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On this track, we will discuss differences and correlations between fear and anxiety and phobias and panic. The purpose of this discussion is to eliminate confusion regarding the meaning behind these words as they relate to clinical diagnoses of phobias and phobic conditions. As you know, a phobia refers to a specific object of fear.
The definitions of fear and anxiety are often confounded, the words being used interchangeably for the same general concept, even though there are obvious advantages to using two distinct words to designate separate though related phenomena. In order better to understand the meanings of these terms, let’s consider their dictionary definitions. The traditional meanings are more useful in clarifying the semantic and conceptual confusion than are some contemporary distinctions made by behavioral therapists.
Fear points to the possible occurrence of an "unwanted" or calamitous event; the event has not yet occurred (that is, it is in the future); and the client is concerned (agitated or foreboding) about the event. Would you agree that fear, then refers to the appraisal that there is actual or potential danger in a given situation? Fear is a cognitive process as opposed to an emotional reaction.
Anxiety, on the other hand, is defined as a "tense emotional state" and is "often marked by such physical symptoms as tension, tremor, sweating, palpitation and increased pulse rate."
Phobia refers to a specific kind of fear and is defined as "an exaggerated and often disabling fear." A phobia is also characterized by an intense desire to avoid the feared situation, and evokes anxiety when one is exposed to that situation. The clinical descriptions of phobias have not changed much since their earliest descriptions.
Panic is defined as a "sudden overpowering fright. . . accompanied by increasing or frantic attempts to secure safety."
#1 Anxiety and Fear
#2 Phobias and Panic Attacks
An example will clarify the complex interrelations among these terms. A client with a fear of small animals perceives these animals to be dangerous. However, he does not experience anxiety until he finds himself exposed to a small animal or imagines himself in such a situation. The presence of, say, a mouse on the scene activates the fear, and the client may think, "The mouse may bite me and I might get rabies and die!" or, "The mouse may bite me and I might faint and become embarrassed in front of all these people!"
Similarly, a client who is phobic of certain social situations such as attending parties or giving lectures is less afraid of the situations themselves than of possible consequences of being in them. The social phobic is afraid, for example, that, in a social situation, he will make a fool of himself or "go out of control" and embarrass himself. This client might feel jittery or shaky, sweat profusely, and experience any or all the uncomfortable affective and physiological symptoms of anxiety or panic.
Panic is an intense, acute state of anxiety associated with other dramatic physiological, motor, and cognitive symptoms. The physiological correlates of panic are an intensified version of those of anxiety—that is, rapid pulse, dizziness, cold and profuse sweating, and tremor. In addition, one has a sense of impending catastrophe, pervasive inhibitions, and an overwhelming desire to flee or get help.
On this track we have discussed differences and correlations between fear and anxiety and phobias and panic. As you know, a phobia refers to a specific object of fear.
On the next track we will discuss Hoch’s Paradox. You might find that an understanding of Hoch’s Paradox can become a solid foundation on which to base a cognitive therapy intervention with your phobic client. In addition, we’ll examine a case study in which the cognitive therapy technique of counting automatic thoughts is used.
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