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How Anxiety Disorders, Panic Attacks, Fears & Phobias Work


Until recently, abnormal fears such as panic attacks and phobias, were believed to exist purely in the psyche and so were only treated psychologically. But sometimes non-psychological causes, such as disease or chemicals in the environment, can create anxiety and mimic panic like symptoms. Proper treatment relies on an accurate diagnosis.

So, if you suffer from panic attacks or phobias, you may consider seeing your physician and get a medical examination to rule out a potential medical cause of anxiety symptoms.

Generally, though, it’s hard to pinpoint a single cause of anxiety; the psyche and the body are one and in collusion.

In the very least, medical problems can contribute to and exacerbate anxiety symptoms. For instance, though a panic attack may be triggered by an allergy, the allergy itself may be influenced by stress that results from negative thought processes and poor coping skills.

This post will discuss the different triggers of fears and the various treatment approaches that allow you to master them.

Roots of Fear:

We don’t know if our cave-dwelling ancestors also suffered panic attacks and phobias: They, after all, had to worry about real demons of the night. But we do know that phobias have been around as long as recorded human history.

He “could not go near a precipice or over a bridge or beside even the shallowest ditch; yet he could walk in the ditch itself.” So wrote Greek physician Hippocrates in the fourth century B.C. about Damocles. Augustus Caesar was afraid of the dark. It wasn’t until Sigmund Freud began pondering the unconscious that phobias were placed in the psychic terrain.

Freud’s Legacy

According to Sigmund Freud, we all possess unconscious fears that stem from unresolved childhood conflicts. When these fears threaten to seep into conscious awareness, we protect ourselves by camouflaging them as “free floating” anxiety, or displacing them onto a fear of an object or a situation. In the extreme, they become a phobia.

For instance, if a child fears his father, whom he cannot escape or defend himself against, he may displace his fear onto that of dogs, from whom he can run or avoid. Fear of a dog’s bark is safer than fear of your father’s bark.

In Freud’s famous case study, a five-year-old boy known as Little Hans refused to venture outside because he was afraid a horse might bite him. Hans described black things around the horse’s mouths and things in front of the eyes, leading Freud to speculate that the horse represented the boy’s father, who wore glasses and had a mustache.

Fear Forum

“Fear is a kind of a bell. …it is the soul’s signal for rallying.”  — Henry Ward Beecher

According to psychoanalytic theory, forbidden fears may also break through as thoughts. To suppress the resulting anxiety, we take action in the form of obsessions and compulsions. Repetitive hand washing, for instance, may help suppress anxiety over your “dirty” urges.

Fears Are Learned:

Around the turn of the century, another school of thought emerged along with Freud’s psychoanalytic theory. This was behaviorism. The behaviorists didn’t buy into Freud’s notion that the unconscious was the culprit behind feelings of fear. To them, fear was a learned reaction that could also be unlearned. The fear’s origins mattered little.

You learn to be afraid because you associate a particular situation with something unpleasant. Let’s say you dined at a restaurant and got food poisoning from eating lobster. Thereafter, the sight of those red claws alone may create some queasiness. After falling down stairs and landing on my head, I received a wound that required stitches and a night in the emergency room.

Fifteen years later, I still walk carefully down stairs and hold onto the railing. In some people, these fears spread so that an initial fear of heights mushrooms into a fear of flying. To reduce your fear, you avoid or escape the situation, thus reinforcing the phobia.

Fears are also catchy, particularly between parent and child. If a child sees her mother on top of the dining room table screaming “Help!” while staring at a little mouse scurrying across the floor, the child too might scream and seek higher ground.

On the other hand, though parental reactions can teach children to be unduly fearful, later phobias don’t necessarily replicate parental phobias. We also learn from our thoughts. If you watch a scary story and persevere on it, you may talk yourself into becoming afraid of ghosts.

Fear Is in Our Genes:

But fears are more than just learned behaviors and unconscious protection against threatening feelings. They are deep within our genes and biochemistry. As you’ve seen, biological evolution has pre-programmed us to fear that which can potentially harm us. This is why many fear snakes but not flowers which, unless you have an allergy, are unlikely to harm you.

Anxiety disorders, which are typified by autonomic over-arousal, are merely an exaggeration of behaviors that contribute to our survival.

For instance, in obsessive-compulsive disorder, washing ourselves becomes ritual hand washing and checking territorial boundaries becomes checking and rechecking a door known to be locked. In other words, fears are at the same time pre-wired in our brain, transmitted genetically and learned.

Fear Poem:

Everyone feels fear and anxiety.
Fears don’t become phobic until you start avoiding them.
Fears have different causes and different treatments.
Fears are never all in your head.


How Anxiety Disorders, Panic Attacks, Fears & Phobias Work