A patient of mine, a man of thirty-five years, was afraid of going
out in the dark. This was traced to early associations of fears of
the dark, to superstitious beliefs in ghosts and spirits cultivated
in the patient’s early childhood. He was afraid to remain alone
in the dark or to go down at night into cellars or other secluded
places. This fear was unfortunately still more intensified by an
accident. At the age of twenty-seven, one night when returning
late from a visit, he was assaulted from behind by foot-pads. This
accident fixed the fear of darkness.
A lady of sixty-seven years, with pronounced arteriosclerosis, had
an attack of hemiplegia of the left side. She suffered from motor
aphasia, but did not lose consciousness. The paralysis cleared up
in a few days, but the sudden attack demoralized her. Since that
time she is in terror of another attack. She watches for symptoms,
and the least sensation of faintness throws her into a panic. The
patient is the wife of a general and was in China during the Boxer
riots, in the Spanish American war, in the Philippines, and other
military engagements. The fear instinct was cultivated in her by
all such conditions.
In her early childhood there were fears and frights of child
character, enough to arouse the fear instinct, which was gradually
developed and cultivated by the circumstances of life and by
worries in the course of the various wars, of which she was a
witness. Finally the fear culminated by the stroke of paralysis.
Similarly, I had patients who suffered from tuberculosis, from
asthma, from heart trouble, and from all kinds of intestinal
affections which specially abound in psychopathic cases. All
such cases can be clearly traced to various somatic symptoms
based on the fear instinct. The etiology is fear, the arousal and
development of the fear instinct in respect to the special symptom
complex.
A patient, aged twenty-six years, suffered from agoraphobia at
various intervals. As a child of nine years, he was attacked by
rough boys. He freed himself and ran in great terror. The boys
threatened him with another “licking” when he appeared again
on the street. He was afraid to go out for several weeks. The
parents forced him to go and buy some things. Living in a rough
neighborhood, on account of his father’s circumstances, he had been
many times subjected to knocks, blows, and assaults by rough boys,
until the fear of the open street became fixed into the well known
form of agoraphobia.
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