Drive Phobia: Symptoms, Causes and Treatment

People maintain a continuous mental activity. We are rational beings who build our reality through thought, so it does not cease in its effort to give meaning to what surrounds us.

Every human work, without exception, was a thought before becoming tangible. For this reason we must appreciate its importance in the creative process, as well as its intimate relationship with behavior and emotion.

Drive phobia stresses this indivisible link between thinking and acting, but adopting a pernicious nature that generates great discomfort in those who experience it.

In this article we will review the concept, as well as its characteristics and its consequences on health and quality of life, together with the therapeutic modalities available today to address it with success.

• Related article: "Types of Anxiety Disorders and their characteristics"

Phobias: characteristics and symptoms

Phobias are anxiety disorders that are characterized by the appearance of a disproportionate fear response in the presence of stimuli or very specific situations, which

activate natural alarm mechanisms in order to respond to what is perceived as a threat. To understand them we can resort to the metaphor of allergies, which are erected as excessive reactions of the system immune to substances or other elements that are generally innocuous (but are faced as a dangerous pathogen).

As we will see, the drive phobia has this main characteristic, although it is true that also shares features of impulse control disorders and OCD.

Returning to phobias in general, it is also important to take into account that their onset and maintenance depend on different explanatory mechanisms. They are formed from direct and adverse experience with the object that will later be feared, or by vicarious/social learning (seeing another person exposing yourself to the stimulus or hearing negative stories about it), but the continuity of the problem is rooted in attempts to avoid or escape it of the. The latter motivate an equivocal feeling of relief, as it ends up extending the problem over time.

In this sense, the affected person articulates cognitive and behavioral strategies aimed at avoiding any coincidence with what It is scary, because when it does, it experiences a succession of sensations (autonomous hyperarousal) and cognitions that are difficult to understand. bear. The range of situations or other stimuli that can be associated with this irrational fear is almost infinite., which is why so many tags are created to define it.

People who suffer from specific phobias rarely go to a psychologist to treat the problem, because if the triggering stimulus is infrequent or can be avoided without major consequences for life, adaptation to the changes that it fosters is simple and does not affect either autonomy or welfare. On the other hand, when what is feared cannot be ignored, fear becomes an omnipresent emotion. and disabling, which generates symptoms linked to anxiety: cold sweats, irritability, muscle tension, etc

The latter makes drive phobia a really severe problem, because as we will see below, it constitutes an intense fear towards a stimulus to escape from can be really difficult: intrusive thoughts and their possible behavioral consequences (impulses).

What is drive phobia?

Drive phobia is a concrete form of fear that is not projected towards an external object, but towards the interior. Specifically, people who suffer from it feel an intense fear of certain types of thoughts, which is a fact that is very difficult for them to share.

It is about apparently innocuous mental contents, but which are understood in terms of threat and which burst unexpectedly. But in the case of drive phobia, just as important is the way in which these thoughts make us feeling is the way in which it makes us predict the way in which we will feel and act in the future immediate.

And it is that the drive phobia generates a logic of self-fulfilling prophecy (as often happens with anxiety disorders in general), so that what is feared or that generates anguish constantly captures our attention.

To exemplify the problem, we will divide it into smaller parts and address each of them separately. Thus we will distinguish between thought, interpretation and conduct.

1. The thought

All of us have at some point experienced a thought that arose automatically., without the mediation of our will. Very often we can be able to observe it and discard it, because we do not recognize in it anything that can be useful to us, or for understand it as a harmless word or image that will fade away as soon as we decide to focus our attention on other things that matter to us. surround.

In other cases, it is possible that an idea arises that generates a severe emotional impact, since we interpret it in terms of harm or danger. These may be issues related to acts of violence directed at ourselves or others, sexual conduct that we judge to be deeply abhorrent or expressions that violate deep values ​​(blasphemies in people who harbor deep religious beliefs, for example).

It is a mental content that appears suddenly and that may or may not be associated with a situation we are experiencing. Thus, it would be possible that while walking along a cliff the idea of ​​jumping into the void suddenly arises, or that being accompanied by a person (with whom we maintain a close bond) a bloody scene would emerge in which she was the protagonist. In other cases, however, it can happen without an obvious environmental trigger.

The very fact of being a receptacle of these ideas can alert the person to the possible underlying motives, since They are directly opposed to what you would do in your daily life (I would never commit suicide or harm a loved one). It is at this precise moment that such mental contents reach the field of psychopathological risk, since they precipitate a cognitive dissonance between what we think we are and what thoughts seem to suggest we are. are.

