THE COUNSELING NEWSLETTER
Winter 1993
Published Every Now and Then
THOUGHTS ON FEARS AND PHOBIAS
God did not give us a spirit of timidity but a spirit of power and love and self-control. II Timothy 1:7
PHOBOS: to panic or be frightened, fright, fear
FEARS IN DAILY LIFE
Fear is an emotional experience that is common to all--even the most spiritually mature. The Bible records
many historic accounts of fear to which we can relate. Saints of old such as David, Elisha, Gideon, and Moses,
experienced a variety of fearful situations. The Apostle Paul also experienced periods of anxiety, nervousness,
and fear (1 Cor 2:3, 2 Cor 7:5).
One especially fearful time for me occurred during graduate school. I was required to write and defend both
a masters thesis and a doctoral dissertation. During the oral defense of my masters thesis I experienced my first
episode of social fear. I can clearly recall the furrowed brows of the graduate committee as I launched into my
prepared oral presentation. As I continued speaking I began to hyperventilate. My respiration rate and heart rate
increased and my breathing became increasingly shallow. My heart felt like a drum beating within my chest and
beads of sweat appeared on my forehead. As this state of fear and hyper arousal intensified I knew that shortly I
would run out of breath and would not be able to continue speaking. I felt as if I could not stop this spiraling
process within me.
The good news is that after asking for a moment to gather myself (catch my breath, squeegee the sweat from
the brow, take a slow drink of water) I went on to successfully defend my thesis. The not so good news is that
since this semi-traumatic event I have felt uneasy when speaking in front of large groups. I am especially tense
when those listening are in a position of evaluating or judging me in some manner. In fact, I sometimes
experience the same cluster of symptoms (shallow breathing, increased heart rate/respiration) even today when
speaking in public. It is as if this critical incident has caused me to be vulnerable to similar experiences. A pivotal
point in dealing with my fear of public speaking occurred when I began to do two things: 1) I surrendered to God
my uneasiness and fear of speaking in large public settings, and 2) I began to reinterpret my symptoms of hyper
arousal as signs of preparedness to speak rather than as signs of an impending negative experience.
A POINT OF CLARIFICATION
From a Christian perspective fear can be a very good thing. When fear has as its impetus and reference point
the holiness of God we are compelled to experience a sense of respect, awe, and reverence. And through this
healthy experience of reverential fear we find our source of wisdom (Prov 9:10), knowledge (Prov. 1:7), and life
itself (Prov. 14:27). Since most Christians believe these things to be true, how has fear earned such a "bum rap" in
the larger Christian community?
I have a hunch that part of our conception of fear is based upon a misunderstanding of a passage found in I
John 4:18-19 which reads, "There is no fear in love, but perfect love casts out fear, because fear involves
punishment, and he who fears is not perfected in love." Many Christians have interpreted these verses to
suggest that all encounters with fear are sinful and are due to an inadequate understanding and experience of
God's love. And although this conclusion may be true in some cases, it is important to remember that this passage
refers specifically to fearing the judgment of God. John is presenting the argument that it is appropriate for those
who do not know God to fear His judgment.
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Conversely, for those who know God and His perfect love there is no need to fear His judgment for they have
been made right with Him through Christ. The context of this passage, then, concerns fear and its relationship to
God's judgment for those outside of His redemptive love. In many cases I believe we have been too quick to infer
that this matter of fear is equivalent and identical to other situations concerning fear.
In this edition of the Newsletter I will explore the spiritual and psychological nature of fears and phobias
drawing upon both reliable psychological research and inspired Biblical truth.
WHAT EXACTLY ARE FEARS AND PHOBIAS?
In its most basic form, fear is a reaction to either some real or imagined internal or external threat. Fear can
help us prepare for, and react to, threatening situations, and it can motivate us to take needed action. It is
important to remember that God is the one who created us with the capacity to experience fear. He built into us
this emotional response, just as He gave us the capacity to feel passion and affection. Just as affection and passion
have a "good side" and a "dark side," fear also has both destructive and positive qualities.
In many ways fear can function much like physical pain. None of us enjoy the sensation of physical pain, but
actually physical pain is a good thing. Pain is unpleasant, but it prompts us to slow down, evaluate our
circumstance, and make needed changes. Fear can serve the same function in our emotional lives. The experience
of fear is helpful when it alerts us to a potential problem, causing us, again, to slow down, think and pray about
the fear, and make needed adjustments.
In a similar way, fear can be likened to a warning light on an automobile dashboard. The warning light
signals to us to slow down, pull over, and determine what is happening under our "emotional hood." The
warning light is not the source of the problem, but merely an indicator that we should take action to address the
real and underlying problem. It wouldn't make sense to blame the warning light for flashing. It is merely an
indicator of trouble. In much the same way, we may be missing the point if we focus on the emotion and
experience of fear rather than the circumstances which generate the fear response.
