes.

How such phobias begin is something of a mystery, said Hicks, a psychologist with Anxiety Treatment Resources in Bloomington. "Sometimes we'll see a bridge phobia as part of a larger cluster of phobic concerns," such as a fear of heights or water, or claustrophobia "which is not always about close spaces, but a fear of being in a situation you can't get out of. I don't think I've ever seen a case entirely related to bridges."

Treatment often is highly successful, but not always sought, partly because sufferers become skilled at avoiding what they fear. Autumn Braddock, director of the anxiety disorders clinic at the Mayo Clinic in Rochester, Minn., said many people come in wanting to reclaim their lives.

"They say, 'I never used to have a problem with this. I wish I could do what I used to be able to do. I used to be able to see my friends in Minnetonka without driving two hours out of the way to avoid the bridges,' " she said.

While there are drug treatments for anxiety disorders, addressing a specific phobia is best done with cognitive behavioral therapy: in essence, changing how a person thinks and acts.

Braddock said she guides clients into questioning what evidence exists for their fear, then what evidence runs counter to that fear. Gradually, the treatment moves toward physically exposing the patient to what scares them.

This is called "in vivo" therapy, or going into the situation to gradually desensitize them, Devine said. "We might start out with pictures of something they're afraid of, then gradually approach the situation. You cannot try to pressure a person into doing this. They have to work at their own pace."

In other words, no one gets thrown off the end of the dock.

Hicks described an "exposure hierarchy," in which a client whose fear of driving was first addressed simply by sitting in the car. Gradually, they drove around the parking lot, then the neighborhood, moving onto a busy street, a two-lane highway, a three-lane highway, driving at night, driving over bridges, and finally successfully crossing a bridge at night without anxiety.

It can take months, he said, but once the fear is conquered, relapse is rare.

Braddock doesn't know how many people will suddenly fear crossing bridges. "Far more common would be if someone had a previous fear of bridges, or of driving in any way, or perhaps even a panic disorder, then we might see a flare-up," she said.

She urged people who are having difficulties related to the bridge disaster to seek help as soon as possible. She recommended contacting the Association of Behavioral and Cognitive Therapies (www.abct.org) and clicking on "find a therapist."

Hicks urged people who blithely cross bridges, stroll past spider webs and snooze on airplanes to have some understanding for those for whom such actions seem impossible, and to support their efforts to confront their fears. "You have to understand what a monumental thing this person is doing and respect that," he said. "Nobody gets to pick in life what they're afraid of."

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