Theoretical Approaches to the Fear of Anxiety
Richard J. McNally Harvard University
Pathological fears have often been defined by their eliciting stimuli. Nosologists, for example, have traditionally defined acrophobia as fear of heights, claustrophobia as fear of enclosed spaces, and agoraphobia as fear of open, public places. This tradition is notable for its neglect of the intentionality of fear. Intentionality does not mean deliberateness as in someone doing something intentionally. It refers to the aboutness of something ( Brentano, 1889/ 1984). Rather than specify why an agoraphobic person fears shopping malls, subways, and so forth, traditional approaches to nosology merely identify the range of external cues that evoke excessive fear. Yet specifying the intentional object of fear (i.e., what the fear is about), and not merely its eliciting stimuli, has important nosological implications. For example, people with agoraphobia and people with specific flight phobia both nominally fear the same stimuli, yet the motivation for avoidance is entirely different. The intentional object for agoraphobics is panicking while aloft, whereas the intentional object for flight phobics is crashing ( McNally & Louro, 1992).
In their landmark article on the reanalysis of agoraphobia, Goldstein and Chambless ( 1978) departed from the traditional perspective in important ways. Instead of viewing agoraphobia as a fear of stimuli embodied in public places, they emphasized the intentional object of agoraphobic fear-namely, panic and its presumed consequences. They also revived the notion that one's own fear responses could constitute the focus of dread, popularizing the idea that agoraphobia is best conceptualized as a fear of fear itself.