Normal Fear And Anxiety

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To review the conceptualisation of fear within the SPAARS framework it might be useful to consider a new example; after all, Susan has been running from the bear for so long now that she is almost certainly exhausted. Let us consider a common example from the cognitive therapy literature (e.g., Beck et al., 1979). Imagine the event of a loud noise in your house (in which you are alone) in the middle of the night. There are a number of interpretations of such an event; for example, one might interpret the noise as evidence of an intruder: "There is an intruder in the house—he might come up the stairs—he might kill me ...". Such an interpretation is likely to be appraised at the schematic model level within SPAARS as one pertaining to threat, and to lead to the generation of the physiological arousal components associated with fear and, thus, the experience of the emotion of fear. A schematic diagram of this process within SPAARS is presented in Figure 6.1.

Fear Fear Model
Figure 6.1 Generation of fear within SPAARS following a noise in the night.

The reason that the example of the noise in the night is used in cognitive therapy is that there are, of course, alternative interpretations of such an event. For example, the noise may merely be the cat patrolling its territory downstairs. Such a feline interpretation is unlikely to lead to the generation of fear. Hypothetical scenarios such as the intruder/cat example are used to indicate to the client that the way we think about (or interpret) things determines the way we feel about them. However, having used this example to illustrate to a client this very point, one of us (TD) was presented with a cartoon illustrating that things were never quite that simple (see Figure 6.2).

MY GOD IT'S A BURGLAR

SNORE, SNORE IT'S ONLY A CAT

ANXIOUS PERSON (Perhaps It's a case for cognitive therapy?)

NORMAL, HEALTHY PERSON

HOUSE IS RANSACKED BY A CAT BURGLAR!

Figure 6.2 The perils of cognitive therapy.

The cat/intruder example, we suggest, illustrates the generation of fear via the schematic model level of meaning within SPAARS. However, as we have discussed in Chapter 5, there are two routes to emotion within SPAARS and it is possible for fear to be generated via the associative level. For example, in Chapter 5 we presented the case of Peter who throughout his childhood had been shouted at and bullied by his father. As an adult, Peter experienced the automatic generation of both anger and fear at the sound of the father's raised voice. In this case, we have argued, the repetition of the appraisal-based generation of fear had become associatively generated during Peter's development and became part of the emotional baggage he carried as an adult.

For most of us such associative generation of fear is a frequent occurrence. In our everyday lives we continually encounter events and stimuli that send a shiver down our spine because of the associative fear reaction they induce. A number of these automatic fear responses will be the result of repeated experiences of events, as in the case of Peter. Yet others will be reactions to stimuli that are biologicaly prepared in some way (Seligman, 1971), such that we only need one bad encounter with them or to see someone else react fearfully to become afraid ourselves. Such stimuli include spiders, snakes, rats, mice, heights, and so on. Finally, some event attributes such as "fast-moving" or "approaching" seem to induce innate fear reactions.

Such associatively generated fear often leads to feelings of conflict. Feeling afraid of things that we think we should not be afraid of, or which society deems as non-threatening, is a common occurrence and individuals often go to some lengths to avoid embarrassing situations such as finding themselves screaming because of the harmless mouse nibbling crumbs on the kitchen worktop. Sometimes such avoidance can become disabling and the fear can become disordered; we consider this later in the chapter and in Chapter 9 when we discuss phobias.

So, what sorts of things most commonly elicit normal fear? One of the first truly systematic studies to address this question and survey the types and extent of fear in the normal population was carried out by Agras, Sylvester, and Oliveau (1969) who interviewed randomly chosen residents of Burlington, Vermont about their fears. There are a number of methodological difficulties with the study; however, the principal findings are as follows: the most commonly reported fear was one of snakes with 25% of the sample expressing intense levels of such fear; the second most common fear was that of heights; also high on the list were fears of public places and transport, fear of injury, and fear of illness. A larger community study was carried out by Costello (1982) with a sample of 449 women. The results indicated that animal fears were again most prevalent, followed by fears of tunnels, heights, and enclosed spaces. Next came social fears, fears of mutilation, and fears of separation. As a rider to this, it is important to note that studies in children (e.g., Rutter, 1984) reveal a slightly different fear taxonomy and that many childhood fears such as fear of the dark disappear with age (see Gullone, 2000).

These data generate a number of interesting issues regarding the relationship of normal, common fears and abnormal fears or anxiety. First, some of the most common fears appear to be of the "irrational" type we considered above, in that the feared event or object is neither dangerous nor consciously thought to be so by the individual concerned (e.g., house spiders). Second, a number of such common fears, whether rational or not, differ from those that are most commonly seen in clinical settings (for example, animal fears are rarely seen in the clinic). So, although these fears might meet many of the criteria for the psychiatric definition of phobia (e.g., the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, [DSM-IV]; American Psychiatric Association [APA], 1994), they are in fact quite normal and non-pathological. Third, fears of events or objects that reason would demand are fearful or threatening are somewhat uncommon; for example, driving at speed (Rachman, 1990) is hardly ever cited as a cause of fear in the normal population. Finally, as we have suggested above, the distribution of human fears appears to be non-random—some fears (for example, the fear of snakes) are very common while others are extremely rare. This confirms that a number of common fears, at least, are biologically "prepared" in some way (Ohman & Mineka, 2001; Seligman, 1971) and, as a consequence, those things of which we are most afraid are the ones that presented the most danger to our primitive ancestors rather than those that are most threatening in contemporary society.

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