Phobia

“ Phobia means only "fear" in Greek, but the term is much more satisfying to nervous people than the shorter but too definite English term, dread, or fear. There is acrophobia, or the fear of looking down from a height; claustrophobia, or the fear of narrow places, as the dread of walking through a narrow street because of the sense of oppression that comes with the shut-inness of it. Then there is agoraphobia, market-place dread, or the fear to cross an open space because one has, as it were, grown accustomed to be near buildings and misses their presence. ”

“ Here the available fear is merely used to strengthen those aversions which are instinctively implanted in every man. But usually a com.pulsively acting phobia is formed only after a reminiscence is added to an experience in which this fear could manifest itself ”

“ When fear becomes as extreme as this it amounts to a disease, and is recognised as such by the medical profession, being technically known as a “phobia.” It is through scientific study of these phobias, as recently carried out by medical specialists with a252 psychological training, that full realisation has been gained of the tremendous rôle played by fear in the life of man, and the need for its proper control and direction. ”

“ It is not at all the content but the intensity of these neurotic phobias that appears strange to us. The fear of the phobia cannot even be described. Sometimes we almost receive the impression that the neurotic is not really afraid of the same things and situations that can arouse fear in us, and which he calls by the same name. ”

“ If we subject the content of the dream to analysis, we become aware that the dream fear is no more justified by the dream content than the fear in a phobia is justified by the idea upon which the phobia depends. ”

“ For example, it is true that it is possible to fall out of a window, and that some care must be exercised when one is near a window, but it is inexplicable why the anxiety in the corresponding phobia is so great, and why it follows its victims to an extent so much greater than is warranted by its origin. The same explanation, then, which applies to the phobia applies also to the dream of anxiety. ”

“ I tried to find whether or not those fears had any relation to my wishes or to my sexual experiences. I must say that I find they bear no relation whatever to wish or sex. My mental states grow on fear, take their origin in fear, and feed on fear. Fear is the seed and the soil of all those infinite individual phobias that keep on torturing me unless opposed by a supreme effort of my will. ”

“ If not in such an extreme form as a phobia, or other functional disease, the early fears will nevertheless make their presence felt in later life. In some men they may engender lack of self-confidence, and even a despicable cowardice; in others they may breed superstitious terrors and usages. Always, in some way, one may depend on it, they will affect the character, the intellect, the whole moral and mental make-up.
Nor will their influence be confined to the individual. Fear, as every psychologist knows, is one of the most contagious of the emotions. ”

“ Suggestion does not touch the root repressed emotion, and I fancy that after suggestion the symptom merely changes. A man has a phobia of cats. By suggestion I can dispel his fear of cats, but the fear is transferred to something else, and he then has an exaggerated fear of catching tuberculosis. ”

“ We thus learn that the symptom has been constituted in order to guard against the outbreak of the anxiety. The phobia is thrown before the anxiety like a fortress on the frontier.
Unless we enter into the part played by the affects in these processes, which can be done here only imperfectly, we cannot continue our discussion. Let us therefore advance the proposition that the reason why the suppression of the unconscious becomes absolutely necessary is because, if the discharge of presentation should be left to itself, it would develop an affect in the Unc. ”

“ Similar intense fears may occur in the first stage or following the administration of an anaesthetic, or attacks of terror may occur in the waking state as part of an anxiety-neurosis. Another pathological form taken by fear is shown by the various phobias, in each of which some special stimulus may arouse fear in one who otherwise may not know what fear means. ”

“ They may break into a profuse perspiration and assert that they feel as if chained to the ground....’ And here, listen to this, ‘batophobia, the fear that high things will fall, atrophobia, fear of thunder and lightning, pantophobia, the fear of every thing and every one’.... ”

“ Neuropsychologists seem to take a special pleasure in inventing some new phobia or at least giving us a fine long Greek name for a set of symptoms by no means new and that might well be explained in simpler terms. ”

