Introduction
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Fear
is a very ancient and universal emotion in man. It can be defined as the
sensation that you are in danger, that something bad is about to happen.
Fear is almost always accompanied by a host of physical symptoms which are
quite disturbing. When it is not justified by the presence of real danger
or threat, or by any rational cause, and when it is also accompanied by a
systematic avoidance of the situations which lead to it, then we have what
is called a phobia.
Phobia is actually a kind of panic reaction caused by specific stimuli
or situations. There are three basic types of phobia:
- Agarophobia, literally, it is the irrational fear of the
agora (in ancient Greece, this was the place where the market was
located), in other words, the generalized fear of places or situations
where there is a potential difficulty or embarassment to escape from it,
or where help might not be available in case of need. This includes
going out of our own's home, travelling without company, or being in the
middle of a crowd, standing in queues to leave a place, etc.
- Social phobia, when the person has a marked and persistent
fear of some specific or generalized social situations, such as the
shame of misbehaving in front of other people, the fear of participating
in group reunions, of starting or maintaining a conversation with
strangers, of initiating a romantic encounter, of talking to persons of
authority, etc.
- Specific phobias, when there is a marked and persistent fear
in the presence, or even by anticipation of encountering specific
objects and situations, such as the fear of flying, injections,
coackroaches, dogs, of seeing blood, high places, taking a lift, driving
an automobile, or staying in enclosed and restrictive places, such as
tunnels or traffic jams.
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Origins |
Six of every ten persons who suffer phobias are
able to remember when the fear crisis occurred for the first time, i.e.,
when the sensation of panic became attached to the place or situation
where it first happened.
For these persons, there is a very clear connection between the object
and the sensation of fear. For example, a man, by some unexplained reason,
suffers for the first time a strong attack of anxiety or panic when he is
driving his automobile. From this day on, he avoids driving alone, out of
fear that he will be subjected to the same sensation and will lose
control, without anyone near him to help him out. Then, this fear may
expand to and cover other situations where he might feel ill and the
escape from it is difficult, such as in a movie theather. In this manner,
agarophobia arises , the generalized fear of "getting ill" and be unable
to escape from it or get help.
In another example, a woman had a traumatic experience in a car crash.
From this day on, she is panick-stricken everytime she is required to
board a vehicle and develops a specific phobia to cars. Please note that
agarophobia (the previous example) and car phobia are fundamentally the
same, but their origin, and even the kind of fear, are different from one
another. In the first case, what the patient is avoiding is any situation
where help might be difficult or complicated, while in the second case,
what the patient is avoiding is the object in itself, i.e., the car.
But why a person becomes afflicted with phobia ? And why some phobias
are more common than others ?
Many neuroscientists believe that there is a clear involvement of
biological factors. For example, functional brain imaging studies have
shown that there is an increased blood flow and cell metabolic actiity on
the right side of the brain in phobic patients. It has also been
demonstrated that identical twins may develop the same type of phobia,
even when they were reared separately soon after birth, and educated in
different places.
It may be also true that human beings are biologically prone to acquire
fear of certain noxious animals or situations, sich as rats, poisonous
animals, animals with a disgusting appearance, such as frogs, slugs or
cockroaches, etc. In a classical experiment, the American psychologist
Marting Seligman associated an aversive stimulation (a small electric
shock) to certain pictures. Two to four shocks were enough to establish a
phobia to pictures of spiders or snakes, while a much larger series of
shocks was needed to cause phobia to pictures of flowers, for example.
One possible explanation is that those fears where originally important
for the survival of the human species thousands of years ago and that they
lie dormant inside our brains, just waiting to be awaken at any time.
Another reason for the development of phobias is that we often
associate danger to things and situations that we cannot prevent or
control, such as lightning strikes during a storm, or the attack of a
dangerous animal. In this sense, patients who have a
clinically-established panic disorder, often end developing phobia to
their own crisis, because they feel totally helpless in controlling it. In
consequence, they start avoiding going to or staying in places or
situation where they might become publicly embarassed or unable to escape,
due to the onset of the crisis.
Finally, there is also the social component or cultural influences on
phobia. For example, there is a kind of phobia called taijin
kyofusho, which occurs only in Japan. In contrast to what happens in
the social phobias (when the patient is afraid of being hummiliated or
loathed by other persons), taijin kyofusho is the fear of offending other
persons by an excess of modesty or showing respect ! The patient is afraid
that his social behavior or an imaginary physical defect might offend or
embarass other people. As you can see, this kind of fear occurs very
rarely in a Western society...
What is a common feature of all phobias, then, is that the brain
establishes powerful and enduring new connections in situations of great
emotion.
In order to understand better what goes on inside our brain when these
connections are formed, you could think a little about an universal
situation. You probably remember a situation in the past , when you was
enjoying the company of another person, in a very pleasant atmosphere,
with a nice musical background. Now, every time the same melody is played,
you recall the situation. Perhaps even the same pleasant sensations will
be felt again.
This was a positive feeling, but in our brain the phenomenon occurs
exacty in the same way for fear sensations. In general, any strong emotion
bcomes easily attached to the surrounding events or environment. Usually,
phobias develop as the consequence of feelings of anxiety or panic being
elicited in potentially dangerous situations.
No animal likes to be cornered or trapped in a place or near another
animal where it cannot escape from in case of danger. And we are animals
too, remember ?
To be trapped in a traffic jam, inside a lift cabin or in a shopping
mall full of people evokes a similar sensation of being cornered, with no
way out, for people who suffer phobias. This is the simple reason why so
many patients with clinical panic disorder develop a phobia to enclosed
spaces (claustrophobia). |