For the past twenty years, 57-year-old clinical psychologist Michael Telch has seen around ten patients every week, some of them so afflicted by anxiety that they've had trouble simply getting to his office.
One woman, who'd often spend eighteen hours a day chanting to herself in the shower, had to be physically retrieved for her
Another had been scared to leave her
bedroom for fifteen years.
But while some clinicians might be frustrated by such challenges, Telch
doesn't express the faintest irritation.
These are his
Telch is the founder and director of the Laboratory for the Study of Anxiety Disorders at the University of Texas at Austin, also known as the Telch Lab.
bears a slight resemblance to Mel Gibson, if Gibson's face were frozen in an expression of extreme concern.
speaks calmly, a trait one might expect in an anxiety therapist, and moves his
hands slowly while he
talks, stirring tea if he's
office or, if he's at home
, petting one of his
springer spaniels, who like to curl up in his
lap and snore like a buzz saw.
Much of Telch's research
involves exposure therapy, a potent anxiety-reducing technique that has become prevalent over the past few decades.
When I visited his
office in January, he
explained how it worked.
Say a person is afraid of frogs.
"In the old days, a psychoanalyst might have assumed the phobia was symbolic of a deeper disturbance," he
has treated a bewildering variety of ailments-arachnophobia, cynophobia (fear of dogs), obsessive-compulsive disorder, even the fear of fear itself.
But until five years ago he
hadn't spent much time researching one devastating condition: post-traumatic stress disorder, the long-term debility caused by exposure to a traumatic event.
recognized the unique opportunity he
was being offered.
"For PTSD, too much focus has been on the treatment rather than its causes," he
Sufferers can see a psychologist or take drugs such as Zoloft
, which have been shown to help.
But not all the soldiers who need assistance will get it.
According to a 2008 RAND Corporation
study, only slightly more than half of the soldiers returning from combat in Iraq and Afghanistan with symptoms of PTSD and depression sought treatment, and only half of those received treatment that was considered "minimally adequate."
Telch wasn't the first researcher to try to determine what predisposes people to PTSD.
But the vast majority of risk assessments had taken place after the patients had been diagnosed, and those reports relied on questionnaires that focused on broad demographics-rank, race, gender.
These biographical details offered helpful clues but little more.
suggested a far more comprehensive attack that would include genetic and cognitive elements, pre- and post-deployment tests, and online stress surveys completed by the participants while they were in Iraq.