• Know something about the person’s background before the date.
• Accept “blind” dates only arranged by people you know and trust.
• Seek out people who treat others with respect. • Date people who agree with your values. • Avoid people who are overly critical or abusive. 170 dasein analysis
or light. Some agoraphobics fear being out during daylight, or after dawn, but are comfortable going out in the dark. Others who fear dawn and day- light may fear being seen by others or fear criticism about their appearance or their actions.
See also DAYLIGHT, FEAROF; LIGHT, FEAROF.
daydreaming When people daydream, they are awake and experiencing a pleasant reverie, usually of wish fulfillment. Daydreaming occurs during idle moments or when people are unconcerned about the activity around them. In these ways, daydream- ing, which may be a form of relief from anxieties, differs from serious, logical, and controlled think- ing, which is done in a more deliberate manner.
Some people may daydream about developing great ideas or inventions or taking new directions in life; in daydreaming, their mind is free to roam without inhibition and self-censorship. Different outcomes of looking at work and family situations are often developed during moments of daydream- ing, because daydreams are usually concerned with ends, not means.
People of all ages daydream. Young and old may be caught staring out the window, putting down a book and gazing at nothing in a trancelike state. Unless they share their dream, it is difficult to tell if they are lost in revery or just bored.
See BOREDOM; CREATIVITY.
daylight, fear of Fear of daylight is known as phenogophobia or phengophobia. Manifestations of this fear involve secluding oneself in curtained rooms where sunlight cannot enter and permitting only illumination by artificial light. Usually the indi- vidual can exit at night and move around at night.
Fear of daylight may be related to a fear of being seen in public, being watched, or of criticism by oth- ers for behavior or appearance. Some agoraphobics go out only at night because they are fearful of being seen having a panic attack during the daylight.
Feydeau, the French playwright, is said to have feared daylight; he practically never went out dur- ing the day. Fear of darkness is more common than fear of daylight.
See also DAWN, FEAROF; LIGHT, FEAROF.
daymare A term roughly related to ANXIETY ATTACK or PANICATTACK and which is produced by an ongoing thought or image.
dead bodies, fear of Fear of dead bodies, corpses and cadavers is known as necrophobia. Individuals who fear looking at dead bodies may indirectly fear that they will also die or that there may be some “contagion.” Some necrophobes may also be fearful of disease or injury.
See also CORPSES, FEAROF; DEATH, FEAROF.
deadlines The time within which something must be completed. Most people have experienced anxiet- ies in meeting or failing to meet a deadline. Once they have fallen behind, it is difficult to catch up. They find that rushing tends to add to the anxiety level and decrease effectiveness. Ineffectiveness leads to frus- tration. Some people become moody, emotional, and blame themselves or others for the deadline failure.
The key to avoiding anxieties produced by dead- lines is setting realistic time schedules, enlisting the help needed when deadlines go awry, and negoti- ating new deadlines when it appears that for one reason or another, deadlines are going to be missed. For individuals to keep a positive outlook, they should break deadlines down to a series of small steps. As each step is completed, they will feel some success, and that success, in turn, will keep them motivated toward their final goal.
See also AUTONOMY; CONTROL; WORKPLACE.
deafness Loss of hearing, either complete or partial. Hearing loss becomes a source of anxiety for many individuals who begin to lose their hearing. While hearing aids help many individuals, some are embar- rassed to wear them or find them uncomfortable. Some try to draw attention away from their loss or otherwise conceal it. Some people associate loss of hearing with aging, and hence postpone getting a hearing aid to preserve their image of youthfulness.
Deafness and hearing loss is a major societal problem. Estimates are that about a quarter-million persons in the United States are completely deaf and about 3 million have major hearing problems.
Causes of Hearing Diffi culties
Hearing difficulties are related to many things, including problems within the ears themselves, overall body health, emotions, and external envi- ronment. People tend to shut off certain sounds at certain times and will hear only what is interesting or significant. For example, a man may hear all of a sports newscast but not hear a request to fix some- thing around the house. In some nursing homes, it has been observed that individuals say they can- not hear, but when asked whether they want ice cream they are able to answer. The term psycho- genic deafness pertains to such mental “shutting off” of hearing carried to an extreme. Some patients may have such a strong subconscious desire not to hear, they become completely deaf yet have physi- cally normal ears.