“ Thus it happens that in recurrent morbid fears—known as the phobias or obsessions—a group of symptoms are met with which at first sight appear to be unrelated bodily disturbances, but which when analyzed are seen to be only a certain number of physiological manifestations of emotion welded into a complex. On every occasion that the fear recurs this complex is reproduced. ”

“ As a matter of fact there is a great number of fear states or of phobias in the neurotic patient. A few only appear to predominate in the network of fear events. The network of fears is woven into an incongruous whole by the impulse of self-preservation and the fear instinct. ”

“ The various phobias in which the suppressed experience finds expression are of a kind which makes this mode of solution unsatisfactory if the conditions which re-arouse the dreads are liable to be frequently encountered, but if they are of exceptional occurrence it is possible for the subject of a phobia to lead a normal and comfortable life, though there is always the possibility that his life may take a course which will expose him to conditions which arouse the phobia and make the solution altogether ineffectual. ”

“ Many persons who cannot be termed ill show this tendency to anticipate disaster. We blame them for being over-anxious or pessimistic. A striking amount of expectant fear is characteristic of a nervous condition which I have named "anxiety neurosis," and which I group with the true neuroses.
A second form of fear in contrast to the one we have just described is psychologically more circumscribed and bound up with certain objects or situations. It is the fear of the manifold and frequently very peculiar phobias. ”

“ The patients cannot tell what they are afraid of and connect their fear, through an unmistakable secondary elaboration, with phobias nearest at hand; death, insanity, paralysis. When we analyze the situation which gave rise to the anxiety or to symptoms accompanied by it, we can generally tell which normal psychologic process has been omitted and has been replaced by the phenomenon of fear. Let me express it differently: we reconstruct the unconscious process as though it had not experienced suppression and had continued its way into consciousness uninterruptedly. ”

“ If I did not imagine myself in the actual embrace of some grave physical or mental disease, I feared that something would in the near future attack me; and that brings me to the main topic of this chapter—morbid fears.
These foolish, fanciful and often groundless fears are dignified by the name of “phobias.” A man who is afraid of everything should not [Pg 51] be dubbed a low-down coward—he is simply afflicted with “pantaphobia.” It doesn’t cost a bit more to be scientific and it carries with it more éclat.
Another one of these fears is agoraphobia—the fear of an open space. ”

“ Thousands of persons experience these things without thereby becoming victims of a phobia. When a phobia does result, some exceptional circumstances must be operative, and it is manifestly desirable to learn, if possible, what these are.
It is the more desirable since, as investigation is daily revealing more and more clearly, abnormal dread is not the only malady resulting from a fear-occasioning event. Where one man, as the result of a sudden fright, may in course of time become a258 phobiac, another may develop symptoms, not of mental trouble, but of bodily disease. ”

“ When we review the abnormal or morbid forms of the affective life: destructive impulses, phobias, incurable melancholy, sexual perversions, failure of the moral sense, insanity of doubt, etc., and seek their causes, we at once find some which are proximate or immediate. Among the most frequent are physical maladies, injuries to the head, sudden shocks, as in railway accidents; sorrow, whatever its origin, whether love, ambition, ruin, separation ”

“ Abnormal fear, however it may seem to be externalized, always implies at the bottom a fear of something within. There is no truth which is harder to believe on first hearing but which grows more compelling with further knowledge, than this truth that an exaggerated fear always implies a desire which somehow offends the total personality. When we observe the various distressing phobias, such as the common fear of contamination, a woman's fear to undress at night, a fear that the gas was not turned off, or that one's clothing is out of order ”

“ Morbid anxiety is certainly the commonest neurotic symptom, and the theory of its pathogenesis has been the occasion of a very great deal of investigation,15 with, in my opinion, very fruitful results. We meet it in the form of a general apprehensiveness of impending danger and evil, as the anxiety-neurosis, and also in hysteria in the form both of apparently causeless attacks of dread and of innumerable specific phobias. ”

