Implosive therapy is especially appropriate for the treatment of phobic individuals who characteristically tend to avoid certain kinds of behavior, situations, or objects because of the severe anxiety and agitation these produce in them. Implosive therapy, when effective, can be dramatically effective in a comparatively short time. However, less arduous approaches to therapy can often be as effective and may involve less risk of increasing a client's existing anxiety. Alternative short-term therapies especially well-suited to the treatment of phobias include behavior modification (Chapter 12), Gestalt therapy (Chapter 10), reality therapy (earlier in this chapter), primal {167} therapy (earlier in this chapter), and biofeedback, relaxation training, and hypnosis (Chapter 15). DIRECT DECISION THERAPY _For individuals capable of exercising determination and self-discipline who earnestly desire to change._ [I]f there's one thing my experience as a psychotherapist has taught me, it is that no one has to be a victim. However important external factors like health, physical appearance, and upbringing may be, they don't have to determine the happiness quotient in anyone's life story. The way we experience our lives is, quite simply, up to us. Harold Greenwald, _The Happy Person_ At the time of this writing, the majority of academic and research psychologists regard themselves basically as Freudians. Yet most psychiatrists, psychotherapists, social workers, and counselors have moved beyond Freud's formal categories and made use of their own common sense and interpretive abilities. Harold Greenwald's emphasis on the central role of _choice_ in making fundamental life decisions implicitly represents the approach of a great many therapists and counselors today. His conception of therapy is casual, simple, and often good-humored. Greenwald (1910-2011) was originally trained as a psychoanalyst. As Greenwald gained professional experience, however, his perspective began to change. He gradually came to believe that many patients had, at some critical moment, made a _decision_ to "go crazy." There was a point when they could exercise control, and at that moment, they chose to be depressed or anxious, to withdraw completely into catatonia, to become schizophrenic, alcoholic, or whatever their decision might be. I discovered in working with people who have had psychotic breaks ... that most of them described a particular moment when there was a choice of whether to stay in control or let go.... You will find, again and again, if you speak to patients who have broken down, and if you search for it, that there is always {168} a point at which they had a choice, and it is at that point that they still have the possibility of controlling themselves. If they have confidence in their ability to control themselves they can exercise it.[7]