Health: Don't call me, please, and I won't call you: To most of us, the ringing of the phone is at least a potential pleasure. But to some it is a source of anguish. Barbara Rowlands reports

MARILYN MONROE called the telephone her best friend. It was the only thing, she said, she could depend on. It gave her instant access to friends to whom she could pour out her anxieties. Like a quick fix, one phone call could lift her mood.

Eighty million phone calls a day are made in Britain and 86 per cent of households have a phone, so it would seem safe to assume that most people regard the phone if not as a friend, at least as a useful acquaintance.

But for 44-year-old Sasha Mason the telephone is an instrument she has to steel herself to use. The person on the other end of the line is a disembodied voice, disapproving and menacing. 'When I'm talking to someone I take a lot of signals from their body language. On the telephone that's not there at all,' she says.

According to Dr Guy Fielding, a psychologist and communications specialist at Queen Margaret College, Edinburgh, Mrs Mason is one of 2.5 million people in Britain - 10 to 15 per cent of the adult population - who suffer from 'telephone apprehension', an anxiety or fear experienced when using the phone or anticipating making a call. Of these 'apprehensives', 2.5 per cent are so anxious that they are truly 'telephonophobic'.

Some, like Mrs Mason, have to summon up courage to make calls; others are terrified of receiving them. 'What you're picking up is a person who is more nervous about using the phone than they are about any other forms of communication,' Dr Fielding says.

Such people are also terrified others will discover their fear. Harold Fisher of the Phobics Society has recently treated two Catholic priests, a headmistress and a professor of foreign languages for telephonophobia. He says these people feel stigmatised. 'They know they are going to be ridiculed, so they'll avoid telling anyone - and avoid using the phone.'

Telephonophobics will hyperventilate or have a panic attack either when the phone rings or when they anticipate having to make a call. Such fear can and does ruin careers. It is a social phobia characterised by an extreme anxiety about being judged by others or behaving in a way that will lead to embarrassment or ridicule. The most common fear like this is of public speaking. Others include a fear of intimacy, and fear of blushing, vomiting or choking in public.

Dr Amanda Lurie, a clinical psychologist at Charing Cross Hospital in London says: 'The ring of the phone might trigger a whole series of thoughts - that they will have to speak, talk, perform. What is the person at the other end of the line going to think of them?'

Dr Fielding believes telephone apprehension is likely to be related to one or two bad experiences. Receiving an obscene or angry call can make picking up the phone the next time that much harder.

'They fear that someone might be rude to them on the phone, or they'll say something they oughtn't. In practice it might never happen, but their behaviour is dominated by this,' he says.

Sasha Mason did have a frightening experience when she was 18 and living at home. A stranger rang and said he had abducted her father. 'He said he would do something unpleasant to my father unless I did what he said. It turned into an obscene call. I panicked and put the phone down, but he stayed on the line and I couldn't phone out. I ran to the police station. I was in a terrible state.'

Mrs Mason's telephone calls are fraught with anxieties. She is always desperately worried that she could have rung at the wrong moment. 'They might not want to speak to me and even if they sound friendly, they could just be being polite.' Then she has problems ringing off. 'When you're with people their body language indicates a withdrawal from conversation. I don't like to close the conversation in case I might upset them.'

Her greatest fear is a crossed line. 'It's this horror that you could get into another world. It's as if the other voices are not people. They could have come from another realm, another dimension.'

Dr Fielding's findings show more men than women suffer from telephone apprehension. In partnerships women tend to pick up the phone before men. But there is a general tendency for women to be more skilled at interpersonal communication than men, he says. The woman usually looks after a couple's social relationships; the telephone is an essential tool with which she is very familiar.

Men are most comfortable making business calls at work or on a mobile phone. But Dr Fielding says that 40 to 60 per cent of time on the phone at work is actually spent chatting. 'It's not that men don't like talking about personal things; they don't like being identified as talking primarily about them.'

People who suffer from telephonophobia often encounter difficulties at work. Dr Fielding cites the case of a nurse who disliked the phone and avoided it at all costs. 'That was fine until she was promoted to ward sister and then it became a total nightmare. People would ring and want to talk to the sister and she just couldn't cope. Essentially she had reached a level of incompetence not related to her abilities as a manager or as a clinician, but because of a phobia akin to a fear of spiders.'

British Telecom, which naturally has an interest in helping to reduce telephone anxiety, has published two free booklets, Be Your Own Boss and The Language of Success, written by Guy Fielding and Dr David Lewis, a social psychologist.

Those whose anxiety goes deeper can be treated in the same way as other phobics. Telephonophobics should be introduced to the phone slowly, says Dr Lurie. They could start by ringing the speaking clock, then friends or family, and then get a friend to ring at unpredictable times during the evenings, so that they can practise challenging their thoughts.

'They should start at the bottom with something they feel is achievable, but perhaps causes them a little stress,' she explains. Dr Lurie offers an 'anxiety management package' in which the patient learns to monitor the thoughts that occur when the telephone rings or when anticipating making a call, and then to challenge those thoughts, or focus on relaxed breathing if breathing becomes laboured.

Nigel Thomas, a behavioural psychologist at the Charter Nightingale Hospital, London, says it is important to identify what the patient finds frightening about the phone. 'It might be easy to phone parents, a bit more difficult to phone friends, more difficult to make a business call,' he says. 'It's essential to form a hierarchy and to get people to make calls in a graduated way and in increasing length.'

Admitting that the telephone scares you rigid is taboo, says Dr Fielding. 'To say that you are frightened of planes is almost to say that you're frightened of the current world, but just about acceptable, since every so often planes do kill people; telephones by and large don't'

The Phobics Society, 4 Cheltenham Road, Chorlton-cum-Hardy, Manchester MZ1; Phobic Action, Claybury Grounds, Manor Road, Woodford Green, Essex 1GB 8PR; British Telecom, 81 Newgate St, London EC1A 7AJ.