In 1798 Benjamin Rush wrote the first “scientific” analysis of phobias when he identified 18 specific phobias, some of which were satirical. He wrote: “The insect phobia. This disease is peculiar to the female sex. A spider, a flea, or a musqueto (sic) alighting upon a lady’s neck has often produced an hysterical fit…” Okay, I put my hand up. I wouldn’t like a musqueto alighting on my neck – for good reason since we know they can carry malaria – although I don’t think I would become hysterical over it. And I have seen grown men reduced to gibbering wrecks by some insects. But leaving aside Mr Rush’s bias, I think a historical look at phobias is really interesting. Maybe that’s just because I sometimes suffer from claustrophobia and a darkened, enclosed space can induce a panic attack in me. I’ve often thought that throughout history people must have responded to their fears in exactly the same way that we do now and I wondered how they referred to it and what, if anything, were the treatments for it.
The word phobia comes from the Greek meaning panic, fear, terror and flight. The God Phobos was honoured for provoking fear and flight in the Greeks’ enemies. Until the mid-nineteenth century the word “phobia” was only used in the sense of “hydrophobia” which was a term for Rabies. It was another 75 years before the word “phobia” was attached to a set of diagnostic criteria and came to mean: “A persistent, abnormal and irrational fear of a situation or thing that compels one to avoid it despite the awareness and reassurance that it is not dangerous.” Early accounts of phobias arise in medical and philosophical writings from the Ancient Greek and Roman periods. Hippocrates recorded the case of a man taken by an irrational terror when he heard the sound of a flute at a banquet in the evenings. He was fine if he heard a flute during the day but not at night. Hippocrates also mentioned a man with a fear of heights and another with a cat phobia. Hippocrates put these fears down to “melancholia,” suffering from an excess of black bile, which was one of the three major types of insanity. Later physicians also attributed phobias to this melancholy over-heating of the brain and the belief persisted well into the 18th century. I couldn’t find much reference to treatments other than blood-letting but in one case the treatment for Hydrophobia was to throw the patient into a water tank when he was off his guard! If he could swim (which presumably they wouldn’t find out until he was in there) then he should be pushed under; if he couldn’t swim he should be allowed to sink underwater and then fished out. There is no record of this treatment being successful…
In the intervening time from the Ancient World to the late 18th century references to phobias mainly occur in theological texts. During this period they were seen as manifestations of evil spirits and sufferers were sometimes subject to exorcism as a cure. Two very specific phobias recorded were Plague Phobia in the late 16th and early 17th century and Syphilophobia (fear of syphilis) in the 17th and 18th centuries. Both of these seem entirely understandable phobias to develop. In 1650 Descartes wrote about phobias to objects as diverse as roses and cats, and Shakespeare described animal phobia in The Merchant of Venice: “Some men there are that love on a gaping pig; Some that are mad when they behod a cat…” (Cats seem to feature large in historical phobias).
During the 18th and 19th centuries there were several attempts to understand and classify phobias in a medical context. Pinel called it “mania without delirium.” Esquirol called it “emotional delirium.” Theories on the cause of phobias varied from stomach ailments to a poor upbringing. In 1872 a seminal work about agoraphobia referred to three male patients with the following symptoms: “impossibility of walking through certain streets or squares, or possibility of so doing only with resultant dread of anxiety…” So it wasn’t just women who suffered from phobias. Of course not. But during the Victorian period particularly there was a cultural approach to seeing women as “hysterics” who needed to be treated with drugs, or sex, or who, in the worst examples, were locked up in an asylum because they were categorised as “mad” simply because they had a certain phobia.
Do you suffer from a phobia? I drew on my own experience of claustrophobia when I was writing Mistress by Midnight in which Merryn and Garrick are trapped in a fallen building during the London Beer Flood.