Abstract

Emotions represent a sensorial, immediate, and precognitive channel for understanding, responding, and communicating with others about environmental phenomena. Each emotion, therefore, has its own meaning and function. This article will explore the emotion of fear from both a functional and psychological perspective, provide a developmental perspective, and finally present a clinical case study to illustrate how fear can affect children and the methodological and practical implications for therapeutic work.

 

Emotions, body and expression

Emotions are not mysterious energies; they derive from bodily sensations and are expressed through the muscles and posture of the body (Perls, 1995). We tend to locate our entire existence within the brain; in reality, our mind resides in every muscle, tendon, and organ of our body, and so emotions also have a direct connection to the body (Oaklander, 2015).

Furthermore, emotions emerge in response to events around us and, precisely for this reason, are a direct reflection of our connection to the environment in the present situation. Our organism, in fact, alters in response to a real situation, and from this alteration emerge sensations and then clear emotions. Quoting Perls, we can say that emotions are tendencies that unify certain physiological tensions with favorable or unfavorable environmental situations and allow us to gain ultimate knowledge of what we need to satisfy our needs (Perls, Hefferline, Goodman, 1997).

Emotions therefore play a central role in identifying our needs and directing our actions to satisfy them. (Perls, Hefferline, Goodman, 1997)

Conversely, when we lose awareness of our sensations, we risk feeling grounded, that is, without any contact with ourselves or with our surroundings; a bit as if we were missing our roots. (Kepner, 1997)

Furthermore, we often hear emotions discussed in negative or positive terms; happiness is generally considered a positive emotion, while fear, sadness, and anger are considered negative. In reality, all emotions serve our survival.

The basic emotions identified by Ekman are joy, sadness, anger, surprise, fear, and disgust (Ekman & Friesen, 2007). Among these, joy represents the pleasure of sharing and has the important social function of connecting us to others. Anger is an energy that emerges when a person encounters an event in their environment perceived as an obstacle to the satisfaction of a need or when they feel their boundaries threatened by external intrusions. Sadness signals the presence of a loss that demands processing or, in its more nostalgic form, a lack. Last but not least, fear is an important ally because it alerts us to the presence of danger and enables us to follow instinctive defensive reactions.

Of course, some emotions can be unpleasant, and this happens when we feel overwhelmed by them.

Every emotion, every sensation, from pleasant to unpleasant, becomes unpleasant when its tension or intensity exceeds a certain limit. A hot bath may be pleasant, but if we raise the temperature it can become unpleasant, to the point where we burn ourselves and our lives are in danger. […] Children love to be hugged, but they don’t appreciate being ‘hugged to death’ at all (Perls, 1995, pp. 188)

Generally, when we perceive an unpleasant emotion, we tend to reject or silence it, and this undermines our well-being. The body, in fact, needs to complete emotional situations to move from a state of tension to one of relaxation and make room for the emergence of new experiences. This need is well represented by the comparison with the need to urinate (Perls, 1995). “You can hold your urine for a number of hours, but you don’t urinate for more than a minute. Holding in emotions leads to emotional poisoning, just as holding in urine leads to uremia (Perls, 1995, pp. 187).”

When an emotion is held in, it is released in small amounts and we may then feel bad for days, or project it onto others (Perls, 1995).

The reasons that lead us to hold back emotions deemed unpleasant are varied and usually originate in our infancy; newborns are in full contact with their needs and spontaneously express emotions, for example through crying, as an attempt to obtain from the environment what they need to feel good (Oaklander, 2015).

Over time, it is not unlikely to hear children, especially boys, say things like:

“Strong children don’t cry!”, yet literature is full of brave men who are not ashamed to cry! (Perls, 1995).

When children at the contact boundary experience being disrespected for their emotional displays, they risk developing feelings of shame. That is, they will do everything possible to hide and become a backdrop, for example, covering their face whenever that feeling emerges. The risk is that, over time, they may partially or completely lose awareness of that emotion, and shame may become the predominant sensation. In shame, the most exposed areas of the body are irrigated by an increased blood flow, producing the typical blush (Perls, 1995). The paradox is that the child invests much of his energy in trying to hide, yet that same blush highlights him to others.

In addition to contempt and denial of emotional expressions, experiencing traumatic situations also undermines the ability to connect with oneself and with the environment.

Children, in fact, tend to repress emotions related to traumatic events; this occurs due to their natural egocentricity, a tendency that causes them to take responsibility and blame for what happens in their environment and end up blaming themselves for it. As a result, they learn to repress their emotions to the point of losing awareness of them. Over time, their ability to connect with themselves and their environment diminishes, with negative consequences for their well-being. For all these reasons, in sessions it is important to support the patient in naming, specifying, and tolerating their emotions, and it is even more important that the psychotherapist does the same. Only this can foster a genuine healing process (Oaklander, 2006).