“ The first is directly connected with fear and includes all manifestations, implying in any degree whatever the fear of pain, from that of a fall or the prick of a needle, to that of illness or death. The second is directly connected with disgust, and seems to me to include the forms which have sometimes been called pseudophobia (Gelineau) . Such are the fear of contact, the horror of blood and of innocuous animals, and many strange and causeless aversions. Let us remark furthermore that fear and disgust have a common basis, being both instruments of protection or defense. ”

“ But I believe that the mechanism of the transposition of the affect will be demonstrated in the greater part of the phobias and obsessions, and I must assert that these neuroses, which are found just as often isolated as combined with hysteria and neurasthenia, are not to be thrown together with the ordinary neurasthenia for which fundamental symptom a psychic mechanism is not all to be assumed. ”

“ Thus, in H. O., attacks of recurrent nausea and fear almost prohibiting social intercourse were always due to thoughts of self-disgust hidden in the fringe.
Let us take a concrete case, that of a person who has a pathological fear and who, as we know is often the case, can give no explanation of his viewpoint. The fear may be that of fainting, or of thunderstorms, of a particular disease, say cancer, or of so-called “unreality” attacks, or what not. This so-called “fear” is of course an idea of self or other 355object linked with, or which occasions as a reaction, the strong emotion of fear. ”

“ What kind of an emotion of fear would be left if the feeling neither of quickened heart-beats nor of shallow breathing, neither of trembling lips nor of weakened limbs, neither of goose-flesh nor of visceral stirrings, were present, it is quite impossible for me to think. Can one fancy the state of rage and picture no ebullition in the chest, no flushing of the face, no dilatation of the nostrils, no clenching of the teeth, no impulse to vigorous action, but in their stead limp muscles, calm breathing, and a placid face? ”

“ When I became older, about the age of eighteen to twenty, a new form of fear appeared, like a new sprout added to the main trunk, or possibly growing out of the main fear of disease and death, that is the fear of some vague, impending evil. The fear of some terrible accident to myself and more so to my family, or to any of the people of whom I happen to take care, is constantly present in the margin of my consciousness, or as you would put it, in my subconsciousness. ”

“ And spiritual fear—which is one of the noblest of all affections, as bodily fear is one of the basest—is, if properly defined, nothing less or more than the fear of doing wrong; of becoming a worse man.
But what has that to do with mere fear of the unseen? The fancy which conceives the fear is physical, not spiritual. Think for yourselves. What difference is there between a savage’s fear of a demon, and a hunter’s fear of a fall? ”

“ The effect of fear on the brain may be to the extent of that which is produced by extremity of rage, so that even sudden death, from syncope, may ensue. I have known two such instances as these, but the more common effect is an intense irritability, followed by doubt, suspicion, and distrust, leading toward or to insanity. From a sudden terror deeply felt the young mind rarely recovers, never, I believe, if hereditary tendency to insanity be a part of its nature. ”

“ But all along the line it is the same thing—a paralyzing impression upon the centers of life which can produce, through the agency of the nervous system, a vast variety of morbid symptoms in every tissue of the body.
We have very seldom reflected upon the fact that fear runs like a baleful thread through the whole web of our life from beginning to end. We are born into the atmosphere of fear and dread, and the mother who bore us had lived in the same atmosphere for weeks and months before we were born. ”

“ As fear increases into an agony of terror, we behold, as under all violent emotions, diversified results. The heart beats wildly, or may fail to act and faintness ensue; there is a death-like pallor; the breathing is laboured; the wings of the nostrils are wildly dilated; “there is a gasping and convulsive motion of the lips, a tremor on the hollow cheek, a gulping and catching of the throat;” [1217] the uncovered and protruding eyeballs are fixed on the object of terror; or they may roll restlessly from side to side, huc illuc volvens oculos totumque pererrat. ”