01. agosto 2013 · Commenti disabilitati su Fears and Phobias · Categorie:Senza categoria

Fears and Phobias: An Ethological Interpretation

The fear term is related to common emotional, cognitive, physiological and behavioral reactions to situations, places, objects, activities, people, animals previously tested in the past as physically painful (some examples are the fears to touch electrical wires after taking a shock or fire after being burned or of dogs after being bitten) or mentally (examples are fears of repeat exams after having previously failed badly or returning to school after being heavily teased by bullies) or perceived in the present as dangerous (i.e as potential causes of future physical, economic, social, psychological or otherwise damages) or deemed by educators (an example is the fear of many girls walking alone on the dark streets after have been alarmed by the parents of the dangers they face of being molested or raped) or by the most part of the people belonging to a sociocultural population (in the Western Societies two examples are the fears of thieves and social and economic failure).
The phobia term indicates the same reactions to situations, activities, objects, people, animals and places subjectively perceived as dangerous only by some people in different opinion and perception of the most part of the other members of the same sociocultural population. For examples, in adults of Western Culture, the demophobia or phobia of stay in public and among the crowds and the sociophobia or phobia of social relations; the erythrophobia or phobia of blushing in face to others; the “trac” and the glossophobia or phobias to act and speak in public; the scotophobia and the nictophobia or phobias of the dark and darkness; the erpetophobia or phobia of common snakes, lizards and geckos; the general entomophobia or phobia of insects and specially the aracnidophobia and the scoleciphobia or phobias of common spiders and maggots; the acrophobia and the kenophobia or phobias of high places and vacuum; the claustrophobia and the agoraphobia or phobias of tight or closed spaces and open spaces; the dysmorphophobia or phobia of being deformed by small defects and so on.

The phobias are considered neurotic because they determine in social and cultural maladaptive ways the development of emotional balance of the general psychic development and personality and consequently of the personal productivity and the ability to work. They aren’t considered psychotic because does not disturb the general examination of reality but only that specific of what is perceived as dangerous, that the most part of other people considers unreasonably and unnecessarily feared and avoided, and however the phobic patients retain a certain critical ability towards what they fear and avoid. Even their etiology is considered to be distinct: psychological that of neurosis (based primarlily on the defense mechanism of displacement outside of unconscious aggressivity) and organic that of psychosis although today in psychiatry the studious hypothesize constitutional bases or organic components, at least in a part of the first, and the actions of some psychological factors, at least in a part of the last. The phobias are also distinguished from other neuroses because they structure the personality less than the ones. You can consider for example the hysteric, the obsessive-compulsive and the hypochondria disorders: these ones structure the cognitions, emotions, behavior and mental and physical functioning more than phobias, so that the most part of those neurotic patients feel their disorders in less ego-dystonic ways compared to phobic patients but more ego-dystonic compared with personality disorders and even more compared to psychotic disorders. Really the other psychological disorders, differently than phobias, structure more the thinking, the behavior, the emotions and the physical and mental functioning. This means that those patients feel their disorders in a more ego-syntonic ways than the phobics. The same overanxious personality disorder, characterized by a tendency to be afraid of everything and everyone, structure more the personality and has felt in more ego-syntonic ways than phobias. Once diversified phobias from psychopaths (the Personality Disorders) as the first differently of the last would be characterized by anxiety while the last not. But for examples even the Overanxious and the Overdependent Personality Disorders are characterized by anxiety.

