Phobophobia: features, possible consequences and treatment methods

“There is nothing more pleasant than vanishing fear,” wrote the famous American writer and philosopher Richard Bach. Only a person who has experienced “fear of fear” - phobophobia - can appreciate this saying at its true worth and accuracy. Fear itself, as a habitual reaction to any danger, is a useful feeling, but phobophobia is fear in the absence of an object of fear.

Phobia is an intense, unaccountable fear that appears during the perception of a certain object. The resulting condition is pathological, irrational, and uncontrollable. At the same time, the feeling of fear appears regularly, which is explained by the existence of many stressors. With phobias, fears, as a rule, are imaginary, that is, they depend on the individual characteristics of a person's perception of situations and objects. Phobophobia ("fear of fear") is the fear of the appearance of obsessive fear. This mental disorder is closely associated with panic attacks and other phobias.

A distinctive feature of this mental phenomenon is that its manifestations are not associated with a real object, they are born within the psyche of the sick person and depend solely on the specifics of his emotional-associative perception of the world. Phobophobia is characterized by intense and painful individual sensations fixed in the memory of a person, which are far from always amenable to management and self-control. The emergence of such sensations is irrational, they are not associated with the external environment and its stressors.Provoked by the horror of the possible onset of previously experienced feelings of deep anxiety, helplessness and hopelessness, phobophobia is a closed figure of fear.

The obsessive fear caused by the thoughts and feelings of the patient gradually, as the disease progresses, acquires a generalized, all-encompassing quality, which becomes dominant in its development. The patient involuntarily begins to monitor the state of his emotional and mental sphere, expecting a new attack. Gradually, the expectation of fear becomes permanent and extremely painful, and attempts at self-control and mastery of the situation remain hopeless. In the future, the forced and painful tracking of the state of one's emotional and mental sphere becomes dominant. The process leads to significant restrictions on the patient's capabilities in almost all areas of his activity and, as a result, to possible social self-isolation.

The life of a phobophobic person is reminiscent of the well-known character from A. Barto's poem for children "The Bull".

There is a bull, swaying,

Sighs on the go:

- Oh, the board ends,

I'm going to fall now!

Only a person in this situation does not just "sigh", he really and deeply experiences, painfully and cautiously awaiting a fall into this oppressive, dark abyss of fear. Such tense anticipation exhausts the psyche, depletes the body up to the occurrence of serious diseases of somatic origin.

The disease is provoked by the following external factors:

• the circumstances in which the sick person was once and experienced fear;
• events remembered from books or films;
• emotions similar to the emotions experienced by the patient in previous attacks of phobophobia;
• randomly recorded phrases of the interlocutor and others.

The development of phobophobia occurs in stages.

1. The period of anxiety develops from the "shock phase" overcoming the body's resistance. Somatics also contribute to the formation of anxious sensations - there are malfunctions in the work of the adrenal glands, immune and digestive systems. Appetite often worsens.
2. The stage of resistance is the mobilization and adaptation of the organism to new conditions. Feelings of anxiety, aggression, excitability characteristic of the first stage are dulled. Despite the relative calmness, the sense of anticipation of ominous fears persists and continues its destructive work.
3. The stage of exhaustion - the body's resistance is exhausted, psychosomatic disorders are exacerbated. Long-term depressive conditions and nervous breakdowns are possible. Medical help is required.

The defining elements of the process of the onset of the disease are the peculiarities of the perception of the situation of fear and its imprinting. With typical phobias, getting into a provoking situation, patients associate fears with any specific object. With phobophobia, the main element is strong, incomprehensible, spontaneously (as it seems to the patient) emerging internal feelings of the patient, existing autonomously and depending solely on his emotional state.