Continuing with the analogy of the dashboard warning light, phobias come to life when we begin to fear the
flashing of the warning light (the early indicator of problems) more than the actual mechanical problem under the
hood. Rather than dealing with the mechanical problem, we develop rituals and strange behaviors in the hope of
stopping the red light from flashing again. It is as if the warning light of fear becomes our preoccupation and
focus of attention.
Phobias consist of over learned and over emphasized fears. Phobias are born when fear is repeatedly paired
with a specific object (e.g., dogs, spiders) or situation (e.g., flying in airplanes, being in crowded places). In many
cases the onset of phobias can be traced to a specific traumatic/fearful event. Often times the traumatic event is
associated with a number of physical and emotional experiences. Taken in isolation, these physical and emotional
factors are not particularly significant. But they do become important when they are paired with the past event of
danger and fright. This is because phobia sufferers begin to over interpret and misinterpret these benign cues. In
the past, these physical sensations and feelings signaled the onset of a terrifying situation---and so phobic people
reflexively conclude that a similar event must be approaching since they feel much the same way again. In a very
real way the physical and psychological symptoms (like increased heart rate) begin to assume the same triggering
power as the actual stimuli.
The fear response then becomes increasingly entrenched, persistent, and recognizable to the sufferer and
those around him or her. Those who suffer from phobias realize that their fearfulness is not grounded in reality,
yet they still experience a sense of psychological paralysis when faced with these areas of fear. It is important to
note that the person may openly acknowledge that the phobia is unreasonable, but he is not able to erase either
the fear or the desire to avoid the phobic situation. He may be able to ascent to the fact that their fear is
exaggerated or unfounded, but the emotional pull of the stimuli compels him into retreat and avoidance.
WHAT SUSTAINS AND NOURISHES FEARS AND PHOBIAS?
For the most part fears and phobias are learned behaviors. It is true that we are born with some hard-wired
fears, such as the fear heights, that serve our need for safety, but for the most part we learn and acquire fearful
responses.
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Most fears and phobias have at their core a cluster of unspoken and subtle beliefs. Often times those suffering
from phobias and severe fear disorders are unaware of these distorted and exaggerated beliefs. They do not
suspect these thinking patterns because their fearful thoughts have become nearly automated. They have over
learned and over rehearsed the fearful response of avoidance. They now invoke the reaction so quickly that it
seems as if they do it "automatically."
Fears and phobias can only continue to exist within a context of avoidance. Lets suppose that you had a
phobic fear of dogs. One way to deal with this phobia would be to avoid all situations in which you might
encounter dogs. This coping strategy would work as long as you were able to avoid all contact with dogs in your
community. You might alter your regular walk to avoid seeing the dog that lives down the street. You might
even avoid visiting with friends who had house dogs as pets. As long as you were able to eliminate contact with
dogs, your coping strategy would be effective.
But there is a downside to this strategy. Research indicates that as we avoid feared objects and situations, our
level of fear and anxiety about those stimuli will increase. Avoiding contact with dogs would actually intensify
your fear of them. Although escaping the fearful situation provides short-term relief, avoidance of the feared
object or situation also allows the phobia to sustain itself and move into other areas of life. You may find yourself
eventually afraid of a variety of animals.
HOW DO FEARS AND PHOBIAS USUALLY PRESENT THEMSELVES?
Patients suffering from severe fear disorders or phobias present with a variety of concerns. Most often they
come for help complaining of anxiety and panic related to specific domains of fear (objects, persons, situations).
Associated with these complaints clients often describe impaired performance at home or work related to a
decreased ability to attend and concentrate. It is also common for phobic clients to report experiences of physical
discomfort such as abdominal pain, stomach upset, chest pain, and headaches. Patients also describe sadness and
embarrassment over their tendency to exclude themselves from common activities (e.g., flying on an airplane,
riding an elevator).
It is interesting to note that obsessive-compulsive tendencies are often present in those suffering from
phobias. Basically, the obsessive-compulsive coping style is driven by the need to prevent discomfort or avoid a
dreaded event or situation. The obsessive-compulsive person exerts excessive effort to control and suppress the
idea, thought or impulse which causes them distress. The common thread connecting phobias and obsessive
compulsive disorders is the unremitting need to control one's environment.
TREATMENT OF FEARS AND PHOBIAS: INTEGRATING SPIRITUAL MATTERS AND PSYCHOLOGICAL
TREATMENT
It is always a challenging and somewhat precarious task to integrate inspired spiritual truth with reliable
psychological research. But this topic of fears and phobias requires that we appreciate the contributions of both
the spiritual (soul) and psychological (cognitive/emotional) domains. From a spiritual perspective it seems that
fears and phobias concern three key issues: rest, security, and basic beliefs.
