Obsessional states are immensely complex phenomena. In some ways the fear or anxiety components involved in some obsessions are the easiest aspect of the disorder to account for. Individuals might be afraid that if they do not check the gas tap then the house will blow up and people may be killed. Such anxiety is reduced by checking that the tap is switched off. What is much more difficult to account for is why the obsessional individual has to check again and again and again that the gas is turned off. It is beyond the scope of our ambitions here to provide a comprehensive empirical and theoretical review of fear-based obsessional states, because it does not seem clear that the emotional component is central to the disorder. Others have done this job more than adequately (e.g., Rachman, 2003; Tallis, 1995a, 1995b). What we do wish to spend some time on, however, is the suggestion that some obsessional states can best be conceived of as disorders of disgust; particularly those involving washing compulsions and contamination-related intrusions. Until recently, the role of disgust has been sadly neglected in such cases and we present an analysis of disgust-based obsessions in Chapter 9.
In this chapter we have considered normal fear and its disorders. The balance in the chapter does not reflect the balance in nature. We spent relatively little time discussing normal fear even though it is ever present in our lives; this is mainly because we have used and abused the example of fear throughout the rest of the book and have assumed that the reader is aware by now of the parameters of normal fear reactions. Similarly, we have spent considerable time discussing three so-called anxiety disorders, panic, generalised anxiety, and PTSD, and relatively little time on phobias, which are far more common. This focus reflects our belief that the three disorders we have concentrated on are theoretically more compelling and offer challenges to our own model, SPAARS, which specific phobias do not. Finally, although we have used standard psychiatric labels to refer to varities of disordered fear, it is our contention that what is needed is a taxonomy of emotional disorders that is theoretically derived and not based on surface features. Consequently, we have provided a number of pointers as to how such an analysis within the SPAARS model might depart from the traditional psychiatric classification; for example, a number of specific phobias would be derived from the basic emotion of disgust as would some obsessional states. In other chapters we consider how disorders of more complex emotions might be derived from fear; for example morbid jealousy (see Chapter 8).
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