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Phobia
In psychology the term phobia, ancient Greek phobos (φόβος), means a set of psychological suffering which present themselves differently in children where they are often inconsequential, or in adolescents and adults. In taking value of symptoms, they should be valued as a sign of psychological suffering that is to analyse before thinking about any therapeutic measure. For psychoanalysts, or phobias are never isolated entities and stable, they are always attached to a pole organization or borderline neurotic (hysteria anxiety, obsessive-phobo neurosis, etc.).. The phobia of small Hans in the stories of Freud are paradigmatic.
In psychoanalysis
For psychoanalysis, the phobia is the product of a compromise acting by a displacement of representations, a significant object (the father in Little Hans) loved and hated, subject to a less significant but for fears (the horse at Hans).
The result is defensive: "I do not want to trouble my father rival of Oedipus is the horse who tries to bite me." There are twofold: projection and displacement, hatred is projected onto the horse because qu'insupportable the light of censorship or Ego, and this is the horse which is threatening to me.
The psychoanalytic treatment aims to highlight the mechanisms or symptoms phobiques, anxious, and so on. It aims to re-meaning, then his preparation by the subject, including in its configuration œdipienne unconscious.
From the time of Freud, it was found that fear was a fleeting symptom unstable and fragile, one speaks of hystéro-phobia, obsessive-phobo neurosis, and so on. The anguish is often presented as an alarm signal as was very clearly demonstrated Freud. Therefore, only address the symptoms events may appear to be very inadequate. Unlike the approach béhavioriste for psychoanalysis, a symptom phobic has a meaning that is deciphered to achieve sub-bassements unconscious.
* The psychoanalysis - or psychoanalytic psychotherapy
Are therapeutic indications whose goal is, through the investigation of the unconscious patient to reach a deep understanding of symptoms and their raison d'etre. This investigation is done in the context of a relationship transférentielle which updates the conflict unconscious in order to enable it to be overcome and exceeded. This psychotherapy depths is longer and more engaging than the cognitive-behavioral psychotherapy insofar as it addresses the causes of neurosis and not just its manifestations secondary. In cases where this is necessary, some psychoanalysts call for a joint work with therapists using the TCC, because of the sometimes intrusive symptoms, and then allow analytical processing itself.
Epidemiology behavioral
In classifications as DSM or ICD, these reactions should be sufficiently debilitating so we can talk about a phobia. The phobias are the most frequent forms of the family of anxiety disorders. It is estimated that 5 to 25% of the general population suffers from phobia (s). The phobias represent the same psychiatric disorder most prevalent among women, and the 2nd most common among men. [Ref. necessary]. Diagnosis requires to remove any organic origin of the symptoms (including emergencies that may have the same format-infarction, pulmonary embolism, Pheochromocytome, stroke, hypoglycemia…), a more structured neurosis, a dysthymique disorder or psychosis ( phobias atypical). The phobia is characterized by an irrational fear and a major presence of the stimulus phobogene, could evolve into a panic attack if avoidance is not possible. The phobias not become "pathologies" that they lead to significant suffering for patients, and a deterioration of its quality of life. They then become disabling by the presence of symptoms phobogene stimulus, and by the strategies to be put in place the patient in order to avoid them.
Some phobias have no psychological component, but are reactions to stimuli physically unbearable because of a particular medical condition:
* Photophobia, fear of light, one of the possible symptoms of meningitis.
* Hydrophobie, fear of water, means in the case of a patient with rabies unable to swallow liquids, insofar as they lead a laryngeal spasm.
Classification and visible signs
The classification behaviorist separates phobias into three categories:
* Specific phobias (or phobias "simple"), where symptoms are triggered by an external object: mouse, planes, blood, etc.. Often neglected by the entourage toured and sometimes ridiculous, they can be a source of major psychological distress, and in some cases a serious impact on the quality of life (phobia transport phobia of animals, natural phenomena phobia…) .