• You may be interested in: "Intrusive thoughts: why they appear and how to manage them"

2. Interpretation

The interpretation of intrusive thoughts is an essential factor in precipitating this phobia.. If the person deprives them of any sense of transcendence, they are diluted and stop generating a pernicious effect on her mental life. On the other hand, if a deeper meaning is attributed to them, it takes on a new dimension that affects the self-concept and promotes a feeling of distrust towards oneself and towards one's own activity cognitive.

One of the characteristic phenomena of this phobia is the connection that is forged between thought and potential behavior. In this way, when he accesses consciousness, the person fears losing control of himself and being overwhelmed by the impulse to carry out the acts that are related to him. Following the previous example, she would feel an irresistible fear of falling from a great height or of harming the relative who was accompanying her. Therefore, a fusion between thought and action arises.

This connection can generate doubts about whether the thought is a product of the imagination or if it is the memory of an event that really happened at a time in the past. All this causes emotions that are very difficult to tolerate and a significant confusion, which also forces doubts about the reason that could be the basis of thinking as one thinks (considering oneself a bad person, losing one's mind, suffering from hidden impulses or being an offense in the eyes of a God in whom one believe).

For this reason, drive phobia is not only linked to an intense fear of thoughts that could precipitate a loss of control, but also ends up conditioning the self-image and severely deteriorating the way in which the person perceives himself. It is for this reason that talking about what is happening can be extremely painful, delaying the therapeutic approach to the problem.

3. The conduct

As a result of the fear generated by these thoughts and their possible consequences, the person tries to avoid them using all the means available to him.

The most common is that, first of all, the will tries to impose itself on the discourse of the mind (which seems flow automatically), seeking a deliberate disappearance of the mental contents that generate the emotion. This fact usually precipitates the opposite effect, through which his presence becomes more frequent and intense. As it is a purely subjective phobic object, the person feels the source of her fears as omnipresent and erosive, quickly arising a sense of loss of control that leads to the helplessness

Other behaviors that can take place are those of reinsurance. They consist of persistently inquiring as to whether the facts that have been thought about have occurred or not, which implies verifications that end up acquiring the severity of a ritual compulsive. Besides, the tendency to continually ask others about these same facts may also arise, pursuing the judgment of others to draw their own conclusions about it.

Both types of behavior, the avoidance of subjective experience and the reassurance about one's own acts, constitute the basic elements for the aggravation and maintenance of the problem in the long term. term. Likewise, they can be articulated in a progressively more complex way, in a way that ends up hindering the development normal daily life (avoid situations or people that have been associated with the appearance of thoughts, for example).

Treatment

Drive phobia can be successfully treated. For it there are both pharmacological and psychotherapeutic interventions.

In the first case, they usually use benzodiazepines in a timely manner and for a short period of time, while the changes required for an antidepressant to begin to generate its effect take place (approximately two or three weeks). Selective serotonin reuptake inhibitors are often used, which help reduce the presence of negative automatic thoughts.

Regarding psychological treatments, which are absolutely necessary, specific strategies of a cognitive and behavioral, aimed at modifying the way in which thoughts and associated sensations are perceived (exposure to a living person, restructuring cognition, etc.). These procedures include controlled exposure and systematic desensitization, in which the patient is facilitated to face the situations that produce the phobic reaction without that he loses control, and letting time pass until anxiety levels decrease. In this way, as progress is made through a series of situations that go from the easiest (in the first psychotherapy sessions) to the most difficult (in the last ones), the drive phobia loses power and finally ceases to be a problem.

On the other hand, cognitive restructuring is also used to help weaken dysfunctional beliefs that keep drive phobia "alive"; This is something that is achieved above all through dialogues based on questions that the patient must ask himself, and in which he sees that his usual way of thinking not only does not fit with reality, but also causes him issues.

Acceptance and Commitment Therapy is also useful., as it emphasizes the importance of experiential avoidance, a key phenomenon in drive phobia. This type of therapy encourages the patient to adopt a mentality in which an obsession to avoid discomfort at all costs does not appear.

This type of intervention in patients, in the case of those people who have impulse phobia, helps them to face the symptoms without giving in, getting used to associating the presence of this discomfort, on the one hand, with the non-occurrence of their fears, on the other other.

Finally, it will be necessary to rule out the presence of other mental disorders that could express themselves in a similar way to this particular type of disorder. phobia, such as Obsessive-Compulsive Disorder, and rule out mood pathologies in which its appearance can also occur (especially depression elderly).

Bibliographic references:

• American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing.
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• Coelho, C. and Purkis, H. (2009). The Origins of Specific Phobias: Influential Theories and Current Perspectives. Review of General Psychology, 13(4): pp. 335 - 348.
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