Anemophobia

If Kate Moss were to sweep seductively into James's office right now, wearing a fetching little Ralph Lauren cardigan and a flirty Catherine Maladrino dress, he would, without a doubt, refuse to sleep with her. Some might - quite correctly - surmise that a loving relationship with his wife was holding him back, others might suppose that the queen of the catwalk was simply not his type. But few would guess that even if he were single, and pulsating with lust, and a slavering devotee of Ms Moss's every move, he would turn her down for one overwhelming reason: the fact that she was wearing a cardigan.

James's phobia of cardigans emerged when he was in his late teens. At school, and at university, he became increasingly aware that this otherwise cosily benign article of clothing aroused feelings of hostility inside him. "It makes me shivery," he reveals, "and I've been in potentially sexual situations with people wearing cardigans, where I've had to move away. If the woman is simply a friend, I could just about give her a hug, but when sex is possibly down the line it's a problem. I realised how much I loved the woman who is now my wife when she told me she had thrown away every cardigan in her wardrobe."

There is a memory that sticks out from James's childhood. At the age of three, he is suffering from whooping cough, and the wispy hairs on his mother's mohair cardigan seem to aggravate the relentlessly painful irritation he is suffering in his throat. It is the only possible reason he can find for a fear that one psychotherapist has dismissed as a cover for deeper problems. The therapist could not develop this any further, so for now James is resigned to the vagaries of self-diagnosis, and the prospect of hell every time wool and buttons are back in force on the fashion agenda.

Drop the word phobia into a conversation, and alongside the flurry of spider, snake, and vertigo anecdotes, fears like James's will often be put forward as tantalisingly incomprehensible. For most people, it is difficult to relate to traumas like his or those of Sarah Myers, who cannot bear either to see other people brushing their teeth, or to watch herself brush her teeth in the mirror; or Martin Toseland, who developed such a strong reaction to sand that over the last 20 years he has only been able to spend three uncomfortable hours on the beach; or Hanna Wiggins, who freaks out at the thought of touching cotton wool. Perhaps our ultimate incomprehension of any phobia - even our own - is a reason for our enduring fascination, immortalised by cultural classics such as Orwell's Room 101 in 1984 or Hitchcock's Vertigo. On the internet, too, a number of websites fuel this interest with a phobic vocabulary stranded somewhere between Greek and Double Dutch. Supposedly valid terms include the fear of air (anemophobia), the fear of knees (genuphobia), the fear of peanut butter sticking to the roof of the mouth (arachibutyrophobia), and the - surely sensible - fear of bullets (ballistophobia).

The arrival of Helen Saul's book Phobias: Fighting the Fear sheds light on this compelling area by looking at the most up-to-date research in a number of disciplines. Asking the crucial, unanswered question "Does the cause of phobia lie in the thinking mind or the physical brain?", Saul calmly assesses the findings of those who approach the brain chiefly as a biological entity (geneticists, neurophysiologists, molecular biologists) and those who deal purely with the mind (psychiatrists and psychotherapists). Some of her questions are as fascinatingly bewildering as the phobias themselves: Why are some phobias easier to deal with wearing sunglasses? Why should holding a magnet to your head affect your levels of anxiety? Why do some phobic women lose their fears when they are pregnant?

Saul, a science journalist who freelances for the New Scientist and Radio 4, does not suffer from any phobia herself, but was drawn towards the challenge because there were exciting breakthroughs in phobia research. What strikes her most is the realisation that the word phobia - like the historical term for swelling, dropsy - is a blunt term. Combining disciplines such as genetics and psychotherapy will help refine into different categories the problems, say, of the woman who was so afraid of dentists that it took her years to tell her husband, or the man who could only walk through doorways backwards using his left foot first.

Although it will be decades before researchers reach their destination, several interesting sign-posts have been discovered. Take the story of Nikki Gerry. Morning sickness might not seem like an incentive for catching a bus, but for Nikki it was a sign that for the first time for years, she could escape her crippling social phobia and use public transport. When she was 14, despite being an A- grade student, her weight went down to six-and-a-half stone because she was so scared of group situations such as school assemblies. She eventually left school virtually unqualified, unable to contemplate the terror of being locked into a room with several other people for her examinations. It was only when she became pregnant that a seemingly miraculous breakthrough occurred.

"Pregnancy gave me an excuse," she explains. "If I had to rush off the bus suddenly, or leave in the middle of a meeting, people would assume that it was morning sickness, and not because I was weird." Unfortunately, Nikki's phobia resumed when she gave birth, although she has now happily managed to go to university with the help of medication and therapy.

Although overall surveys have proved disappointingly inconclusive on the link between pregnancy and the abatement of social phobia or agoraphobia, there have been enough strong case studies to make it a focus of research. Some psychologists propose simply that pregnancy boosts self esteem and sense of purpose, while providing a distraction from the phobia. But the prestigious American Journal of Psychiatry has advanced the more biological explanation that pregnancy hormones may reduce the rise in blood pressure and heart rate that accompanies panic. Other reseach suggests that progesterone - the dominant hormone for most of a pregnancy - breaks down naturally into chemicals found in barbiturates, which are used for treating anxiety.

If pregnancy seems an unexpected route for approaching a cure for phobias, consider the use of magnets. In her book, Saul recounts the intriguing moment when Mark George, a neurologist and specialist in brain imaging, realised that, although he could form the numbers in his mind, he could not count to 10 when a magnet was held over a specific area of his head. The moment the magnet was taken away, however, his numerical ability reasserted itself.

At the Institute of Neurology in London, George became increasingly drawn into a technique known as Transcranial Magnetic Stimulation. Returning to Charleston, South Carolina, he and his team discovered that stimulating the right prefrontal lobe with a magnetic field put people on a somewhat anxious high, while stimulating the left made them feel transiently sad. He applied his findings to those who suffered from anxiety problems such as Obsessive-Compulsive Disorder. Many individuals reported a substantial - but temporary - improvement in their condition, including the man who walked through doorways backwards with his left foot first. After the application of magnetism to his right pre-frontal lobe, he was able to walk through doorways normally.

The chief impression from reading Saul's wide-ranging book is that phobias straddle that anomaly of what it is to be human - that on the one hand, we are a complex chemistry set, but on the other, we are seemingly steered by consciousness. Are we afraid because of our parents' behaviour or because of our breathing patterns? Is an agoraphobic suffering from fears that hark back to our Stone Age existence or do they just react unpleasantly when stimulated by certain forms of light? What is in no doubt is the urgent need for a cure for those with extreme phobia.

I talk to Wendy who, since the roof was blown off at a factory where she was working 12 years ago, feels reduced to jelly by anything from a breeze to a gale. As she relates the debilitating details of her fear, I ask how much money she would be prepared to pay for a cure. "If I won the lottery tomorrow," she replies, "I would spend it all."

Helen Saul's `Phobias: Fighting the Fear' is published today by HarperCollins, pounds 7.99

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