Phobophobia

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Phobophobia is a phobia defined as the fear of phobias, or the fear of fear, including intense anxiety and unrealistic and persistent fear of the somatic sensations and the feared phobia ensuing. Phobophobia can also be defined as the fear of phobias or fear of developing a phobia. Phobophobia is related to anxiety disorders and panic attacks directly linked to other types of phobias, such as agoraphobia. [1] When a patient has developed phobophobia, their condition must be diagnosed and treated as part of anxiety disorders. [2]

Contents

Phobophobia: is the fear of fear itself, but more specifically, of the internal sensations associated with that phobia and anxiety, which binds it closely to other anxiety disorders, especially with generalized anxiety disorders (free floating fears) and panic attacks. It is a condition in which anxiety disorders are maintained in an extended way, which combined with the psychological fear generated by phobophobia of encountering the feared phobia would ultimately lead to the intensifying of the effects of the feared phobia that the patient might have developed, such as agoraphobia, and specially with it, [1] and making them susceptible to having an extreme fear of panicking. [1] Phobophobia comes in between the stress the patient might be experiencing and the phobia that the patient has developed as well as the effects on their life, or in other words, it is a bridge between anxiety/panic the patient might be experiencing and the type of phobia they fear, creating an intense and extreme predisposition to the feared phobia. Nevertheless, phobophobia is not necessarily developed as part of other phobias, but can be an important factor for maintaining them. [1]

Phobophobia differentiates itself from other kinds of phobias by the fact that there is no environmental stimulus per se, but rather internal dreadful sensations similar to psychological symptoms of panic attacks. [1] The psychological state of the mind creates an anxious response that has itself a conditioned stimuli leading to further anxiety, [1] resulting in a vicious cycle. Phobophobia is a fear experienced before actually experiencing the fear of the feared phobias its somatic sensations that precede it, which is preceded by generalized anxiety disorders and can generate panic attacks. Like all the phobias, the patients avoids the feared phobia in order to avoid the fear of it.

Cause and symptoms

Phobophobia is mainly linked with internal predispositions. It is developed by the unconscious mind which is linked to an event in which phobia was experienced with emotional trauma and stress, which are closely linked to anxiety disorders and by forgetting and recalling the initiating trauma. [3] Phobophobia might develop from other phobias, in which the intense anxiety and panic caused by the phobia might lead to fearing the phobia itself, which triggers phobophobia before actually experiencing the other phobia. The extreme fear towards the other phobia can lead the patient to believe that their condition may develop into something worse, intensifying the effects of the other phobia by fearing it. Also, phobophobia can be developed when anxiety disorders are not treated, creating an extreme predisposition to other phobias. The development of phobophobia can also be attributed to characteristics of the patient itself, such as phylogenetic influence, the prepotency of certain stimuli, individual genetic inheritance, age incidence, sex incidence, personality background, cultural influence inside and outside the family, physiological variables and biochemical factors. [3] Phobophobia shares the symptoms of many other anxiety disorders, more specifically panic attacks and generalized anxiety disorder:

  1. Dizziness
  2. Heart pounding
  3. An excess of perspiration
  4. Slight paresthesia
  5. Tension
  6. Hyperventilation
  7. Angst
  8. Faintness
  9. Avoidance

Association with generalized anxiety disorder

Generalized anxiety disorder is when our minds are troubled about some uncertain event, [4] or in other words, when we feel threatened, although the source of the threat might not be obvious to us. [4] It is a disorder when it happens frequently, and disables people from accomplishing some of their daily activities. Generalized anxiety disorder always comes before phobophobia, and some of its symptoms are listed below:

  1. Paleness of skin
  2. Sweating
  3. Dilation of pupils
  4. Rapid pounding of heart
  5. Rise in blood pressure
  6. Tension in the muscles
  7. Trembling
  8. Readiness to be startled
  9. Dryness and tightness of the throat and mouth
  10. Rapid breathing
  11. Desperation
  12. A sinking feeling in the stomach
  13. A strong desire to cry, run or hide

The main problem with this disorder is that we do not know what we are troubled about, which may lead to our desire to escape. Anxiety becomes a disorder only when we experience psychological trauma, in which our knowledge of past events trigger a fear of uncertain danger in the future. In other words, the primarily event is anxiety which arises for no accountable reason, panic might develop from anxiety [4] and the phobophobia is developed in the very end as a consequence of both of them, [3] sharing some of the symptoms. If either of these initiating disorders are not treated, phobophobia can be developed because an extended susceptibility and experience of this feelings can create an extreme predisposition to other phobias. Anxiety is mainly fixed to a certain specific event or specific events, a strong learned drive which is situationally evoked which is stressful to one person but not to another, and this makes it much easier for phobophobia to develop, as well as other phobias. [5]