Often, different fears can be combined, while one of them, for example, fear of insanity, dominates, while others form a fatal background of the picture of the disease.Depending on the various circumstances and characteristics of the patient's emotional-associative series, various fears are activated alternately. Thus, when experiencing fear of fear, the sick person may be afraid of the following aspects:

• repetition of the painful sensation of terror;
• experiencing fear as a threat to your health, since the symptoms of horror can remind you of the symptoms of a heart attack or an asthma attack; hence, fear for one's life arises, and any strange bodily sensations become suspicious;
• some symptoms of fear form unusual sensations in the head, dizziness, a feeling of loss of connection with reality, visual distortions; after which the patient begins to fear for his sanity;
• often the dominant role in the process is played by the fear of losing control over oneself (over one's body, behavior, memory, attention).

The main reason for the occurrence of phobophobia is the influence of negative factors of psychogenic origin, which reduce the degree of stress resistance and worsen the patient's physiology. The features of the manifestation of the initial symptoms depend on the level of strength and the mode of exposure to the initial negative stressor. If the initial traumatic event was relevant to the individual, then there is definitely a possibility of the disease occurring. With repeated but weak exposure to stressors, the disease will develop gradually, proceeding covertly until it reaches its peak. The most susceptible to this disease are people such as:

• highly emotional;
• with low stress resistance;
• shy and timid;
• overly suspicious;
• with a choleric or melancholic temperament;
• conflicting.

There are a number of scientific concepts to one degree or another explain the causality of the occurrence of phobic disorders.

• Psychoanalytic. Psychoanalysts believe that one of the causes of the disease may be the costs in the family upbringing of children (overprotection, isolation, and others). In their opinion, the cause of phobias can be suppression of sexual desires, fantasies, transformed into neuroses and panic attacks.
• Biochemical. Biochemists are of the opinion that fear develops due to disturbances and failures in the work of hormonal and other body systems.
• Cognitive. The cognitive-behavioral concept defends the opinion that the formation of prerequisites for the disease is facilitated by: concern about their health, conflict and negativistic way of thinking, social isolation, unhealthy family environment.
• Hereditary. Hereditary views on the causes of a disease refer to the likely influence of genes on its development. Several scientific studies support this concept.

The following factors can influence the possible development of phobophobia to varying degrees:

• traumatic brain injury;
• overwork, lack of adequate rest;
• alcoholism, drug addiction;
• nervous overexcitement and conflicts;
• poisoning;
• diseases of the internal organs.

The psychosomatic picture of the disease determines an extremely wide range of symptoms (signs) in the development of phobophobia. Disturbing memories can be triggered by completely different factors. In addition, such a variety of symptoms largely depends on the individual characteristics of temperament, character, personal characteristics of a person and his life experience, the combination of which, as you know, is unique. Self-control, as one of the key traits of a person's character, which determines not only the ability to control oneself, emotions, and act effectively in significant and critical circumstances, makes it possible to obtain a worthy social status. A person who is unable to control himself, as a rule, becomes an outcast in any social group. This social taboo, in tandem with psychasthenic and demonstrative personality traits, often leads to the formation of phobias.

Feeling the futility of personal control over their thoughts and memories, phobophobic patients attempt to control the outside world. To do this, they often form a complex system of rituals, usually hidden from others. In particular, the absence of a specific object of fear leads to a strengthening of the tendency to avoid. A phobophobic person may fear an attack of claustrophobia while traveling in a car, flying on an airplane, or being afraid of communicating with another person.

Often, patients with phobophobia associate personal fears with concerns about their health. In these cases, emphasis on autonomic symptoms or disturbances in the perception of oneself and the world are possible. Typically, these patients complain of palpitations, shortness of breath, weakness in the legs, dizziness, stomach discomfort, nausea and urge to urinate. Some patients record a feeling of loss of control over their body, some "emptiness" in the head, narrowing of the field of vision and visual distortions. Such symptoms lead to the appearance of a fear of death, insanity, or memory loss.

