Understanding Phobias

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Phobias are irrational, debilitating fears of objects like spiders, heights, or being stuck in enclosed spaces that really do represent some danger to the continued survival of the human organism but whose dangerous dimensions are blown way out of proportion.

It’s interesting that the psychology with the most superficial explanation for phobias, behavioral psychology, has probably had the most success treating them. It’s not looking for underlying psychological or emotional reasons for the manifestation of the phobia but instead takes things as they are. The phobia is the problem so the route to cure starts and ends with the phobia, not with the possible deeper reasons for its existence. Through a stair step approach of increasing exposure to the source of fear where upon greater comfort at each level the intensity is ratcheted up most people end up overcoming their particular phobia.

But the depth psychologies like psychoanalysis and existentialism say “Not so fast!” They posit that the phobia is the visible manifestation of deeper psychological issues and that treating the manifestation is all well and good but upon ‘cure’ actually what ends up happening is that some other problem of living rises up in place of the phobia since the source hasn’t been treated or cured at all. Behavioral psychology retorts “If and when a new manifestation crops up we’ll treat that too.” And on and on the battle of the psychologies rages.

But there’s no reason why the psychologies can’t be used in harmony to create a more complete treatment program. From our psychoanalytic/existential point of view all phobias are an unconscious strategy to take painful, ephemeral, free floating, hard to describe existential anxiety and bunch it all together into a visible, concrete, easy to conceptualize fear. Existential anxiety, as we’ve written so many times, is the threat of nothingness, which means its dimensions are by its very nature indefinable and unknowable. The solution to this problem is to try to turn nothing into something, to try to make sense of those painful feelings flitting at the edge of conscious awareness by giving them a visible shape. Phobias are just an extreme example of this psychological process and the result of the felt inability to confront painful existential anxiety honestly.

This in no way means behavioral psychology shouldn’t be employed to help clients with their presenting problem. They come in seeking relief from a specific phobia so why not use the treatment paradigm with the highest success rate for phobias? But for us the treatment is incomplete unless it includes philosophical conversations around what existential anxiety is and the various ways it manifests in daily life. Unless you pull a weed out by the roots it will grow back, even though for a while it seems like it has disappeared.