Association with panic attacks

When people experience panic attacks, they are convinced that they are about to die or suffer some extreme calamity [6] in which some kind of action is done by the individual (such as fleeing or screaming). In case of phobophobia, a panic attack might be encountered as the fear that they will in fact experience the calamities of the feared phobia and see it as something inevitable. Also, the nature of the panic is of profound personal significance to the individual, on a similar way phobophobia is related to the individual. [6] This is why panic attacks are closely related to phobophobia. Nevertheless, they can differentiate themselves by the fact that phobophobia is a psychological fear of the phobia itself that intensifies it, while panic attacks are extreme fear of encountering the calamities of an imminent disaster, and in this particular case, of encountering other phobias, which can be often accompanied by at least four of the following common symptoms of panic attacks:

  1. Dyspnea
  2. Palpitations
  3. Chest pain or discomfort
  4. Choking or smothering sensations
  5. Vertigo or unsteady feelings
  6. Feelings of unreality (depersonalization or derealization)
  7. Paresthesias (tingling in hands or feet)
  8. Hot and cold flushes
  9. Faintness
  10. Trembling or shaking
  11. Difficult breathing
  12. Sweating

Panic attacks can also be accompanied by disturbance in heart action and feelings of desperation and angst. [6] Being closely related, phobophobia and panic attacks, the first one can be treated like a panic attack with psychological therapy. Moreover, in combination with phobophobia, a patient might be more susceptible to believe that their continuing anxiety symptoms will eventually culminate in a much more severe mental disorder, such as schizophrenia. [6]

Treatment

There are many ways to treat phobophobia, and the methods used to treat panic disorders have been shown to be effective to treat phobophobia, because panic disorder patients will present in a similar fashion to conventional phobics and perceive their fear as totally irrational. [6] Also, exposure based techniques have formed the basis of the armamentarium of behaviour therapists in the treatment of phobic disorders for many years, they are the most effective forms of treatment for phobic avoidance behavior. [7] Phobics are treated by exposing them to the stimuli which they specially fear, [6] and in case of phobophobia, it is both the phobia they fear and their own sensations. There are two ways to approach interoceptive exposure on patients:

Cognitive modification is another method that helps considerably to treat phobophobics. When treating the patients with the method, doctors correct some wrong information the patient might have about his disease, such as their catastrophic beliefs or imminent disaster by the feared phobia. Some doctors have even agreed that this is the most helpful component, since it has shown to be very effective especially if combined with other methods, like interoceptive exposure. The doctor seeks to convince patients that their symptoms do not signify danger or loss of control, [7] for example, if combined with the interoceptive exposure, the doctor can show them that there is no unavoidable calamity and if the patient can keep themselves under control, they learn by themselves that there is no real threat and that it is just in their mind. Cognitive modification also seeks to correct other minor misconceptions, such as the belief that the individual will go crazy and may need to be "locked away forever" or that they will totally lose control and perhaps "run amok". [6] Probably, the most difficult aspect of cognitive restructuring for the majority of the patients will simply be to identify their aberrant beliefs and approach them realistically. [6]

Relaxation and breathing control techniques are used to produce the symptoms naturally. The somatic sensations, the feared stimuli of phobophobia, are sought to be controlled by the patient to reduce the effects of phobophobia. [6] One of the major symptoms encountered is that of hyperventilation, which produce dizziness, faintness, etc. So, hyperventilation is induced in the patients in order to increase their CO2 levels that produce some of this symptoms. By teaching the patients to control this sensations by relaxing and controlling the way they breathe, this symptoms can be avoided and reduce phobophobia. This method is useful if combined with other methods, because alone it does not treat other main problems of phobophobia.

Etymology

The word phobophobia is an English adaptation of the Greek φόβος, phobos, "fear". Phobophobia literally translates to "fear of fear".

See also

Related Research Articles

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A phobia is an anxiety disorder, defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, often found in agoraphobia and emetophobia. Around 75% of those with phobias have multiple phobias.

<span class="mw-page-title-main">Panic attack</span> Period of intense fear

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing control. Typically, symptoms reach a peak within ten minutes of onset, and last for roughly 30 minutes, but the duration can vary from seconds to hours. Although they can be extremely frightening and distressing, panic attacks themselves are not physically dangerous.

Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the object or situation, persistence of the fear, and significant distress or problems functioning associated with the fear. A phobia can be the fear of anything.

<span class="mw-page-title-main">Claustrophobia</span> Medical condition

Claustrophobia is a fear of confined spaces. It is triggered by many situations or stimuli, including elevators, especially when crowded to capacity, windowless rooms, and hotel rooms with closed doors and sealed windows. Even bedrooms with a lock on the outside, small cars, and tight-necked clothing can induce a response in those with claustrophobia. It is typically classified as an anxiety disorder, which often results in panic attacks. The onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.

<span class="mw-page-title-main">Fear of needles</span> Phobia of injections or needles

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Systematic desensitization, or graduated exposure therapy, is a behavior therapy developed by the psychiatrist Joseph Wolpe. It is used when a phobia or anxiety disorder is maintained by classical conditioning. It shares the same elements of both cognitive-behavioral therapy and applied behavior analysis. When used in applied behavior analysis, it is based on radical behaviorism as it incorporates counterconditioning principles. These include meditation and breathing. From the cognitive psychology perspective, cognitions and feelings precede behavior, so it initially uses cognitive restructuring.

Pseudodysphagia, in its severe form, is the irrational fear of swallowing or, in its minor form, of choking. The symptoms are psychosomatic, so while the sensation of difficult swallowing feels authentic to the individual, it is not based on a real physical symptom. It is important that dysphagia be ruled out before a diagnosis of pseudodysphagia is made.

Cynophobia is the fear of dogs and canines in general. Cynophobia is classified as a specific phobia, under the subtype "animal phobias". According to Timothy O. Rentz of the Laboratory for the Study of Anxiety Disorders at the University of Texas, animal phobias are among the most common of the specific phobias and 36% of patients who seek treatment report being afraid of dogs or afraid of cats. Although ophidiophobia or arachnophobia are more common animal phobias, cynophobia is especially debilitating because of the high prevalence of dogs and the general ignorance of dog owners to the phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) reports that only 12% to 30% of those with a specific phobia will seek treatment.

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Blood-injection-injury (BII) type phobia is a type of specific phobia characterized by the display of excessive, irrational fear in response to the sight of blood, injury, or injection, or in anticipation of an injection, injury, or exposure to blood. Blood-like stimuli may also cause a reaction. This is a common phobia with an estimated 3-4% prevalence in the general population, though it has been found to occur more often in younger and less educated groups. Prevalence of fear of needles which does not meet the BII phobia criteria is higher. A proper name for BII has yet to be created.

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<span class="mw-page-title-main">Panic disorder</span> Anxiety disorder characterized by reoccurring unexpected panic attacks

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<span class="mw-page-title-main">Interoception</span> Sensory system that receives and integrates information from the body

Interoception is the collection of senses providing information to the organism about the internal state of the body. This can be both conscious and subconscious. It encompasses the brain's process of integrating signals relayed from the body into specific subregions—like the brainstem, thalamus, insula, somatosensory, and anterior cingulate cortex—allowing for a nuanced representation of the physiological state of the body. This is important for maintaining homeostatic conditions in the body and, potentially, facilitating self-awareness.

References

  1. 1 2 3 4 5 6 7 8 Griez, E. J. and Van den Hout, M. A. . Treatment of Phobophobia by Exposure to CO2-Induced Anxiety Symptoms. The Journal of Nervous and Mental Disease 171 (1983): 506-508. ISSN   0022-3018.
  2. ↑ Edmund J. Bourne. The Anxiety & Phobia Workbook. 4th ed. US: New Harbinger Publications, 2005, ISBN 1-57224-413-5.
  3. 1 2 3 Mark, Isaac M. Fear and Phobias. Great Britain: Academic Press, 1969, LCCN 75084222.
  4. 1 2 3 Mark, Isaac M. Living with fear: understanding and coping with anxiety. US: McGraw Hill, 1978, ISBN   0-07-040395-3.
  5. ↑ Levitt, Eugene E. The psychology of Anxiety. US: The Bobbs-Merrill Company, 1967, LCCN 67-19654.
  6. 1 2 3 4 5 6 7 8 9 Baker, Roger. Panic Disorder: Theory, Research and Therapy. Ed. Roger Baker. Great Britain: John Wiley and Son Ltd., 1989, ISBN   0-471-92319-2.
  7. 1 2 3 Wolfe, Barry E., et al. Treatment of panic disorder: A Consensus Development Disorder. Ed. Barry E. Wolfe and Jack D. Maser. US: American Psychiatric Press, 1994, ISBN   0-88048-685-6.
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