worth saying that mankind has experienced phobias since the dawn of time.
In the works by Areteus of Cappadocea (latter half 1st century B.C.) there’s a description of a case in which you can easily recognize what today would be called agoraphobia.
“Some patients don’t show anything unusual at home, but in less familiar atmosphere, you can notice at once the incapacity of their mind. One carpenter was like this. He measured the planks carefully, was a skilled woodworker, made reasonable arrangements with the customers, but all this was only when he was within his usual scope of activity. But every time he was going to the square, to the market or baths he put down his tools with a deep sigh, bent his back, started to shake and went into a state of sad agitation as he was losing sight of his workshop and his apprentices. After he turned back home, he calmed down and went about work again.”
Felix Platter (1537—1614) describes obsessive-compulsive disorders amongst other mental diseases:
“One woman, a correspondence clerk’s wife, can’t dismiss a fear of killing her husband, whom she loves very much by the way. Another woman, a cantiniere, feels the same kind of worry concerning her newborn baby; both of them would like to forget about these thoughts, but they can’t”
The number of phobias is almost immeasurable. There are people who try to classify fears and add new exotic names to the list… This list called the doctrine of fears, was named by one specialist as “the garden of Greek roots” (You can see it at Appendix I). In my opinion, such classification is more philological than bearing any practical value. The keys to working through these unpleasant states is the knowledge about the processes which go on in the mind when a person is afraid, rather than the terms used to name various conditions.
Risk factors
There are several important factors which affect the chances of a person developing a phobia.
1. Natural factor: the nature of a person. There are people who are naturally resistant to changes in their surroundings and those who feel at a loss even if there’s a slightest confusion in their life. Some people worry and are frightened even when the reason for it is insignificant. Their body type is in most cases elongated: a narrow face, a thin neck, comparatively long arms and legs. This constitution type ([битая ссылка] phenotype) is called asthenic or gracile.
People with fine skin and soft hair often worry too much about their family. These peculiarities are typical of so called “pyknic”, or sumptuous body type.
There is another phenotype that falls within the danger area. These people are inclined to day-dreaming and exaggerating reality. They have deep-set eyes, a narrow nose and a chiselled face: their body type is “bony” and lean.
2. The memory of generations. According to the ideas of some researchers (B. Hellinger, V. Dokuchaev, L. Dokuchaeva), the information from the precedent generations can be transmitted to their succession through the family spiritual field, through the “big soul” which all of us belong to. Sometimes my patients notice that the positive experience and support comes from “the roots” or “from the back”. But the memory of stressful situation which the ancestors had gone through can also be inherited. In this case a person experiences fears which cannot be explained by his or her own life or the contemporary situation.
3. Early childhood impressions. It often happens that the beginning of life creates a base for phobias and other traumas. Lack of experience and support, high levels of sensibility; there aren’t many people who managed to avoid “childhood fears”. In many cases they transform and become a part of the adult life. Some of the authors also pay special attention to pregnancy and childbearing periods (O. Rank, S. Grof).
4. Type of education. It’s quite important what kind world view was received from the patient’s family. It’s great if the overall spirit was that every problem could be solved: “there’s a chance in every crisis, I see the goal and I don’t see any obstacles.” But it’s a different story if the mood of panic was predominant in the family and if every trouble is seen as apocalyptic. It’s one thing when the child was taught to lead a healthy lifestyle and to wash hands before eating. However, it’s a totally different thing if there was a constant “fight with germs” and if they suggested the idea of people being helpless as if the immune system didn’t exist at all. Of course the risk of development of stable fears is much higher in the latter case.
4. General level of education and life competence. The more you know about life and ways of solving the problems, the calmer and more self-assured you are. The calmer you are, the more adequate your actions are. The more adequately you act, the more self-assurance you get. And vice versa, the less experienced you are, the more nervous you get and it’s more likely that you won’t accept the challenge.
5. Situations when it’s really difficult to adapt. There are extreme cases which even a very reasonable person can find difficult to maintain his or her cool. Unexpected situations may arise at the time when one simply has no experience dealing with and feels completely helpless. Such situations can happen at any stage in our life: from infant to elderly.
6. Whether one enjoys or lacks the support of other people or of society in general. An active team member can find it easier to overcome challenges than a lonely person. Keeping one’s cool is much easier when everything is calm rather than when the situation is critical. A state with a well-established social programme facilitates the resolution of various emergency situations unlike a society where every man is for himself.
Other risk factors
There are other reasons that may cause fear. If one’s immune system is weak, it is easier to get an infection. In exactly the same way when the overall energy level of a person is low (or even when one hasn’t had enough sleep or has recently had the flu), then there is a chance that this person has lower self-esteem and might end up suffering from a phobia.
Our brain works consistently if it gets enough oxygen. In the case of painless ischaemia, that is in the case of insufficient blood supply, our brain’s energy “goes down”. In this situation a person is prone to “catching” a fear.
Lack of oxygen can also cause panic attacks. When the brain doesn’t get enough oxygen, it tries to increase the blood flow and triggers an adrenalin rush. As a result, the blood flow increases, the heart rate increases, and blood pressure goes up, but this state is rather unpleasant. In this situation a person might think that he or she is losing their mind or dying.
Unfortunately, the majority of people who experience a sympathoadrenal episode don’t know that this is a sign of life and not a preview of death. It’s just a very awkward way our body regulates itself. Such episodes trigger our fears that something might be wrong with our health. If that is your case, you will find more information on it in part 1.15 where I will show several examples from practice and will offer you a step-by-step action plan.
Special cases
Important information: some conditions can have different origins but are manifested through similar symptoms. It is very important to understand that not all these conditions have psychological grounds.
Anxiety and phobic disorders after chemical intoxication (delirium alcoholicum, for example) are to be treated with a complex approach. In such cases medication, and psychotherapy only wouldn’t be enough. More than that, relying exclusively on psychotherapy may lead to the death of the patient.
Phobias caused by endogenous psychosis such as schizophrenia, manic-depressive psychosis, etc. which are usually accompanied by hallucinations and delusions are a separate case. In these situations, a patient would also need a combination of medication and psychotherapy.
Organic