Impulse phobia: symptoms, causes and treatment

People maintain continuous mental activity. We are rational beings who construct our reality through thought, so that it does not stop in its effort to make sense of what surrounds us.

Every human work, without exception, was a thought before it became tangible. That is why we must appreciate its importance in the creative process, as well as its intimate relationship with behavior and emotion.

Impulse phobia emphasizes this indivisible link between thinking and acting, But by adopting a pernicious nature that generates great discomfort for those who experience it.

In this article, we will review the concept, as well as its characteristics and consequences on health and quality of life, as well as the therapeutic modalities we have today to respond to it successfully.

    Phobias: characteristics and symptoms

    Phobias are anxiety disorders characterized by the appearance of a disproportionate fear response to the presence of very specific stimuli or situations, which they activate natural warning mechanisms to respond to what is perceived as a threat. To understand, we can resort to the metaphor of allergies, which are erected as overreactions of the immune system to generally harmless substances or other elements (but which are confronted with a dangerous pathogen).

    As we will see, impulse phobia has this main feature, although it is true that it also shares its own characteristics of impulse control disorder and Bam.

    To come back to phobias in general, it is important to note, moreover, that their appearance and their maintenance depend on different explanatory mechanisms. They are formed from direct and unfavorable experience with the object that will be feared later, or through vicarious / social learning (seeing another person exposed to the stimulus or hearing negative stories about it), but the continuity of the problem has its roots in attempts to avoid or escape from it. The latter motivates a feeling of misguided relief, because it ends up spreading the problem over time.

    In this sense, the affected person articulates cognitive and behavioral strategies aimed at avoiding any coincidence with what frightens him, because when he does so, he experiences a succession of sensations (autonomic hyperactivation) and cognitions that are difficult to bear. The range of situations or other stimuli that can be associated with this irrational fear is almost endless.This is why so many labels are created to define it.

    People who suffer from specific phobias rarely go to a psychologist to treat the problem, because while the detonating stimulus is infrequent or can be avoided without additional life consequences, adjusting to the changes it causes is easy and n ‘affects neither autonomy nor well-being. On the other hand, when what one fears cannot be ignored, fear becomes a pervasive and disabling emotion, which generates symptoms related to anxiety: cold sweats, irritability, muscle tension, etc.

    The latter makes impulse phobia a really severe problem, because as we will see later, it is an intense fear of a stimulus that can be really difficult to escape: intrusive thoughts and their possible behavioral consequences (impulses).

    What is impulse phobia?

    Impulse phobia is a concrete form of fear which is not projected towards an external object, but towards the inside. Specifically, people who suffer from it experience an intense fear of certain types of thoughts, which is a very difficult fact to share.

    These are seemingly harmless mental contents, but they are understood in terms of threat and erupt unexpectedly. But in the case of impulse phobia, as important as how these thoughts make us feel is how they make us predict how we will feel and act in the immediate future.

    And does impulse phobia generate a logic of self-fulfilling prophecy (as often happens with anxiety disorders in general), then what is feared or that generates anxiety constantly attracts our attention.

    To illustrate the problem, we’ll break it down into smaller parts and deal with each of them separately. We will thus distinguish between thought, interpretation and behavior.

    1. Thought

    We have all experienced at some point a thought that came automatically, Without the mediation of our will. Very often we may be able to observe it and dismiss it because we don’t recognize anything in it that can be of use to us, or understand it as a harmless word or picture that will fade as soon as we decide to focus attention. to other things around us.

    In other cases, an idea may crop up that will have a severe emotional impact on us, as we interpret it in terms of harm or danger. These can be problems related to acts of violence directed against ourselves or against others, to sexual behavior that we find deeply detestable or to expressions that violate deep values ​​(blasphemies in people who harbor religious beliefs deep, for example).

    It is mental content that appears suddenly and 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 ​​throwing oneself into the void suddenly arises, or that by being accompanied by a person (with whom we have a close bond) a bloody scene emerges. in which she was the protagonist. In other cases, however, it can happen without an obvious environmental trigger.

    Even being a receptacle for these ideas can alert the person to possible underlying reasons such as they are frontally opposed to what they would do in their daily life (He would never kill himself or hurt a loved one). It is at this precise moment that these mental contents reach the realm of psychopathological risk, as they precipitate a cognitive dissonance between what we believe to be and what thoughts seem to suggest we are.

      2. Interpretation

      The interpretation of intrusive thoughts is an essential factor in precipitating this phobia. If the person deprives it of any sense of transcendence, it dilutes itself and ceases to generate a pernicious effect on his mental life. On the other hand, if we give them a deeper meaning, it takes on a new dimension that affects self-concept and promotes a feeling of mistrust of oneself and one’s own cognitive activity.

