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The Genealogy of Social Phobia PDF
The Genealogy of Social Phobia PDF
http://ebooks.cambridge.org/
Fearing Others
Ariel Stravynski
Chapter
Background
The term phobia derives from the Greek word phobos (attendant and son
of Ares the god of war) denoting fear, terror, panic. Its source is the
worship of Phobos, who had the power to instill terror in enemies of
ancient Greeks. The deity was often depicted on weapons, especially
shields.
The term phobia only reappears in the literature in the mid-nineteenth
century, after an absence of 1,300 years. In the intervening period,
irrational fears combined with glum mood and much else went under
the heading of melancholia (black bile). For according to Hippocrates
‘‘temporary fears and terrors are due to overheating of the brain and
are associated with an expansion and preponderance of bile in that
structure’’ (Errera, 1962, p. 327).
In European culture before the eighteenth century, anxiety was mostly
linked to spiritual anguish, of interest to theologians and philosophers. A
common Christian belief for example was that such fear resulted from
sin. In this view timidity reflected an insufficient faith (in god) and
shyness expressed insufficient love (charity) for one’s neighbor.
With the secularization of life, the eighteenth century witnessed the
beginning of the medicalization of the abnormal experiences of fear.
Thus, medical treatises dedicated to the gut and the heart, for example,
described what today would be regarded as anxious complaints (e.g.
abdominal cramps, dry mouth, oppressive feeling in the chest:
Berrios, 1999, p. 84). Palpitations, for instance, were described as symp-
toms of heart disease and hyperventilation a disease of the lungs (1999,
p. 84). While the process of medicalization reached its peak in the first
half of the nineteenth century, a process of psychologization (e.g. Freud)
got under way in the second half. What in the former era were regarded
as symptoms of independent disease, in the latter period become facets
of putative entities (e.g. neurasthenia, anxiety-neurosis).
Launched in the USA and later adopted in Europe, neurasthenia was
conceived as a new disease category induced by ‘‘modern life.’’ As
defined, it involved fatigue and a vast range of depressive and anxious
manifestations. Anxiety-neurosis as proposed by Freud narrowed the
field to encompass an anxious state of distress combined with a ‘‘nervous
over-excitement’’ involving flushes, sweat, tremors, diarrhea, etc. Both
neurasthenia and anxiety-neurosis were considered by their proponents
diseases of the nervous system, the putative sexual etiology of the latter
notwithstanding. The continued failure however to find any neurological
or other cause accounting for ‘‘nervous disorders’’ during the nineteenth
century, cleared the way for psychological theories.
Discussion
Anxiety-related experiences and behaviors were well known before
the nineteenth century. Palpitations, dizziness, intestinal cramps, and
other somatic manifestations, however, were taken to be expressions
of separate diseases. There was a major conceptual shift when these
phenomena began to be considered as neuroses (i.e. resulting from
disorders of the autonomic nervous system). Against this background,
gradually social phobia, agoraphobia, depersonalization, and paroxys-
mal surges of anxiety were described. Perhaps the emergence of these
constructs may be related to the process of psychologization that set in
with the failure to find any support for considering them neurological
diseases.
The construct of social phobia began to emerge with the realization
that this pattern stands out among other anxiety-linked problems for
not in kind but in degree. In comparison to the normal, the social phobic
response is exaggerated, over-generalized, and chronic. The issues raised
by these incompatible points of view attending the inception of the
notion of social phobia are as relevant now as they were then; they are
as controversial and not anywhere near being settled.