How to treat extreme fear of the dark.
They may cling to security blankets, pillows, teddy bears or even mosquito nets-all of which may make them feel secure. Some may grow up to be adults with their subconscious or unconscious minds programmed that they need these items to protect them from any danger.
It is indeed most unfortunate if the nyctophobia is aggravated by fear-inducing techniques of parents, elder siblings or babysitters.
'The case of the 9-year-old boy who still wets his bed demonstrates clearly the impact of fear-inducing techniques on young children,' says Dr. Carmen 'Mameng' Sugai, a child psychiatrist who is trained at the Rutgers-Robert Wood Johnson Medical Center and Tulane Medical Center in the United States.
She adds that the intense fear raises stress and anxiety levels, especially when faced with darkness, being alone or talk of ghosts. Over time, this fear can become more broad in scope, such that other situations can provoke the same fear response.
Assess the family
Dr. Sugai stresses that when a child psychiatrist or psychologist encounters children with nyctophobia and other abnormal fears, one must also assess the family-'whether there are other family members, like parents or siblings, who are perpetuating fear in the home, such as an abusive parent or an older sibling.
'There are also other negative feelings such as helplessness, insecurity and even abandonment,' says Dr. Sugai. However, she emphasizes that these are likely to occur in vulnerable children, that is, children with predisposition to anxiety because of family history of anxiety or because of psychosocial factors such as dysfunctional families and a history of physical or psychological abuse.
It is to be noted that children between the ages of six and 12 may feel a bit afraid of the dark, and this is not necessarily something parents should worry about. Dr. Sugai explains that this is a normal stage of development and not a phobia. The same is also true for adults who retain a bit of fear of the dark throughout their life.
It becomes an abnormal fear or nyctophobia requiring professional help if the child or adult becomes 'dysfunctional,' such that he or she experiences severe, inappropriate symptoms related to darkness.
These symptoms include extreme nervousness in any darkened environment, the need to sleep with the lights on, being reluctant to go out at night, bodily symptoms like palpitations or an increased heart rate, sweating, visible shaking or feeling ill (nauseated, upset stomach, or a 'butterflies-in-the-stomach' sensation when made to spend time in the dark).
When the fear of the dark already interferes with a child's or adult's functionality, then professional help is recommended.
'Fear of the dark can definitely be treated,' assures Dr. Sugai. She says the effective treatment is cognitive behavior therapy, also described as exposure therapy. It's like desensitization therapy for an allergy. One is exposed to progressively increasing time in the dark, until one can tolerate sleeping in the dark the whole night.
Patients with nyctophobia are also taught relaxation techniques, especially those who have a tendency to hyperventilate (fast, shallow breathing) when afraid or under stress. They're also trained to manage their negative thoughts and feelings, and replace them with positive and comforting thoughts.
These, combined with appropriate antianxiety medicines, can help nyctophobic children and adults overcome their intense fear of the dark.
I asked Dr. Sugai about the role of hypnosis or hypnotherapy for nyctophobia. It should be reserved for the more difficult cases, mostly in adults, she says.
'I would be cautious in using it for children with mild symptoms of anxiety,' she adds, 'since there are other therapeutic interventions that are much more accessible such as cognitive therapy, which addresses underlying beliefs that fuel the fear or anxiety.'
If ever a therapist suggests subjecting the child to hypnotherapy, the parents must make sure that he or she is a trained hypnotherapist. 'One must verify their training and credentials before going to them,' advises Dr. Sugai.
If performed by inadequately trained hypnotists, meddling with the child's subconscious mind can cause more harm than good. Haphazardly done, hypnotherapy can cause misdirected instructions to the subconscious mind which can cause more confusion and psychological conflicts, leaving the child mentally scarred for life.
Dr. Sugai, who decided to retire in the Philippines recently, had a busy private practice for more than 20 years in New Orleans and Baton Rouge, Louisiana, and five years of clinical staff work in Alaska working with health consortiums of Southeast and Southcentral Alaska. Together with her classmates in medical school (University of Santo Tomas Batch 1977), she has formed a foundation engaged in sociocivic activities.