REST: In Matt. 11:28-29 Jesus calls to all that are "weary and over-burdened" and offers them rest--spiritual
rest. Those who suffer from phobias are often weary and overwhelmed from their self-efforts to find safety. They
are beyond their capacity to cope. Jesus' prescription is that they take on His yoke and learn from Him; that they
learn from His example what it is to be "gentle and humble in heart." Humility is the core of the matter. Within
the context of phobic fear, humility implies letting go of the need to be strong and in control. Sufferers must first
give up the pretense of being what they cannot be and agree with God that they are not in charge. As they
relinquish control, they will be able to humbly trust in Him, and accept His protection.
SECURITY: A counterpart to fear is security. Phobias are fueled by a lack of both security and a general
sense of safety. We cannot find true security through our attempts to control the circumstances of our lives. For
those suffering from phobias it is helpful for them to ask, "When do I look for security?” and, “Can I trust Him
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with my life?" Ultimately we must realize that our only true source of security can be found in an ongoing
relationship with the God who created us (Ps. 27:1).
BASIC BELIEFS: As discussed previously, fears and phobias are predicated upon a series of assumptions
(beliefs about what is threatening and dangerous). Often times fear distorts our perspective and ability to see life
as it really is. We become confused and entangled in a web of distorted and ill-conceived ideas and beliefs. We
may be so confused that we're not able to see the source of our fears.
Paul reminds us in Romans 12:1-2 that our behavior is based upon our beliefs about the world. He
encourages us to change and "transform" our thinking (beliefs, assumptions, attitudes) so that we can accurately
see ourselves and "prove what the will of God is" in our lives. We need to reframe and realign our fears in a way
that is consistent with God's truth. In short, we need to adopt His perspective of reality.
In many ways, empirical and psychological research serendipitously built upon many of these Biblical
principles. Through rigorous and well-controlled treatment outcomes studies some consistent findings have
emerged. These research findings cluster in three main categories.
Exposure Based Treatment: The cornerstone of all proven and effective treatment for phobias includes a
strong emphasis on exposing the client to the fear inducing stimuli. The central treatment strategy is called
systematic desensitization. Through this process the client identifies the core elements of his phobia
and
develops a list of graduated fear inducing thoughts and activities around the core stimuli.
Through a gradual
process of imaging contact with the feared stimuli (covert desensitization) and onto actual contact with the
feared stimuli (in vivo desensitization) the client develops coping strategies which
allow him to remain in the
formerly threatening situation while not experiencing panic or hyper arousal.
During systematic desensitization clients are not into thrust into the feared situation. Rather, treatment
moves slowly and deliberately---backing off whenever the treatment generates a fearful response.
Reframing the Fear: When interviewing phobic clients they often recount their phobic experience in terms
of an inner drama. They tend to catastrophize and personalize their fears. This brings a heightened sense
of
emotionality to the situation as well as a tendency to over interpret benign data. Phobic clients
tend to greatly
exaggerate the probability of harm and they experience levels of distress that are disproportionate to the actual
risk. In my work with fearful and phobic clients I try to help them reinterpret the physical and psychological
symptoms they associate with fearful events. I attempt to
help clients move from the notion that these
symptoms predict danger and being out of control to
understanding these sensations as signals to prepare and
take action in a healthy and adaptive way.
Response Prevention: For most phobic clients there is a compelling desire to retreat from fearful situations.
A key component of treating phobias is to deal with the tendency toward retreat and avoidance. The desire to
avoid the feared stimuli must be countered with gentle yet firm nudges, encouraging the client to "face into their
fear." As treatment progresses this will invariably require them to directly confront feared situations. As an
example, for the person who is a afraid of dogs, this means that a key component of treatment would
include discouraging him from taking a circuitous route home to avoid a barking dog (behavioral intervention)
while also helping him develop coping strategies
(cognitive intervention) to deal with his fears of being in the
presence of dogs.
The Role of the Christian Community
The Christian community is in a unique position to serve as a supportive and healing environment for those
dealing with phobias and severe fear disorders. Here are a few ideas:
•Pray for those dealing with phobias and serious problems with fear.
•Be patient. Since phobia sufferers are driven by the need to control their environment it is important to give
them the freedom to work through their fears at their own pace and without feeling hurried.
•Acknowledge your own areas of fear and insecurity. Let them see and know this side of you.
•Help them see that the experience of fear can have redeeming qualities if it prompts us to prepare and
respond in an adaptive manner.
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•Remind them that God knows our fears and our insecurities and that He is the only true source of security
and safety.
Richard E. Morey, Ph.D.
Licensed Psychologist---PSY. 12822
Post Office Box 714
8575 Morro Road
Atascadero, CA 93423
Atascadero, CA 93422
805/703-0429 Fax 805/466-2322
www.richmoreyphd.com
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