Risk factors

There are several important factors which affect the chances of a person developing a phobia.

1. Natural factor: the nature of a person. There are people who are naturally resistant to changes in their surroundings and those who feel at a loss even if there’s a slightest confusion in their life. Some people worry and are frightened even when the reason for it is insignificant. Their body type is in most cases elongated: a narrow face, a thin neck, comparatively long arms and legs. This constitution type ([битая ссылка] phenotype) is called asthenic or gracile.

People with fine skin and soft hair often worry too much about their family. These peculiarities are typical of so called “pyknic”, or sumptuous body type.

There is another phenotype that falls within the danger area. These people are inclined to day-dreaming and exaggerating reality. They have deep-set eyes, a narrow nose and a chiselled face: their body type is “bony” and lean.

2. The memory of generations. According to the ideas of some researchers (B. Hellinger, V. Dokuchaev, L. Dokuchaeva), the information from the precedent generations can be transmitted to their succession through the family spiritual field, through the “big soul” which all of us belong to. Sometimes my patients notice that the positive experience and support comes from “the roots” or “from the back”. But the memory of stressful situation which the ancestors had gone through can also be inherited. In this case a person experiences fears which cannot be explained by his or her own life or the contemporary situation.

3. Early childhood impressions. It often happens that the beginning of life creates a base for phobias and other traumas. Lack of experience and support, high levels of sensibility; there aren’t many people who managed to avoid “childhood fears”. In many cases they transform and become a part of the adult life. Some of the authors also pay special attention to pregnancy and childbearing periods (O. Rank, S. Grof).

4. Type of education. It’s quite important what kind world view was received from the patient’s family. It’s great if the overall spirit was that every problem could be solved: “there’s a chance in every crisis, I see the goal and I don’t see any obstacles.” But it’s a different story if the mood of panic was predominant in the family and if every trouble is seen as apocalyptic. It’s one thing when the child was taught to lead a healthy lifestyle and to wash hands before eating. However, it’s a totally different thing if there was a constant “fight with germs” and if they suggested the idea of people being helpless as if the immune system didn’t exist at all. Of course the risk of development of stable fears is much higher in the latter case.

4. General level of education and life competence. The more you know about life and ways of solving the problems, the calmer and more self-assured you are. The calmer you are, the more adequate your actions are. The more adequately you act, the more self-assurance you get. And vice versa, the less experienced you are, the more nervous you get and it’s more likely that you won’t accept the challenge.

5. Situations when it’s really difficult to adapt. There are extreme cases which even a very reasonable person can find difficult to maintain his or her cool. Unexpected situations may arise at the time when one simply has no experience dealing with and feels completely helpless. Such situations can happen at any stage in our life: from infant to elderly.

6. Whether one enjoys or lacks the support of other people or of society in general. An active team member can find it easier to overcome challenges than a lonely person. Keeping one’s cool is much easier when everything is calm rather than when the situation is critical. A state with a well-established social programme facilitates the resolution of various emergency situations unlike a society where every man is for himself.

Other risk factors

There are other reasons that may cause fear. If one’s immune system is weak, it is easier to get an infection. In exactly the same way when the overall energy level of a person is low (or even when one hasn’t had enough sleep or has recently had the flu), then there is a chance that this person has lower self-esteem and might end up suffering from a phobia.

Our brain works consistently if it gets enough oxygen. In the case of painless ischaemia, that is in the case of insufficient blood supply, our brain’s energy “goes down”. In this situation a person is prone to “catching” a fear.

Lack of oxygen can also cause panic attacks. When the brain doesn’t get enough oxygen, it tries to increase the blood flow and triggers an adrenalin rush. As a result, the blood flow increases, the heart rate increases, and blood pressure goes up, but this state is rather unpleasant. In this situation a person might think that he or she is losing their mind or dying.

Unfortunately, the majority of people who experience a sympathoadrenal episode don’t know that this is a sign of life and not a preview of death. It’s just a very awkward way our body regulates itself. Such episodes trigger our fears that something might be wrong with our health. If that is your case, you will find more information on it in part 1.15 where I will show several examples from practice and will offer you a step-by-step action plan.

Special cases

Important information: some conditions can have different origins but are manifested through similar symptoms. It is very important to understand that not all these conditions have psychological grounds.

Anxiety and phobic disorders after chemical intoxication (delirium alcoholicum, for example) are to be treated with a complex approach. In such cases medication, and psychotherapy only wouldn’t be enough. More than that, relying exclusively on psychotherapy may lead to the death of the patient.

Phobias caused by endogenous psychosis such as schizophrenia, manic-depressive psychosis, etc. which are usually accompanied by hallucinations and delusions are a separate case. In these situations, a patient would also need a combination of medication and psychotherapy.

