History A 20-year-old woman comes to see a general practitioner saying that fear of spiders is causing her significant problems. When she sees a spider, she becomes fearful. She sweats, shakes and her heart rate increases. She needs to get out of the room very quickly and requires family members to come and remove the spider. She cannot re-enter the room until she is certain the spider is gone.
She requests diazepam tablets, because her aunt uses these for her fear of airplanes, and believes them to be effective for phobias. Mental state examination When she enters the examination room, it is noticeable that she is on edge. She scans the room quickly and explains later that this was to check for spiders and that she does this routinely. Once she has done this she is relaxed and discusses her fears. She explains that they are ‘irrational’ and she knows that most spiders are harmless, but…