The presented images of the tragic consequences of attacks of phobophobia lead to the release of adrenaline, which affects the functioning of the autonomic system - the rhythms of the pulse and respiration increase, the tone of smooth muscles changes. All this leads to the occurrence of the above symptoms. Thus, mental phenomena lead to somatic changes in the body - the prophecies of a phobophobic patient become reality, self-fulfilling.

Any bodily sensation can also provoke an attack. In the future, they begin to be caused not only by negative, but also by positive emotions. The more the disease is started, the more frequent and intense the attacks become. Other mental disorders are added to the fear of fear: depression, generalized anxiety and obsessive-compulsive disorders. Becomes possible: alcoholism, abuse of benzodiadepines or sedatives.

Thus, the main signs of phobophobia include the following:

• a feeling of powerlessness from the inability to exercise control over your thoughts;
• attempts to form and observe a special protective ritual system, leading to isolation;
• bouts of claustrophobia and social phobia;
• appropriate vegetative symptoms.

In its development, phobophobia becomes a pathological, obsessive process dominating the mind and an objective assessment of reality. The self-reinforcing mechanism of phobophobia provokes a significant deterioration in the general condition of the body. In addition, it can be a real basis for the emergence of a number of negative addictions (alcoholism, drug addiction and others), resorting to which patients try to avoid painful conditions. As a result of the triggering of protective mechanisms, patients develop a persistent desire for self-isolation so that casual communication with someone does not lead to another attack.

A real danger is that phobophobia is a constant test for the whole organism. First of all, the cardiovascular, nervous, endocrine and digestive systems are affected. To a significant extent, the psychological state also deteriorates, and severe mental illnesses develop.The damage to the body is significant, and sometimes irreparable. Seeking medical attention becomes necessary. After examining the patient, the doctor will select the appropriate method of correction and therapy.

The diagnosis of the disease is determined on the basis of patient complaints, examination results and special testing. The Beck, Hamilton and HADS scales of anxiety and depression, the Zang scale (for self-assessment of anxiety) and other techniques can be used to diagnose the disease. If there is any suspicion of any somatic pathology, the patient is referred for consultations to a therapist and other specialists. Treatment is carried out according to an individual plan, taking into account the patient's condition, the presence or absence of other mental and somatic abnormalities.

Drug treatment is carried out when concomitant depressive disorders are detected, a high level of anxiety, psychological exhaustion and the absence of any resources for the patient to carry out psychotherapeutic work. Often used are beta-adrenergic receptor blockers, benzodiazepine tranquilizers, tricyclic and serotonergic antidepressants.

In order to eliminate the causes of its development, various psychotherapeutic techniques are used: cognitive-behavioral and rational therapy, psychoanalysis, hypnosis, neurolinguistic programming. The main focus in psychotherapy of phobophobia is to strengthen the body's adaptive abilities to traumatic sensations, to create a new way of the patient's response to the "terrible" reality, which manifests itself in the following:

• in the course of cognitive work with the disease, the individual realizes the mechanism of development of phobophobia and what exactly he is afraid of, a real or imaginary threat;
• there is a building of the so-called anticipatory consciousness of fear perception, readiness and ability to meet an attack, forming a preliminary basis for a productive response;
• teaching the patient the right actions (not passive waiting); such actions must be proactive, conscious and purposeful.

Desensitization is an effective way to gradually master and curb phobias. Significant bodily tension generated by fear is reduced with the help of a special technique of voluntary relaxation, which allows you to master your consciousness and emotional state. The emergence, development of phobophobia and other phobias accompanying the disease is a psychological phenomenon that has not yet been fully studied. It is important to understand that mental stress, irrational and negative ways of thinking contribute to the development of anxiety and fear. This is a clear clue to the patient and an undoubted resource for an effective way out of the situation and victory over the disease. The prognosis of the results of treatment depends on the severity of phobophobia, the duration and stage of its development, the presence of other mental disorders, the maturity and readiness of the individual for the final recovery.