* Social phobias, including fear of interacting with others, to perform certain actions before other people, for example blemmophobie (fear the eyes of others) or the éreutophobie (fear of blushing). It should to relativise the concept of "social phobia", which is an emerging concept of modern psychiatry and was previously commonly referred to as "timid".
* Agoraphobia, ie the fear of leaving his immediate environment and ending up in a place where it would be difficult or embarrassing to escape.
The phobias vis-à-vis diseases, such as nosophobie (fear of diseases in general) or cancérophobie (fear of cancer), are in principle forms of hypocondrie not simple phobias. Nevertheless, some rankings rank fear of being contaminated in simple phobias, and of being sick already in hypocondrie.
Most specific phobias represent an extreme state of a normal feeling: phobia aircraft represents the boost of the natural feeling of apprehension that everyone feels during a takeoff, for example. The symptoms experienced during the confrontation with the object or situation phobogene vary greatly from one topic to another, constituting in extreme cases a panic attack with general malaise, feeling of imminent death, tachycardia, sweating , Etc.. In all cases, the shapes of specific phobia are aware of the irrationality of their fear and suffering.
Most people suffering from phobia tend to flee the subject phobogene or when they are forced to cross, arrange to be accompanied by an object "contraphobique" which reassures: gri gri-box or drugs of a person.
The names of phobias is built using the Greek root corresponding to the subject concerned. The diversity of phobias described that can be referenced hundreds of different specific phobias!
Among the infinite forms in which phobias may arise, see the complete list of phobias (Entia non sunt multiplicanda praeter necessitatem, literally: "The essential things must not be multiplied unnecessarily")
* Fear marked and persistent, excessive or unreasonable, triggered by the presence or anticipatory idea of an object or a specific situation (eg aircraft flying, heights, animals, receive an injection, see the blood) .
* Exposure to phobic stimulus almost invariably provokes an immediate response of concern, which may take the form of a panic attack linked to the situation, or a predisposition to such a crisis.
Note: In children, the concern may be expressed in tears by the moody, by rigidity, or clinging.
* The person admits that the fear is excessive or unreasonable.
Note: For children, this characteristic may be absent.
* Phobiques situations are avoided or, are supported with an alarm or distress intense.
* The avoidance, anticipation anxiety or distress in the feared situation significantly interferes with the normal everyday person, with his professional operation (or school), with its activities and social relationships, or there is a marked distress due to being subject to the phobia.
* For people under 18 years, the situation persists for at least 6 months.
* We have to worry, panic or avoidance phobic related to the object or situation can not be explained better by another mental disorder. This could be another trouble Obsessive Compulsive Disorder (for example, fear of dirt from someone with a fear of contamination), a post-traumatic disorder (eg, avoidance of stimuli related to a factor of stress) , A disorder of separation anxiety (eg, avoidance of school), a social phobia (for example, action to avoid social situations because of fear of embarrassment), a panic with agoraphobia , Agoraphobia without history of panic.
* Genetics
In addition to a supposed organic component is the more often a psychological origin (intrapsychic and unconscious) and, sometimes, a family factor.
* Cognitivo-behavioural
Psychologists believe cognitivistes phobia as a learned behavior and strengthened during the patient's life. The nature of the object phobogène itself is not essential to understanding the etiology of phobia, but rather the cognitive mechanisms which anchor the patient in his phobia.
* The cognitive-behavioral psychotherapy is a therapeutic indication for the treatment of phobias if one wants to address the symptom as such. To this extent, the treatment is to propose the patient to confront the situation feared, first from afar and in a reassuring, then more and more intimately. This exhibition leads to a progressive decrease reactions of fear and allows the disappearance of fear in some cases, by desensitization. The cognitive-behavioral psychotherapy and treats the symptoms, and may be sufficient to enable the patient to live better.
In addition, psychiatrists may find, after evaluation of the patient, whether to prescribe to appoint certain drug classes such as beta blockers, anxiety (including benzodiazepines or anti H2), or antidepressants (including IRS) in dealing with this type of pathology.
Read also Social phobia
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