A Reexamination of Phobias as the Fear of the Unknown

During the last several years, anxiety states, phobias, and panic disorders have received a good deal of attention in general psychiatry. Recent studies and reports published in a number of psychiatric journals and other publications have shifted the emphasis in the understanding and treatment of these disorders from the psychological to the biological and the behavioral approaches. New medication and treatment modalities have been introduced, and patients have been advised by their physicians and by the news media of the limitations of the psychoanalytic treatment of phobias and the need to turn elsewhere for the solution to their problems.

Psychoanalysis has, for the most part, kept silent in this regard. Since Freud's early publications on phobias and anxiety hysteria, and the contributions of the early pioneers of psychoanalysis, little has appeared in psychoanalytic literature during the last twenty-five years that specifically addresses the psychoanalytic conceptualization of phobias and the associated panic states and deals with the specifics of the management and treatment of these conditions. It would be ironic if during this period of the widening scope of the clinical applications of psychoanalytic treatment we as psychoanalysts relinquished to the nonanalytically oriented therapist the clinical field upon which psychoanalysis was originated. Instead, I think the time has come to take advantage of the discoveries in the biological field in order to make a renewed effort to reconceptualize phobias by distinguishing between what we really know about them, what we think we know, and, more importantly, what we do not know about them.

Phobias are known as states of unreasonable and irrational anxiety not