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Freud's formulations on phobias underwent a continual change that reflects the evolution of psychoanalysis, theoretically and clinically. Despite these changes, however, Freud always maintained, in one form or another, the distinction between phobias as a psychoneurotic symptom and phobias as a symptom of “actual neurosis” the latter carrying the inclusion of a biologically based condition.
For a long time in the clinical situation, the analysis of phobias has been dominated by Freud's (1909) case of Little Hans, in which he conceptualized phobias within the category of a hysterical neurosis. Phobics were identified as the hysterics who are unable to repress their unacceptable wishes and fears and instead displace them onto other objects and situations. The phobic symptom, like the dream, was described as another royal road to the unconscious, the analysis of which one hoped would lead to the uncovering of the unconscious wish and fear of retribution.
In the actual clinical situation, this proved to be a very hard road to travel. Attempts to utilize the psychoanalytic conceptual model in the treatment of phobias have often been ineffective. Freud (1919, pp. 165-166) identified this difficulty when he wrote: “One can hardly master a phobia if one waits till the patient lets the analysis influence him to give it up. He will never in that case bring into the analysis the material indispensable for a convincing