The phobic disturbances (Phobias). A survey of the actual state of psychodynamic concepts and remarks on therapy

Journal/Book: Forum Psychoanal. 1999; 15: 175 Fifth Ave, New York, NY 10010, USA. Springer Verlag. 237-252.

Abstract: Psychoanalysis has failed to work out a comprehensive theory of the phobias. While in the older concepts basing directly on Freud the model of the inner conflict dominates, contemporary authors show a broadening use of ego psychological aspects especially coping with ego deficiencies. The phobic mechanism is characterized by displacement and avoidance. The primary anxiety of which the return is constantly feared, is conceived of as a neurophysiologic panic attack or as the consequence of developmental conflicts. The author stresses the reception of contemporary epidemiological and nosological knowledge. The clinical importance of social phobia, widely neglected by psychoanalysis, is presented and a psychodynamic framework for this nosological entity is proposed. For the psychotherapy of all phobias the use of Freud's (1919) active technique is of basic importance. The possible and partly unavoidable combination of psychotherapy and modern antidepressants is pointed out.

Note: Article Hoffmann SO, Univ Mainz, Klin & Poliklin Psychosomat Med & Psychotherapie, Untere Zahlbacher Str 8, D-55131 Mainz, GERMANY

Keyword(s): EARLY SEPARATION ANXIETY; PANIC DISORDER; PSYCHOANALYTIC VIEW; SOCIAL PHOBIA; AGORAPHOBIA

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