The term psychosomatic deafness relates to situations in which actual physical deterioration occurs in the ear as a reaction to a mental or emotional problem. There also may be combinations of both physical and psychologically induced hearing difficulties.
See also DISABILITIES.
death, fear of Fear of death, or thanatophobia, is one of the most universal fears, and may be the basis for many phobias. For example, individuals who fear darkness, choking, suffocation, enclosed places, flying in an airplane, epidemics, having a heart attack, developing cancer or acquired immune deficiency syndrome (AIDS), indirectly fear death under the other feared circumstances. Those who fear having panic attacks also fear death, because at the times when their hearts beat fast and they have difficulty breathing, they are afraid that they will die. Many agoraphobics fear death. The com- monly used term “scared to death” probably came about because some individuals are so frightened by circumstances—or their own reactions—that they fear they will die.
Historically, philosophers and psychoanalytic thinkers have considered man’s preoccupation with and fear of death, and most religions have incorporated teachings about death into their belief systems. Some people fear death because of its unknown aspects. Some fear their own death and worry that it will be painful and unpleasant. Oth-
ers fear death because of what might happen to them after the end of life. For those who believe in a hereafter, they worry about where they will go after death. Fear of death and retribution for pos- sible sins during life may influence some individu- als toward good behavior.
Others fear the death of a loved one, which would result in the survivor’s being left alone. For example, when a spouse does not return when expected, some individuals start fearing an accident or a mugging. Many children fear the death of a parent, because the children fear being left alone. It is not uncommon for a young child to anticipate the return of a dead parent, because young children do not comprehend the finality of death.
Fear of death is common among children, par- ticularly adolescents. Adolescents aged 15 to 18 are more anxious about death than younger children or older adults, while among 12- to 18-year-olds, the most common fear is of nuclear war (a fear of death by nuclear war).
In the United States, many people fear talking about death. As an example, many do not use the words “death,” “dying,” or “died.” Some prefer to refer to another’s death as “passing on,” or “pass- ing away” or “going to one’s reward.” People fear death because it is the ultimate unknown. Part of the reason our cultural attitudes about death con- tinue from generation to generation may be that we hide the topic from children. Many adults view death as unspeakable.
In the last decade, however, death has become more commonly talked about out of necessity because of technology that has developed to keep terminally ill patients alive, the development of legal as well as medical definitions of death, ques- tions about euthanasia (mercy killing), organ dona- tion, and the movement toward hospice care for the dying.
The fear of blood and injury is related to a fear of death, as some phobic individuals associate blood, illness and injury with death. Those who fear nee- dles, injections, or having dental work done may also indirectly fear that they will die as a result of the procedure. However, through exposure ther- apy, by gradually facing the feared circumstance, the individual can learn to reduce these fears. Expo- sure therapy helps many individuals overcome fear 172 death, fear of
of dentistry and medical examinations to the point where they are able to relax adequately for neces- sary procedures.
Some of the factors that influence an individ- ual’s fear of death are the age of the person, the individual’s psychological maturity, and the level of threat of death. Fear of death often becomes more common after age 40. Individuals dread not only the physically destructive aspects of death, but also the expected loss of consciousness, self-control, and aloneness that death implies.
Soldiers in combat are afraid of dying but learn to control or repress their fears. Some use defen- sive coping techniques including the adoption of a fatalistic attitude or the thought that they are invulnerable or immortal. During wartime, fear of death contributes to soldiers’ alertness and readi- ness to use weapons. Because of continually facing this acute fear over a period of time, some servi- cepeople develop POST-TRAUMATICSTRESSDISORDER, during which they relive their fears of death, even years after active duty.
See also CHILDHOOD ANXIETIES, FEARS AND PHO- BIAS; CLAUSTROPHOBIA; DEATH ANXIETY; DEATH- RELATEDFEARS; DENTALANXIETY; INJECTION, FEAROF; PANICATTACK.
Becker, Ernest, The Denial of Death (New York: Macmillan, 1975).