Organic lesion of the central nervous system (CNS) caused by oxygen deficiency during pregnancy or labour (asphyxia) or head injuries and brain tissue injuries, can also lead to phobias: nervous processes are characterized by lower degree of stability, and that is why failures such as micro epilepsy occur.

A vitamin D deficiency during childhood, which influences calcium uptake can lead to the conditions when a child becomes easily scared.

What doesn’t have to be treated

We have to note that one has to distinguish between manifestations of phobias or neuroses and a natural activation of energy sources which takes place before crucial moments in our lives. For an actor who is about to go on stage or for an athlete getting ready for a competition feeling nervous is absolutely natural. There is a special term for it: stage fright. It is characterized by an increase of the heartbeat and hurried breathing. However, this is a healthy reaction if it doesn’t reach any extreme manifestations. Many people would experience the same feeling before public speaking or before an important meeting. The reason why we have to go through these physiological changes is to get some additional strength. It is a way the body prepares itself for a challenge, thus it’s a preparatory stage and not some traumatic consequences.

Lack of confidence, however uncomfortable it may be, cannot be considered as a traumatic consequence either. What one might find there is the lack of competence and a feeling of one’s vulnerability but there is no psychological wound.

It is the reaction to psychotrauma that we would like to talk about in this book. According to the clinical scale “psychosis – psychopathy – neurosis,” we will focus our attention on the disorders of the neurotic level.

A phobia is an information trauma

A phobia is a result of an injury inflicted by frightening information at the moment of one’s confusion. This process triggers old survival strategies characterised by stereotypic simulation of defence mechanisms caused by any sign of danger, however distant and associative it may be.

In other words, a phobia is the state of a body when it experiences tension, feels traumatized by this encounter for the first time, and then tries to avoid this aspect of one’s life in subsequent situations.

When a physical trauma takes place, it means that a foreign object enters the tissue of the body. Trauma impedes the normal functioning of the body. In this case there is something that disrupts the integrity of the body and gets stuck in it (like a splinter, for example), and then there’s a reaction to this intrusion. The body cannot feel good unless this foreign object is removed. When our mind is traumatized, then it means that the “splinters” get into the body of our mind.

The signal of danger is like a splinter in this case. Our intellect fails to find an answer to an important question, and the body goes into emergency response based on the ancient strategies of survival. The trick is that this ancient reaction function in a single-shot mode. Having been activated once, it reappears every time when there’s even the slightest reminder of possible danger. This happens even in the situations when a new encounter doesn’t actually bear any harm but there’s just a hint of danger.

A phobia is similar to an allergy

Just like pollen might seem as a virus to a perturbed immune system, to a person suffering from a phobia some life circumstances are perceived as a threat which require an aggressive reaction, when in fact this problem can be resolved without panic.

Allergies are the state of heightened sensitivity, that is: excessive reaction of the immune system to the environment. A phobia has the same mechanism but at the psychological level. A phobia leads to the distortion of reality and to an inadequate energy-consuming response to a certain aspect of life.

What do our sensations reveal to us?

Fortunately, we are able to observe the processes that cause tension with the help of our internal vision. Our sensations function as a detector.

I have thoroughly studied the sensations of my patients suffering from phobias and discovered that there are two components in this feeling that one should learn to distinguish:

1. Fright as a trauma;

2. Fear as a reaction.

In the case of fright, we are talking about the information which our intellect failed to process and sent to the autonomic depths of our mind. If the intellectual response cannot be produced, then the body will provide an energetic one.

The signal that triggers autonomic reactions usually looks like greyness, darkness or blackness. When a person is frightened, it feels as if some black powder is poured through the top of the head to the solar plexus where it forms a lump of fear.

Ways to react

Fear leads to an increased heart rate and hyperventilation; it increases blood pressure, a person feels hot, there’s tension in the muscles, the pupils are dilated, and all the senses are heightened. When this happens, other functions, such as those responsible for digestion, rest and sexual interest are slowed down or upset. This is done in order to prepare the body for an attack or retreat. Mobilization effects are connected with the active work of the sympathetic division of the autonomic nervous system.

Fig. 1. Physiology of the autonomic nervous system: as we see, the work of the sympathetic nervous system mobilizes the body, and parasympathetic brings it back to calmness and helps to store energy.

The opposite reaction is a collapse: blood pressure falls, and a person feels cool and close to fainting.

This reaction can be compared to the one of a bug that got touched: it keeps still and doesn’t make a single move.

There have been cases when people froze as if they were dead when meeting a bear, and the bear walked away.

We can see the similar reaction in the painting “The Nightmare” by Johann Heinrich Füssli (1741—1825). Fear is sitting on the stomach, while the mind is “switched off”.

Such reaction can be justified at the moment of danger but the problem is that the person remains in this state even after the danger has passed. The body seems to find it hard to return from the extreme mode to a normal state.