Читать книгу Phobias: Fighting the Fear - Helen Saul - Страница 18

Freud and Watson’s pre-eminent positions were eventually usurped in the 1950s by the silicon chip. Computers provided the inspiration for the next way of thinking about thinking. Centuries earlier, doctors trying to understand the heart were baffled until engineers invented the pump. The pump gave them a model for how the heart could work, and it was a good comparison. In the same way, computers introduced notions of information processing and storage which were new. Doctors hijacked these ideas to explain the workings of the human mind and memory. The analogy of programming a computer to carry out tasks was a more satisfactory explanation for how we learn complex skills than anything behaviourism had put forward.

So computers’ first contribution to the progression of thought on phobias was as a model for thought processes and the mind. More recently, computers have driven research into the physical causes of fear in a way that has never been possible before. The power of modern computers allows geneticists to trawl through immense heaps of data in an attempt to pinpoint the genes responsible for panic disorder. Advances in imaging have given scientists new ways of looking at the brain and allowing them to piece together an ever-clearer picture of the physical changes when someone thinks, laughs or is afraid. Computers are being used to design molecules that will surely give us the next generation of fear-busting pills. The neurosciences are advancing in many different directions and none of it would be possible without the modern computer.

But if history has taught us anything, it must be that no one school of thought has all the answers. Hippocrates and the ancient Greeks gave telling descriptions of phobias, but did little to help their patients. The philosophers had some brilliant insights which failed to make it into clinicians’ textbooks. Progress has been halting over the centuries, characterised by dead ends, false dawns and the odd piece of brilliance, quickly obscured.

Freud must be credited with separating phobias from generalised anxiety and establishing them as a new and distinct subject for study. His classification of anxiety types was a big step forward because it drew attention to the special and specific features of phobias which today’s therapists are capitalising on and which are making new treatments so promising. However, his later psychoanalytical work, with its subjective interpretations of hidden feelings, is spectacularly unfashionable in the age of computers and hard data.

Practical progress has been most marked where sciences have interacted. The theory of cognitivism may have overtaken behaviourism, but most phobia clinics now offer cognitive-behavioural therapy. The theories may be irreconcilable, but the two approaches taken together are more effective than either alone.

This could also be true of the neurosciences, psychology and psychoanalysis, which continue to pay scant regard to each other’s findings. They have developed more or less independently, with little reference to each other. Neuroscience is a thriving field at the beginning of this new century and it is tempting to feel we can safely reject everything that has gone before. Undue attention to underlying problems, spearheaded by Freud, held back treatment of phobias for years and the demise of psychodynamics has been liberating and productive for scientists, clinicians and those with phobias. It is thrilling to be able to discard confusing psychoanalytical theory in favour of neuroscience and its promises of definite answers to clearly defined problems. But the dawn of the neurosciences could yet produce a need for a deeper understanding of the meanings of fear. Because, in the end, fear is more than a chemical reaction. No one with a phobia really cares about their hormone levels or brain activity. What they want is an end to their phobia and the sensation of fear.