Driven Buggy

If Ever Was the Time to Get Help for Her Entomophobia, She Knew This Was It

I am sitting on my sofa staring at the 1½-inch-long dark brown cockroach on the coffee table.

It is a fake, a somewhat convincing one, but nonetheless a phony. Still, I am tense, repulsed. My homework assignment is to pick up this rubber bug and place it in my lap or on my arm.

"It's not real. It can't hurt you," Judy Barth, my therapist, had assured me in her office a few days earlier when she tried to coax me into embracing the rubber roach. At her urging, I managed to let it lie on the back of my hand for about 10 seconds -- okay, maybe five seconds -- before shaking it off. Now I am at home, alone with the bug and I'm having second thoughts about this whole thing. But they're coming and I have to do something. I take a few deep breaths and reach for the rubber creature, my hand hovering over the all-too-lifelike replica of my worst nightmare. I gingerly pinch it between my fingernails, wincing at how it feels soft and slick on my fingertips. I sit it on my arm. . . five seconds, 10 . . . 15. Enough. I fling it off and it lands on its back, exposing its abdomen, with its finely detailed ridges, its legs and antenna jiggling. Ugh! Yuck! Eeewww!

Clearly, I am not ready to face the invasion of the cicadas.

Talking It Through

Bugs. I hate them. Even though I grew up in bug paradise -- Florida -- I've never come to terms with their existence. I will never forget the time that my mother, a sweet, church-going woman, cussed me to the high heavens when I swung a broom at a huge palmetto bug crawling up the drapes -- and shattered the living room window. Or the time when, sitting in my boyfriend's car eating an ice cream cone, I screamed and flailed my arms at the sight of a bug -- I think it was a cricket -- hopping onto the dashboard, and splattered ice cream all over the car's interior, not to mention my boyfriend.

I know my fear is irrational. I'm bigger than bugs -- smarter than they are, too. And most bugs, including cicadas, don't bite or sting. But they can fly and they're so sneaky, creeping up the wall just out of eyeshot or, worse, darting out from under furniture or swooping out of nowhere like miniature A-10 Thunderbolts. They slam into your face or dive into your hair -- eeekkk!

I have long toyed with the idea of seeking therapy to conquer my fear. Granted, lots of people find bugs disgusting -- an estimated 10 to 20 percent of the population is afraid of them to some degree. But my reaction is extreme enough to make me an entomophobe.

It's not so bad I'm afraid to go outdoors, the way David L. Kupfer, a Falls Church psychologist who specializes in anxiety disorders, says some severe sufferers are. But when I see one, my heart jumps, I perspire, my skin crawls. Then I feel silly or angry that I let a little ol' bug make me lose my cool. But until now I've always found a reason to put off treatment. Until cicada mania began.

I told my primary-care doctor that the cicada hype was making me freak and I needed help. He referred me to a psychiatrist, who, after chatting over the phone, decided I should first try cognitive-behavior therapy -- a combination of talk therapy and exercises meant to help desensitize you toward what you're afraid of -- rather than psychoanalysis. She referred me to the Ross Center for Anxiety Disorders in Chevy Chase.

When I shared my plans to seek therapy with friends, most laughed. But all encouraged me to go for it, except for one who suggested a mad doctor would strap me to a chair, pour bugs all over me, then zap me until I stopped screaming.

But Barth, my therapist, is cool. She is friendly and patient, and the sessions are actually fun. At our first meeting 10 days ago, we mostly chatted. We discussed which bugs creeped me out the most -- that would be any type of big flying insect. (I try to avoid closer inspections.) She said the goal was not to make me feel at one with the insect world, but to get me to the point where, when set upon by a bug, I would calmly brush it away, as opposed to shrieking, running and engaging in self-flagellation.

The process would be standard desensitization therapy: gradually increasing the level of exposure to the thing a patient fears. Kupfer, the Falls Church psychologist, said the steps for treating entomophobia might start with looking at a picture of a bug, then touching the picture. Next, he said, might come keeping a dead bug in a jar, followed by holding a dead bug in one's lap. Kupfer calls the process "generally very successful because humans like you and I are capable of learning. . . . The problem with phobias is that we tend to avoid the only learning environment that would help us get over the fear."

Length of treatment time varies from patient to patient, said Kupfer. Eight weekly sessions are generally enough, he said, "but a good amount of work has to be done between sessions" by the patient.

In terms of effectiveness, "massed exposure" works better than infrequent exposure, he said. "If you want to get over your fear, you need to sit with a bug in your lap for four hours straight, rather than five minutes a day for a few weeks," he said. "All you learn in five minutes is, 'Whew, it's gone!' If you spend four hours with a bug in your lap, anxiety turns to boredom after the first 45 minutes or so." For the next session, Barth promised, she'd bring a real live cicada. Imagine my joy.