Most people with phobias don’t seek treatment, said Wilson, an associate professor of psychiatry at the University of North Carolina School of Medicine. They self-medicate, so to speak.
“They stop flying, stop going over bridges, don’t get on an elevator, don’t go above the 13th floor, avoid insects. That’s the way to keep a phobia alive, avoid what scares you. They perceive that as acceptable,” Wilson said.
Flying bugs such as cicadas are especially fearsome to people with entomophobia because they can be anywhere and come from any direction.
Scientific evidence has linked the disorder to genes, said Sally Winston, co-director of the Anxiety and Stress Disorders Institute of Maryland.
Sufferers know intellectually they’re in no danger, but the creepiness causes an overwhelming adrenaline rush they can’t control.
There’s really only one way to treat it, Wilson and Winston said. Put the bug right in the patient’s face, make them confront their fear.
Wilson’s approach is direct. He wants a patient to look at videos of bugs, then touch one and hold it, owning the feeling of six legs crawling on their skin.
“I start by asking them: ‘What do you want back in your life? What do you want to do, get back to going to work every day?’ ” he said. “I want them to put their game-face on. Look at video and not have any grimace or fidgeting. Say: ‘I want my life back. I’m not going to continue to have this victim-oriented expression.’ ”
Winston’s approach is more gradual. She starts with black-and-white photos of bugs, followed by a blown-up color photo. Maybe later, she will give the patient a life-size toy insect with stunning detail and have them grow accustomed to it.
After that, the patient gets a look at the real thing in a box or other container. Later the box is placed where the patient can’t see it, to address the fear of the unknown. That step intensifies when the bug is set free, whereabouts uncertain.
Milani said she knows that approach, having started treatment in April. “It’s a standard procedure called progressive exposure,” she said. “You control how much you want to treat this. You see a picture, touch a picture, touch a toy of a bug.”
Garcia said she’s already gotten close enough to a cicada, and the experience wasn’t pleasant. When she was about 12, one flew into her bedroom in Queens early one morning.
“It woke me up out of my sleep. I ran to my mom and said there was a big bug in my room,” said Garcia, a Spanish interpreter. Her mother rushed in with a broom.
“It sounded like she was killing a human being,” Garcia said. “It just kept going. She was whacking it with a broom and it wouldn’t die. It was making this horrible, horrible sound.”
Cicadas make Garcia frantic. “I freak out,” she said. “I hyperventilate.”
Despite her treatment, Milani said she will cower at home again if this year’s expected Brood II swarm shows up in Arlington County.
“I’m waiting to see the first one,” she said. “I made arrangements with my office so I can telecommute.”