The first time that one suffers the panic to the phobic stimulus, it is through an anxiety crisis that catches by surprise, without knowing to what it is due. This crisis can involve a multitude of symptoms such as choking, trembling, tachycardia and even the sensation that one is about to die. The suffering for the affected person is considerable.
It is frequent that after a short time the experience of the phobia is repeated suffering another crisis and that the person attributes it to some physical disease, but the medical examinations do not find a physical origin.
The apparent cause and the real cause of phobias
The stimulus before which the fear arises, is only its apparent cause; in reality it is nothing more than a substitute, to which the person has unconsciously displaced the anxiety derived from the latent stimulus, repressed in the unconscious and consequently forgotten.
Therefore, in phobia we have an apparent cause (the stimulus that provokes fear) and a real cause (the forgotten event that symbolizes the apparent cause).
How do phobias work?
When a stimulus can connect with the traumatic memory, the mind shifts the thought away from the stimulus and avoids reliving the memory. If an attempt is made to confront the stimulus, panic sets in.
The person suffering from a phobia faces his inner conflict, trying to repress his thoughts and impulses. If this repression fails, then, he displaces his conflict to a place, situation, object, animal, etc… in the external world.
The external situation represents his inner psychological conflict: if he succeeds in avoiding this particular situation, he can also avoid his anxiety. It is this avoidance that constitutes the essence of phobia.
Phobic defenses lead to an abandonment of freedom and enjoyment of life, as the patient tries to avoid conflict and anxiety. Despite realizing that his fear is inappropriate, he feels that avoidance of the phobic situation is his only choice because of his panic.
“For avoidance to be effective, the conflict in the person’s mind, has to shift to the outside world.”
Real cases of phobias: from the stimulus to the traumatic memory.
I remember the case of a 30-year-old woman who was unable to be in closed places, impossible to use an elevator, to go by subway or to travel by plane.
The patient stated that she felt overwhelmed, trapped and that this caused her an unbearable feeling of suffocation. The situation itself masked what she had experienced over and over again as a child. The father drank and showed violent behavior towards the mother. She and her sister used to lock themselves and her sister in their room in fear, a traumatic experience that was forgotten without realizing it, relegated to the unconscious and therefore remained in the back of her mind. When we were able to connect with the true meaning of her fear, she was able to let go of it.
On the other hand, a 40-year-old man was treated who was not able to speak in public. It was a big problem for him because it was part of the professional activities he had to perform. Knowing his internal conflict, which had shifted to the situation of public speaking, we were able to treat him, which allowed him to face it and he no longer needed to shift. The patient was not aware that he was afraid of being seen as inferior and not very capable, which was how he had felt treated by his father, and this was happening to him, even though he was a good professional recognized in his company.
I also remember the case of a woman who suffered from agoraphobia. She went out in the street with many limitations, avoiding busy streets, crowded places or large stores. This patient presented a great vulnerability to separation experiences: she could not stand being alone, she needed to feel protected. The agoraphobic fear had to do with fear of suffering a crisis in the street and being helpless, unprotected. Thus we saw that she was currently living in a relationship of great dependence on her mother, which made her feel annulled, without resources to take charge of her life, of which she was not aware.
Treatment to overcome a phobia
The treatment of phobias is done through psychotherapy. It consists in undoing the path taken, to go from the phobic stimulus to the traumatic event. Always respecting the patient’s rhythm so that the forgotten experiences can be integrated. Although it involves great limitations to the person who suffers from it. Its treatment is not complicated, it is common to successfully resolve the conflict.