by Howard Miller

Created on: March 04, 2007   Last Updated: May 02, 2007

Anxiety was defined in the Acute Anxiety article and will not be dealt with in detail in this one. Remember, however, that it is a physical response mediated, primarily, by the sympathetic branch of the autonomic nervous system and a mental response that is best described as a need to escape, or flee, but without conscious realization of what it is you are escaping from and where you can flee. By definition, the feared stimulus is not identified; if it were, it would be fear and not anxiety.

Sometimes, the response is severe and acute and leads to what is called a panic disorder, previously discussed. Sometimes the anxiety, however, never reaches panic levels, but is present all or much of the time in lower amount. It is still uncomfortable, of course, but it can be and often is lived with. However, when present chronically, the person tends to try to find some way(s) to reduce it, defend against it, and that results in the so-called defense mechanisms.

Two issues about the defense mechanisms must be clarified, however. One is that everybody has some, well - almost everybody. Their complete absence occurs only two ways (aside from death); one of which is a fully deteriorated psychotic, which we will not discuss, and the other is in the theoretical perfect, absolute psychopathic personality disorder, which we also won't discuss. All the rest of us, clinically anxious or not, have defense mechanisms. Some of them work better than others; that's issue two. The poorly working defenses that are clung to despite their inefficiency are what define some of the anxiety disorders. Let's look at some of the more interesting categories.

Specific Phobia:

What is interesting about this category is that it appears to contradict the definition of anxiety because there is a specific object or situation of which the individual is afraid. In fact, the definition rests on the fact that there is a "...marked and persistent fear of clearly discernable, circumscribed objects or situations." (DSM IV. p. 405). So what makes this anxiety and not fear? How about the fact that the feared object or situation is not really what the person is afraid of. OK, the individual is, for all intents and purposes, afraid of the stimulus, in fact, terribly, excessively, unreasonably afraid. Therein lies the crux. The fear is excessive; it is unreasonable; it is, in short, irrational in both target and degree. And, in many cases, it isn't really the stimulus that is threatening to the individual; it's

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