Pierre Janet related the phobias to psychoasthenia: a functional deficiency of neuronal energy and mental stress connected to the first leads the phobic patients toward an adaptation to the reality according to structural models of psychological development “inferior”, primitive, automatic, neurotic. The depletion of this energy leads him to irrational behaviors but less primitive, irrational and automatic compared to those of psychotic patients. In both cases the “high” mental functions, i. e the most rational ones which can control the “low” emotional and instinctive functions, are lower than “normal” people. The subsequent disintegration of personality influences both the psychotic and neurotic patients. For examples the obsessive-compulsive disorder is related to a reduction of conative abilities (the will and attention); the hysterias, to an impaired perception of self and other people; the phobias, to an impaired perception of certain objects, animals, people and situations.
If I can try a great synthesis, Sigmund Freud related phobias with the anguish hysteria. According to him they are a variety of hysteria constituted by an autodefensive and unaware shift of anxiety from an original “object” of the past to one or more of the present that symbolizes subjectively in some way the first or its opposite. This shift is managed by the rational part of the personality (“Ego”), in order to avoid an increase of anxiety resulting from fears related with the discharges of instincts (“Id” or “Es”) and the consequent social punishment or disapproval of the individual moral conscience through the internalization of social or parental laws (“Superego”) in childhood or adolescence or from the frustrations of the needs. So the phobic patients use some of their mental and physical energy that distracts from other more real and concrete assets. Avoiding to meet better their needs and instincts they does some irrational operations caught by people in their external aspects, don’t frowned upon and stigmatized.
Also, in an other attempt to synthesis, Otto Fenichel related the structure of the ego with a neurotic personality when, by its weakness or the strength of the needs and instincts, it’s unable to meet the needs and instincts in accordance with the sociocultural and moral laws and consequently tends to satisfy them in rationally and socially not well controlled and adequate ways. So the neurotic personality is characterized and derived by a current unstable struggle between its rational aspect, those emotional and instinctual and the social requests.
Generally the cognitive psychologists believe that the cause of phobic anxiety is to be found in an excessive proximity of the future phobic patient with his attachment figures (parents, adults) especially in the infant era. If the lasts discourage him to explore the external (territories to know and objects to manipulate) and internal environment (introspection of impulses, needs, emotions, affections), this will ensure that, whenever in adolescence or adulthood, he will test fear to move away from his new attachment figures (partners, friends) or when he will feel impulses, needs, emotions or affections, he will be afraid, will test psychophysical disorders (tachycardia, tremors, unmotivated sweating or paleness, headache, fainting, etc.) and, worried, he will avoid independent behaviors, thoughts, emotions and affects. Among the consequences of this he will develop the conviction of not be able to operate independently and will adopt inappropriate behavior from the sociocultural standpoints.

These many different psychological explanation show atleast that there is not a single psychological factor in a relation of cause and effect with the phobias. Moreover all the phobias are considered neurotic since their etiology is considered psychic (subjective) and determining the emotional and general psychological unbalanced development. All the fears instead are considered realistic and with survival purposes, like those of our ancestors and even the animals belonging to the upper steps of the Phylogenetic Scale whose nervous system performs the same qualitative functions of ours, because they are related with objective dangers.
But the clinical experience shows that not all phobias are related to neurotic processes. The histories of phobic patients have not always very important environmental events (as those conceived by psychoanalysts or cognitive psychologist) by which their symptoms are in a relationship of cause and effect or have meaningful relations as well as those of neurotic patients. Often you find distressing environmental events of everyday life don’t linked with a unconscious subjective system of ideas but events that act subjectively rather as triggers for the patients and the general their tendency to exaggerate the importance of many anxiety-producing stimuli of daily life. I. e many phobic patients have an anxious temperament tending to subjectively amplify the dangers and risks perceived by them in the environment. In my professional experience this temperament does not reach the severity and pervasiveness of that found in the anxiety personality disorders (you can see “Personality Disorders” in this website). In neurotic phobic patients instead usually the anxious symptoms are referred to an unique category of dangers or risks perceived and have a subjective symbolic value or a meaningful importance in their history. Furthermore, the corrective treatments predominantly verbal (such as those analytical) are not effective with temperamental phobias and the mainly practical methods (such as the systematic desensitization) are not effective with neurotic phobias and “vice versa”.
If you temporarily exclude the phobias resulting from neurotic dysfunctional processes you can consider all others ones with exagerated survival purposes like those of fears related to some real dangers and risks. Furthermore, the neurotic phobias are due certainly to psychological factors but even these are activated on the same bio-base (internal) like the fears by the power of emotional stimulation of external stimulating factors combined with the constitutional sensitivity (internal) of the individual: if he is characterized by oversensitivity he will be candidate to develop much more anxiety even in front to normal emotional stimulating factors!
I think that we can be agree that all fears, those of today like those of many centuries ago, have a natural purpose of survival and are not all due to neurotic factors or dysfunctional educational pressures. They are related with objects, places, activities, people, situations, animals really or potentially dangerous for the physical survival of the individual and the species and rise attention and sensory levels, increase heart rhythms, speed up the cognitive processes, prepare the muscles proc or to escape. Think on the fears that certainly had our ancestors, without which they could not survive and now we would not be here to quibble on the topic: the fear of wild animals; these that could hit crawling in insidious ways and these that could hit suddenly; the dark places and unexplored territories that could hide pitfalls; other tribal groups with which they had to have caution for their eventual hazard and the running risk to be seen by them and hit by bullets or arrows endangering their physical survival.
Among the fears in modern societies you can think on the thieves and personal social failure equivalent of the ancient fears of losing territories, houses and tools for hunting or work and being physically overwhelmed in the fight against enemies.
You can tink that even the phobias are related even to people, situations, objects, places, activities and animals that contain really or “in nuce” some dangers. For example, the acrophobia: the fear of falling from above and injured or killed themselves; the claustrophobia: the ancestral fear of being trapped with no way out or no air; the zoophobia and agrizoophobia: the general fears of animals and especially of wild animals linked with the realization of uncontrollable and then dangerous their instincts; the entomophobia of those animals that evoke the dangers of sting and hurt by subtle movements such as spiders, worms and beetles or those animals that can do the same actions by moving themselves as fast as flies and mosquitoes or by moving themselves jerkily and hitting suddenly like crickets, lizards and geckos; musophobia of mice that can bite and hurt moving themselves quickly; the ornitophobia of the birds that can peck (“to hit”) from above; the agoraphobia, kenophobia and nictophobia: the ancestral fears of remain in spaces not well known and visible where can be some hidden pitfalls; aicmophobia of pointed or sharp objects which can hurt physically if you do not have a good ability to handle them; so on.
Yiu can consider also some most modern transformations of the ancestral phobias: 1) the sociophobia that hides the fear of being noticed (“seen”) by other people (the equivalent of the ancient tribal groups), analyzed (“targeted”) and misjudged (psychologically “shot”) resulting in damage not physical today but social that make harder or less wealthy survival in modern society and 2) the dysmorphophobia, i. e the fear of being rejected and left alone for little physical defects (so important in modern society of the image and appearance) and not being able to compete with rivals in love what makes more difficult the social or affective conditions and so on.

