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Fear protects us from danger; it is a natural and adaptive
emotion. Fear is based on the perception of threat and produces an
emotional reaction. Anxiety disorders result from incorrect
appraisals and/or the recursive structure of symptoms of and beliefs about
fear.
Social Phobia
People with social phobia fear they
will embarrass themselves. Unfortunately, the attention to the
potential embarrassment produces physiological reactions that may be
themselves be embarrassing - e.g., trembling, sweating, blushing.
Once a person who is embarrassed by blushing begins to blush for any reason,
the recursive nature of the belief that blushing is embarrassing, along with
the fact that embarrassment produces blushing sets the stage for feedback
phenomenon - often called a vicious cycle, anxiety spiral, circular chain.
Ironically, the greater the motivation not to blush, the greater the
blushing.
- Lifetime prevalence rate of 13%; 12
month prevalence rate of 8%.
- Common characteristics:
introverted, self-conscious, tendency to avoid, perfectionistic.
- Persons with social phobia often
have additional diagnoses, most commonly: Generalized Anxiety Disorder,
Avoidant Personality Disorder, and Obsessive Compulsive Personality
Disorder.
Panic Disorder
Panic attacks are common, everyone
experiences them once in a while. Panic disorder results from the
appraisal that the symptoms of panic are threatening. Panic
results from the secretion of neuro-chemicals that make the body strong for
a brief period to protect it against an immanent physical threat.
Adrenelin and Cortisol are are secreted by the adrenal glands and have the
effect of increasing heart rate, blood pressure, respiration rate, and many
other reactions that prepare the body to fight or flee for its life.
We are descended from organisms with a powerful fight or flight response;
those with weak fight or flight responses are not our ancestors.
There is a certain amount of
variability in our heart rate, and sometimes for reasons that are quite
benign heart rate is temporarily elevated. Consider the spiral that
awaits the person who views an elevated heart rate as threatening.
The natural reaction to the threatening
appraisal is the secretion of Adrenelin, which in turn elevates heart rate
even more. The person wants the heart rate to go down, but it is going
up - the person feels out of control. Increasing heart rate, feeling
out of control, perhaps dizziness from hyperventilation is experienced as
even more threatening, which produces even more Adrenelin secretion. . . .
This vicious cycle is not medically
dangerous, and people don't die of panic attacks even though they feel like
they will. The treatment of choice for Panic Disorder is
exposure with response prevention, and it produces excellent long-term
outcome.
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Just as courage imperils life, fear protects it.
-Leonardo Da
Vinci
My brain writes checks that my mouth can't cash.
- Joel Ross
That which doesn't destroy me, makes me stronger.
- Nietzsche
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