      One of the characteristic phenomena of this phobia is the link that is forged between thought and potential behavior. In this way, when accessing consciousness, the person is afraid of losing control of himself and being overwhelmed by the urge to perform the acts related to him. Following the previous example, he would feel an overwhelming fear of rushing from a great height or hurting the accompanying family member. A fusion between thought and action therefore occurs.

      This connection can be generated doubts as to whether the thought is the product of the imagination or whether it is the memory of a fact that actually happened at some point in the past. All of this causes emotions that are very difficult to tolerate and a lot of confusion, which also raises many doubts about the reason that could be at the basis of your thinking (think of yourself as a bad person, lose your judgment, suffer from impulses hidden or be an offense) in the eyes of a God in whom we believe).

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

      3. Behavior

      Due from the fear generated by these thoughts and their possible consequences, the person tries to avoid using all the means at his disposal.

      The most common is that, first of all, he tries to impose his will on the speech of the mind (which seems to flow automatically), seeking a deliberate disappearance of the mental contents that generate the emotion. This fact usually precipitates the opposite effect, through which its presence becomes more frequent and intense. When dealing with a purely subjective phobic object, the person feels the source of their fears as pervasive and erosive, quickly emerging from a sense of loss of control which leads to helplessness.

      Other behaviors that can take place are those of reinsurance. They consist in constantly researching whether the facts which one has thought of have occurred or not, which implies controls which come to acquire the severity of a compulsive ritual. Outraged, there may also be a tendency to continually ask others about these same facts, Pursuing the judgment of others to draw their own conclusions in this regard.

      The two types of behavior, the avoidance of subjective experience and the reassurance of one’s own actions, constitute the basic elements for the aggravation and maintenance of the problem in the long term. They can also articulate in progressively more complex ways, so that it ends up interfering with the normal development of daily life (avoiding situations or people that have been associated with the appearance of thoughts, for example).

      treatment

      Impulse phobia can be treated successfully. for that there are pharmacological and psychotherapeutic interventions.

      In the first case, benzodiazepines are usually used in a timely manner and for a short time, while the changes necessary for an antidepressant to start working (about two or three weeks) follow one another. Selective serotonin reuptake inhibitors are often used, which help reduce the presence of negative automatic thoughts.

      With regard to the psychological treatments, which are absolutely necessary, specific strategies of a cognitive and behavioral nature are generally used, aimed at modifying the way in which the thoughts and associated sensations are perceived (living exposure, cognitive restructuring, etc.). .). These procedures include controlled exposure and systematic desensitization, In which it is easier for the patient to face the situations which produce the phobic reaction without losing control, and allowing time to pass until the anxiety levels decrease. In this way, as one progresses through a series of situations from the easiest (in the first sessions of psychotherapy) to the most difficult (in the last), the phobia of impulses loses power and it eventually ceases to be a problem.

      On the other hand, cognitive restructuring is also used to help weaken dysfunctional beliefs that keep impulse phobia “alive”; it is something that is done mainly 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 correspond to reality, but causes him problems.

      Acceptance and commitment therapy is also helpfulAs he emphasizes the importance of experiential avoidance, a key phenomenon in drive phobia. In this type of therapy, the patient is encouraged to adopt a mindset in which there is no obsession with avoiding everyone’s discomfort.

      This type of intervention in patients, in the case of people who have a driving phobia, helps them cope with 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.

      Finally, it will be necessary to exclude the presence of other mental disorders that may be expressed in a manner similar to how this particular type of phobia, such as obsessive-compulsive disorder, and to exclude the pathologies of the mood in which its onset (especially major depression) may also match.

      Bibliographical references:

      • American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing.
      • Chamberlain, SR; Leppink, EW; Redden, SA and Grant, JE (2017). Are obsessive-compulsive symptoms impulsive, compulsive, or both? Integral Psychiatry, 68: pages 111-118.
      • Coelho, C. and Purkis, H. (2009). The origins of specific phobias: influential theories and current perspectives. Revue générale de psychologie, 13 (4): pages 335-348.
      • Perugi, G; Frare, F; Toni, C (2007). Diagnosis and treatment of agoraphobia with panic disorder. CNS drugs. 21 (9): pages 741 to 64.
      • Power, MN; Coran, LM and Pallantic, S. (2009). The relationship between impulse control disorders and obsessive-compulsive disorder: a current understanding and future research directions. Psychiatry Research, 170 (1): pages 22-31.
      • Tillfors, M. (2003). Why do some people develop a social phobia? A journal focusing on neurobiological influences. Psychiatry North J. 58 (4).
      • Vallejo, J. (2007). Neurotic disorders secondary to stressful and somatomorphic situations (III). Obsessive Compulsive Disorder. Treatise on psychiatry. Marbán: Madrid

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