Choron, Jacques, Death and Western Thought (New York: Macmillan, 1963).
Henden, David, Death As a Fact of Life (New York: W. W. Norton, 1973).
death anxiety Fear of death and anxiety over dying; also known as thanatophobia.
See also CEMETERIES, FEAR OF; DEATH, FEAR OF; ILLNESS, FEAROF.
death-related fears A fear hierarchy, or arrange- ment of fears relating to death, from maximum to minimum, is sometimes used during therapy for an individual who has a death phobia. The individual may be asked to name the situation that arouses maximum anxiety; that fear will be given a rating of 100. The situation that causes the least anxiety
is given a 5. A fear hierarchy or death-related fears for an individual might be:
Seeing a dead man in a coffin Being at a burial
Seeing a burial assemblage from a distance
Reading the obituary notice of a young person who died of a heart attack
Driving past a cemetery (the nearer, the worse) Reading the obituary notice of an old person Being inside a hospital
Seeing a hospital Seeing an ambulance
See also CEMETERIES, FEAROF; DEADBODIES, FEAROF; SYSTEMATICDESENSITIZATION; TOMBSTONES, FEAROF.
Wolpe, Joseph, Our Useless Fears (Boston: Houghton Mif- flin, 1981).
decapitation fear Fear of having one’s head cut off. Some psychiatric points of view consider decap- itation fear a form of castration anxiety, or fear of having one’s genital organs cut off. This bizarre and unlikely concern is usually part of a delusional pat- tern of obsessive fantasy.
See also CASTRATIONANXIETY; SEXUALFEARS.
decaying matter, fear of Fear of decaying matter is known as septophobia. Individuals who have this phobia may be afraid of disease.
See also CONTAMINATION, FEAROF; DIRT, FEAROF; FILTH, FEAROF; GERMS, FEAROF; INFECTION, FEAROF.
decisions, fear of Fear of making decisions is known as decidophobia. Some anxious individu- als find it difficult to make choices in life, ranging from simple choices, such as what to wear, to major decisions, such as whether to get married or not, or where to live. Some individuals who fear NEWNESS or NOVELTY have difficulty making decisions regard- ing changes. ANXIETIES about decision-making are related to FEARS about one’s own capabilities and feelings of self-confidence.
See also MOVING, FEAROF.
deconditioning A behavior therapy technique in which learned responses such as phobias are “unlearned,” or deconditioned. For example, a per- son who has a phobic reaction to water following a near-drowning experience could be deconditioned by going wading with a trusted friend, taking a small step at a time in very shallow water, and gradually going into deeper water. Desensitization is another term for the deconditioning process.
See also BEHAVIORTHERAPY; DESENSITIZATION.
deep places, fear of See DEPTH, FEAROF.
defecalgesiophobia See DEFECATION, FEAR OF; DEFECATION, FEAROFPAINFUL.
defecation, fear of Fear of defecation, or having bowel movements, is known as coprophobia. For some, the fear extends only to the times when the individual perceives that someone is watching or is aware of what is happening, such as in a public bathroom facility. For others, there is a fear of losing part of the body through defecation. Another inter- pretation is that the individual may have regressed, or perhaps never advanced, from an earlier stage of development in which his or her own feces were considered prized possessions.
See also ANALSTAGE; DEVELOPMENTALSTAGES.
defecation, fear of painful Fear of having pain during a bowel movement is known as defecalgesio- phobia. This fear may be long-standing or may occur at times such as following surgery or during illness, where the pain may be real and not imaginary.
See also DEFECATION, FEAROF.
defense mechanisms Patterns of feelings, thoughts, or behaviors that are relatively involuntary and arise in response to perceptions, psychic danger such as ANXIETY, internal conflicts, unacceptable impulses, GUILT, or other threats to the EGO. The term defense mechanisms was first used by SIGMUND FREUD in 1894. Examples of defense mechanisms are AVOID-
ANCE, COMPENSATION, DENIAL, DISPLACEMENT, RATIO- NALIZATION, REPRESSION, and substitution. Defense mechanisms may be useful or harmful, depending on their severity, their inflexibility, and the context in which they occur.
