A Psychoanalytic View of Phobias

The psychoanalytic view of phobias stems from two fundamental psychodynamic concepts: (1) psychological conflict and (2) unconscious mental processes. To illustrate these, I shall proceed immediately to a clinical example borrowed from Morton Prince.1

A woman of 40 suffered from an incapacitating phobia of church bells. The symptom had appeared during her adolescence, but the patient was vague about its onset and had no idea why these objects should be so frightening. Attempts to get her to associate to church bells caused the patient intense anxiety, but she could give no clue as to the meaning of the symptom. Accordingly, Prince hypnotized her and induced automatic writing-a dissociative phenomenon in which, without conscious, voluntary attention or direction, the individual automatically writes sentences that may contain information or memories not available to conscious recall. “While she was narrating some irrelevant memories of her mother,” Prince informs us, “the hand wrote rapidly as follows: ‘G … M … church and my father took my mother to Bi … where she died and we went to Br… and they cut my mother. I prayed and cried all the time that she would live and the church bells were always ringing and I hated them.’”

As the patient wrote these words, she became tearful and agitated, but had no conscious idea why she was upset. After being aroused from hypnosis, she was surprised to find what she had written. She was then able to inform Prince of the circumstances to which the written sentences referred. When she was 13, while visiting in England with her family, her mother had been taken seriously ill and died following major surgery. During her mother's terminal illness the patient was staying at an inn near a church whose bells rang every quarter of the hour, often while she was praying for her mother's recovery. “She could not bear to hear them,” wrote Prince, “and while she was praying, they added to her anguish.” The circumstances of her mother's death as thus