While a large proportion of writers concur with Freud’s concept, some, like P. Hoch, have challenged the logic of his formulation. Hoch posed the question, “If anxiety is a signal that repressed instinctual forces have begun to erupt, why should the alarm burn down the house?” (1950, p. 108).

Hoch’s paradox applies especially to cases in which the fear syndrome interferes with a person’s ability to cope effectively with a dangerous situation, and thus greatly increases the danger. There are times, for in stance, when a person freezes in the face of physical threat. Picture a young man driving a car on a crowded metropolitan street. He signals to make a left turn. As he enters the intersection, he hears the blaring of a car horn. He feels acute anxiety and automatically slams on the brakes. The car is hit from the right. In this example, the automatic defensive response interfered with his ability to execute an effective coping response. If he had accelerated rather than stopped the automobile, he would not have been hit. The freeze reaction, associated with anxiety, was clearly not adaptive in this situation.

The preceding example not only illustrates that fear can interfere with the execution of an effective coping response, but also demonstrates that subjective anxiety is not a necessary condition for the execution of the coping response. In fact, the driver of the car could have executed the appropriate response in this situation if his skillfull behavior had not been disrupted by his primitive inhibitory response and the distraction of the anxiety. Similarly, an athlete can readily mobilize his resources in a split second movement to make a net shot or catch a runner off base—without experiencing anxiety. The competitive situation is sufficient to activate the central nervous system rapidly. It therefore seems that anxiety is neither a sufficient nor a necessary condition for the activation of an instrumental coping response. It can even hinder the execution of an adaptive response to a threatening situation.

Future Danger and Present Danger

I have previously emphasized the essential future orientation of fear (Beck 1967). A particular noxious event may be about to happen–but it has not happened yet. Or, it may be happening, but the ultimate dire consequence.

Theoretical and Clinical Aspects 

has not yet occurred. A person’s fear is activated as he gets closer to the threatening situation. Indeed, he may become fearful simply by talking or thinking about the dangerous situation-or by imagining it. Dwelling on the fear makes the threatening situation more salient and more imminent: that is, it brings a distant danger into the here-and-now.

There is often a notable change in a person’s reactions between anticipation of confronting a danger and actually facing it. As one enters the “dangerous” situation, emergency patterns—such as flight, inhibition, or fainting—may be activated. A medical student became increasingly fearful and anxious as the date for a final examination approached. As she sat down and started to read the examination questions, there was an enormous leap in her degree of fearfulness. She thought, “I don’t know how I can answer these questions.” Her mind became “blank,” and she could not focus on the questions. Her anxiety then built up so far that she could not tolerate it and felt impelled to flee from the room. Direct confrontation with the threat triggered an automatic escape mechanism.

The transition from anticipation of noxious physical trauma to its actual experience is illustrated by a young man who nervously awaited some dental work. When he was finally in the dentist’s chair and the dentist was drilling his teeth, he had vivid visual images of the drilling penetrating his skull. He began to sweat profusely and started to faint. Or, another young man was very apprehensive about giving a public speech. When he was finally in the auditorium and facing the audience, he suddenly “choked up” and found it extremely difficult to utter a word.

In those examples, it is clear that immersion in the dangerous situation may provoke certain automatic behavior that was not evoked in usual life situations. In the case of the medical student taking an examination, there was not only a sharp increase in anxiety but also mental blocking and mobilisation to escape. The dental phobic had a profound reaction of the parasympathetic nervous system (sweating and fainting). These examples suggest that the disabling and disturbing symptoms, such as blocking and fainting, represent survival mechanisms that were once useful, say, in prehistoric times for mitigating the extreme consequences of an attack. In actuality, these primitive reactions only accentuate the problem and, in deed, make the individual even more fearful of confronting the situation in the future—lest the primitive response be repeated.

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