See also DISSOCIATION; PROJECTION; SUPPRESSION.
American Psychiatry Association, Diagnostic and Statistical
Manual (Washington, DC: American Psychiatric Asso-
ciation, 1987).
deformed people, fear of Fear of deformed peo- ple is known as teratophobia. Some individuals have a phobic reaction to deformed people when they see them on the street. Others have anxious reactions just by imagining or thinking of deformed individuals. Some fear giving birth to a deformed child. Fear of becoming deformed oneself is known as DYSMORPHOPHOBIA.
deformity, fear of Fear of a cosmetic defect in one’s appearance is known as dysmorphophobia. The indi- viduals who have this condition are in fact well within normal limits in their appearance but complain about some external physical defect they think is notice- able and upsetting to other people. Some individuals are continually concerned with a specific part of the body, e.g., genitals, mouth and smile, breasts, nose, ears, eyes, chin, bald head, buttocks, arms, legs, eye- brows, stomach, etc. Thoughts may be connected with feelings of inferiority. Dysmorphophobia, like- liest to occur in individuals who have sensitive or insecure personalities, may be an early symptom of obsessive-compulsive disorder or schizophrenia.
The term dysmorphophobia was coined in 1886 by Morselli, who described cases of patients con- cerned over small hands, a dimple on the chin, etc. Pierre Janet in 1908 described patients who had unwarranted feelings of dissatisfaction with their physical appearance. He thought these individuals were neurotic and stressed the obsessional side of their symptoms.
See also NEUROSIS; OBSESSIVE-COMPULSIVEDISOR- DER; SCHIZOPHRENIA.
Hay, G. G., “Dysmorphophobia,” British Journal of Psychia-
try 116 (1970): pp. 344–406.
deipnophobia See DINING, FEAROF.
déjà vu An illusion in which the individual expe- riences a new event for a moment as something already experienced; such an event may be ANXIETY- producing or cause a PHOBICREACTION. The word is French and means “already seen.” The familiar feel- ing may be due to resemblance between the present and the past scenes, or to a similar scene pictured in a daydream or night DREAM. Some believe that déjà vu experiences are due to events in a previous lifetime.
delusion An unshakable belief or system of belief based on a faulty premise and maintained in spite of rational evidence to the contrary. The delusion is not a belief ordinarily accepted by other members of the person’s culture or subculture; it is not an article of religious faith. Delusions may cause the individual great anxiety and even panic reactions.
Individuals with mental illnesses often suf- fer from delusions; for example, individuals with schizophrenia may suffer from the delusion that others are plotting against them (paranoia). Some illegal drugs may induce delusions in the user, such as the excessive use of cocaine, amphetamines, methamphetamine, or hallucinogenic drugs. Some drug abuse causes long-lasting mental illness from which the individual may not recover, including delusional behavior. Alcoholics who are undergo- ing withdrawal may suffer from delusions.
Delusions may be transient and fragmentary or they may be highly systematized and superficially convincing, as in paranoid states, although most delusions fall between these two extremes. Though logically absurd and symptoms of psychosis, delu- sions sometimes have a purpose, such as to relieve an individual’s anxiety or to counteract feelings of inferiority or insecurity and fill the need to blame others for their failures. In other cases, delusions have no discernible purpose.
Delusions should be distinguished from HAL- LUCINATIONS, which are false sensory perceptions. A delusion should also be differentiated from an overvalued idea, an unreasonable belief, or an idea that is not as firmly held as a delusion.
There are many common types of delusions. For example, delusions of being controlled by others involve feelings, impulses, thoughts, or actions that are experienced by the deluded individual as having actually originated elsewhere and as being imposed upon them by some external force. A typical case of this type of delusion is the man who claims that his own words were those of his father. Some deluded individuals believe that they are receiving coded mes- sages through the television set and that characters in a television program are talking directly to them.
Grandiose delusions involve an exaggerated sense of one’s importance, power, knowledge, or identity. Delusional jealousy may occur, for exam- ple, when a person has the delusion that his or her sexual partner is unfaithful. Nihilistic delusion involves the theme of nonexistence of the self or part of the self, others, or the world. An example is the person saying, “There is no need to eat, because