According to this ethological viewpoint the temperamental or constitutional phobias can be due mainly to an overdeveloped or overactive biological functions of survival of alarm (the limbic system) not on the level of the anxiety personality disorders. The fears are working similarly to the electronic alarms installed in the apartments or cars which are well working and are triggered only when enter the thieves; the phobias, similarly to those ones that are bad working and shoot for a breath of air!

The concrete translation of this conception of phobias is that the most effective methods for treatment of the constitutional ones should not be mainly verbal but practical. These include the gradual exposure to anxiety-provoking stimuli with external initial models that should provide patients with non-verbal feedback that there is no danger in the external environment and even internal to them. The explanations and psychological analyzes are not useful to constitutional phobic patients because words do not change their biologic system! This method can be combined with the strategic techniques such as these of Milton Erickson. If the patient avoids to escape from anxiety-producing stimuli you will see a decrease in anxiety after an initial dramatic increase of it with all its accompanying symptoms. You should be taken care, before starting the exposure, to inform patients of this phenomenon, the treatment plan and the importance that they do not run away during highest manifestations of their fear. The escape has the opposite effect of reinforcing their fear because it sends feedback effects that in the environment there are really something to fear and avoid: the next times the phobic patients will test much more fear because they escaped in the past! The method suggested here wants to counter the natural tendency of phobic patients to escape and avoid. The treatment plan must take into account that phobias are reinforced also by any relevant secondary useful that can result for phobic patients in terms of assistance, protection and various psychological and practical support they can get from other people or in terms of unpleasant commitments that they can prevent.
Instead the neurotic phobias should be treated however mainly with verbal methods, such as analytical, for the modification of neurotic unconscious factors that are causing it because as long as they remain active in the psyche of patients the desensitization therapies have little or no effect.

The author of this very short work is sorry for his imperfect use of English and thanks his daughter Simona for drawings pasted in the poster that he published in the XIII European Congress of Psychology, held in Stockholm July 2013, 9-12, in order to give a contribution to Human Clinic Ethology.

Salvatore Cammarata, psychologist, Italy.

cammarata.salvatore@yahoo.it.

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