What is an impulse phobia? Origin ?

What is impulse phobia?

Impulse phobia is now considered a belonging to obsessive compulsive disorder (OCD). Impulse phobia is defined by the irrational fear of committing serious or illegal acts. “Very often it is a thought that happens without the patient’s knowledge and which may be prohibited or socially prohibited. For example, and in the extreme, the person may be afraid of pushing someone out of a window or of inflicting pain on another individual or on themselves. Sometimes these thoughts are of a sexualized nature. On the one hand, the patient suffers from obsession, which is characterized by the intrusion of recurring thoughts, and of another, he suffers from compulsion“, explains Rosa Caron, psychologist, psychoanalyst. For Stéphane Rusinek, professor of clinical psychology, “the patient forbids himself to have these thoughts. When they become daily or obsessive, then it is an impulse phobia. The thoughts disturb him in his being: they do not correspond to his personality. The patient does not accept these intrusive thoughts, because he is afraid to take action. For example, a person is on top of a building. She looks down and her mind tells her that she would be able to jump. If this person begins to think about it and wonder (why did I think that? Can I jump?) and decides not to go to a balcony anymore for fear of being able to jump, then it is likely that she suffers from impulse phobia”.

What is the origin of an impulse phobia?

According to the analytical approach, derived from Freud’s teaching, compulsive thoughts come from events that have had a traumatic character. “A traumatic event is traumatic for someone, while it may be acceptable for others. It is traumatic for the one who undergoes the trauma, surprised by its brutality and its unpredictability. The trauma acts as a break in the psyche. It is then buried, then reappears: it is the theory of return of the repressedexplains Ms. Caron. The effects reappear in snatches, and even if it seems very far from the original event, the trauma leads to compulsive thoughts that have nothing to do with that initial event, because it has undergone transformations. In psychotherapy, we do not always look for the cause of impulse phobia, because the power of the unconscious cannot be denied.

“We can all, at some point, have intrusive and forbidden thoughts”

However, any attempt to seek out the cause runs the risk of bringing about a sort of resistance from the unconscious to further distance us from it. In a schizophrenic patient, we find recurrent images of the hallucination type, but this has nothing to do with impulse phobia. This last depends on the neurotic register, while schizophrenia is on the side of psychosis: we are not at all in the same structure“, details the psychoanalyst. Mr. Rusinek has a more scientific view of the origins of impulse phobia. “We can all, at some point, have intrusive and forbidden thoughts, which can generate anxiety in anyone. There would also exist genetic factors and links with our learning, our lived experiences or the abusive consumption of certain substances (cocaine, heroin, etc.) leading to higher risks of developing an impulse phobia”.

The symptoms of impulse phobia are basically recurrent and obsessive thoughts. These thoughts are dangerous and cause a fear of losing control and give in to those impulses. These thoughts are unmentionable, because they are serious and reprehensible. When the patient tries to fight these thoughts or is paralyzed by the fear of acting out, he may suffer from anxiety attacks, which are manifested by physical symptoms (cries, dizziness, hot flushes, tremors, etc.). “When the suffering and anxiety are too strong and prevent the person from living “normally”, the patient decides to consult“, says the psychologist.

Is there a test to diagnose impulse phobia?

According to the professor of clinical psychology, “there is no real diagnostic test. We classify psychiatric disorders according to clinical findings and an interview including specific questions corresponding to these problems. It is a list of symptoms, and when the patient has a certain number of them, we can say that he has the disorder. We take into consideration the circumstances in which the symptoms appear to better guide the diagnosis.

The standard therapy is cognitive-behavioral therapy (CBT). It is a question of bringing together the types of thoughts (forbidden thoughts and fulfilling thoughts) for the person in pain, in whom obsessive thoughts dominate the others. According to the clinical psychologist, this form of therapy is the most effective. “The first step is called psycho-education: we explain impulse phobia to the patient to reassure him. We also give him crucial information: for the time being, no person with impulse phobia has ever acted out. We can act on the behavioral compulsion by accustoming the patient to the anxiety generated by the thought. We teach him to accept his thought and to manage it better.

“Visualization under hypnosis is a good tool to shift thought and reduce its importance”

visualization under hypnosis is a good tool to shift the thought and reduce its importance, its influence on the patient. Thus, it occurs less and less often and new learning takes place at the behavioral level. Turn to a drug treatment such as anxiolytics is possible, in particular to reduce the anxiety disorder, but CBT often offers better results”, explains Mr. Rusinek. To cure an impulse phobia, the psychoanalysis is also a possible treatment. “It’s about a talk therapy. We are not necessarily directly interested in the causes, and we do not work directly on the symptomsays Rosa Caron. This gets the patient to talk and say whatever comes to mind. Gradually, psychoanalysis transforms its relationship to the world, which often leads to a dilution of the symptom”.

Can we cure it completely?

With good supportit is possible to cure impulse phobia. This strongly depends on the patient, but also on the therapist and the form of therapy which must be perfectly adapted to the situation and the symptoms of the patient.

Thanks to Rosa Caron, psychologist, psychoanalyst and lecturer in clinical psychopathology at the University of Lille (PSITEC lab) and to Stéphane Rusinek, professor of clinical psychology at the University of Lille (PSITEC lab) and Director of Education of the AFTCC (French Association of Behavioral and Cognitive Therapy).

Source: French Association of Behavioral and Cognitive Therapy (AFTCC)