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“I must say a word about fear. It is life’s only true opponent. Only fear can defeat life. It is a clever, treacherous adversary, how well I know. It has no decency, respects no law or convention, shows no mercy. It goes for your weakest spot, which it finds with unerring ease. It begins in your mind, always.” – Yann Martel, “The Life Of Pi”

Fear limits life. Phobias thrive on avoidance, making people so distressed they are willing to give up important relationships and activities in order to avoid the awfulness it delivers. Although people with a phobia believe it is their worst enemy in the struggle with fear, it is really their best ally. Fear is treatable. Treatment starts by opening one’s mind to the possibility of getting well and getting one’s life back. We can help. Cognitive Behavior Therapy (CBT) is the treatment of choice for all phobias. Specifically, exposure-based treatments retrain the fear response, making it possible for phobic people to do what once seemed impossible. Phobias were among the first psychological disorders to be treated by behavior therapy and later cognitive therapy. Today, through CBT, the powerful tools of both behavioral and cognitive approaches can end phobias.Through expert treatment, research in applied neuroscience shows that the metabolic activity in the brain is modified through CBT.

We specialize in treating phobias and have successfully treated common phobias, such as fear of needles, medical procedures, flying, insects, death, vomiting, and animals, and rare phobias, such as fear of the night sky, one’s reflection, the sun, urinals, and the universe. We treat fears across the lifespan, carefully tailoring treatment plans to (where appropriate) include parents and other family members as treatment aids. We also work collaboratively with school personnel to ensure that children with phobias experience a consistent treatment response while at school.

Treatment for phobias includes education, initial training in self regulation, office-based practice, assignments out of the office, and, eventually, gradual efforts outside of the office that get closer and closer to the feared circumstance. Like most everything we treat at NSI, treatment for phobias is a collaborative process in which trust and risk are carefully managed. For some phobias, we offer Virtual Reality (VR) treatment. The virtual environment offers the advantage of private, convenient, office-based experience in several environments including airplanes, elevators, thunderstorms, heights, job interviews, and public speaking. Dr. Keith Saylor has focused particularly on using VR to treat fear of flying.

Our Phobia Services Include


  • Cognitive Behavior Therapy, including exposure-based treatments
  • Virtual Reality Therapy
  • Individual or group therapy
  • Mindfulness-based approaches
  • Parent training (when the patient is a child)
  • Collaboration with school personnel and treatment providers