Theoretical Models of Phobia

In this chapter of the book Phobia: Psychological and Pharmacological Treatment, Mavissakalian and Barlow present a general discussion of several theoretical models of phobia. The term "phobia" itself is defined as a clinical condition in which one or more intense fears is a predominant symptom interfering with a patient's life.

An example of one phobia is "agoraphobia" which is characterized as a fear of going out to public places accompanied by fears of being home alone. The authors note, however, that agoraphobia is generally more complex than other phobias and may deserve a special characterization of its own. Nonetheless, it is characterized by the intense fear that is associated with all other phobias.

According to Mavissakalian and Barlow, there are several different conceptual models of phobia; however, the three primary treatment frameworks used to characterize the conditions giving rise to phobia are the psychoanalytic model, the behavioral model, and the biological model. The authors summarize each of these three models as follows:

(1) The psychoanalytic model. In this clinical view, a phobia is characterized as the effect of neurotic anxiety arising as a result of sexual or aggressive unconscious conflict. Treatment based on the psychoanalytic model emphasizes insight-oriented therapy with the clinician helping the patient to clarify and interpret the unconscious factors associated with the condition.

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f treatment involves having patients imagine themselves interacting with the fearful stimulus while simultaneously lowering their anxiety levels. For example, systematic desensitization procedures would have the patient visualize the stimulus while at the same time engaging in a relaxation response that counters the anxiety response. There are also a number of cognitive-behavioral strategies that are used to treat phobias. These interventions aim at correcting or eradicating the maladaptive emotions, thoughts, beliefs, and expectancies involved in the phobia. For example, one cognitive-behavioral strategy involves having the patient replace internal anxiety-provoking statements with self-generated, calming statements. One point that is made in the chapter is that most treatment approaches to phobia, especially those provided at clinics, do not restrict or limit themselves any one intervention. Rather, a mixture or variety of several techniques and strategies are used by most therapists working with phobias. The techniques are strategies are selected based on considerations of the characteristics of the individual patient and the degree of the phobic condition. CHAPTER 4 CLINICAL TREATMENT OF AGORAPHOBIA Based on t

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