Fear and excitement in the contact cycle

As mentioned, fear is a primal emotion that has always been present in all animals, an integral part of the survival instinct. It manifests itself in the body with symptoms of varying intensity and nature, such as a general sense of alarm, increased heart rate and respiratory rate, muscle stiffness, restlessness, weak legs, dizziness, increased sweating, and so on.

Fear emerges in response to the presence of a real danger in the environment and although it causes unpleasant sensations, it provides us with the necessary impetus to follow our instinctive defensive reactions (www.gestaltbo.it).

In our society, the dangers we face are not necessarily linked to survival, yet our neurovegetative responses lead us to have fear reactions similar to when, still hunters and gatherers, we were threatened by a predator.

At the relational level, fear is present in various forms: fear of judgment, fear of losing the other, fear of intimacy, and so on. Each phase of the contact cycle between the organism and the environment, in fact, arouses desire and fear. When excitement and desire grow, fear also grows, and the possibility of encountering something new also depends on the ability to tolerate fear (Salonia, 2014). A child approaches the environment spontaneously and vitally. His confidence in approaching comes from his expected contacts, which allow him to have an integrated experience of himself, differentiated from others. When this grounding is missing, the new is no longer perceived as an exciting opportunity for growth but as a threat to one’s security. Fear is no longer tolerable, and contact is interrupted (Spagnuolo Lobb & Amendt-Lyon, 2007).

Developmentally, children learn relational skills when they are supported by their parents at various stages of the contact cycle. When a parent becomes frightened by a child’s natural fears, these become intolerable for the child, who, instead of moving toward full contact, will develop a symptom (Salonia, 2014).

Anxiety, for example, is the result of an arousal interrupted in the contact cycle and which remains unexpressed in the body. Although anxiety manifests itself with symptoms similar to fear, it should not be confused with the latter. Unlike fear, in fact, it is not linked to the presence of a real danger in the here-and-now; rather, it is generated by an anticipation of a future event judged to be painful or dangerous. Anxiety is the symptom that replaces the step towards full contact, a step that the organism interrupted because it was overwhelmed by fear of the subsequent phases (Robine, 2014). For all these reasons, anxiety contains within itself a confusing tangle of unexpressed emotions of which awareness has been lost.

Fear should not be confused with phobia, which represents an irrational and invincible fear of objects or specific situations that, according to common sense, should not provoke fear (Galimberti, 2018). Unlike fear, the individual does not fear a real danger in the here-and-now, but perceives the sensation arising from the proximity of the phobic object as unbearable. Phobias are also considered symptoms of contact disruption. In a developmental context, the child, overwhelmed by terror, interrupts contact because his excitement has not found adequate support in the environment (Salonia, 2001b). While anxiety is characterized by the anticipation of a future event in the here-and-now, phobias involve a perceptual distortion: to avoid feeling the emotions he or she terrifies, the individual connects them to an external object. In this way, the child’s ability to control himself also increases; in fact, simply keeping the spiders away will be enough to chase away that terrifying sensation! (Perls, Hefferline, & Goodman, 1997). Furthermore, by displacing that specific emotion onto the phobic object, the child protects the relationship with his parents because he has had the bodily experience that manifesting it at the contact boundary would destabilize that relationship, which is so important for his survival (Salonia, 2014).

Phobias, therefore, arise from the inability to process a complex of painful experiences; they do not arise exclusively from poor management of fear.

Fear in clinical practice

Fear, therefore, is an emotion present in our cognitive and expressive repertoire from birth, and even as newborns, from the first moments of life, we are sensitive to the environment and able to react by activating this specific emotion. But just as the newborn grows and evolves day by day, maturing and consolidating ever more skills, fear also undergoes a process of evolution.

In reality, the neural circuits that activate emotions in general, and therefore also fear, are always the same and function in the same way throughout a person’s life, while what changes are the motives and phenomena that elicit this emotion. As Panksepp (1998; 2001) hypothesizes, the experience of emotions is generated not in the cortex but in the limbic system. Each emotion is based on a particular system of brain patterns located in the limbic layer, behind the cortex (the subcortical area).

It is part of everyone’s experience to have fears as a child that vanish as adults, just as it is clear that the reasons why an adult feels fear are different from those of a child.

Consider, for example, the fear of the dark: almost all children have this fear, while only a few adults are afraid of the dark, of being in a dark room at home. For adults, however, it’s much more common to be afraid of not living up to expectations or of losing a friendship or loved one.

Of course, it’s not the reasons that change, in the sense that the phenomenon itself doesn’t lose its ability to be frightening. Rather, our cognitive skills change, our experience increases, and internal existential dimensions such as self-esteem and a sense of self are consolidated. In other words, we change, we grow, we evolve, and this influences the way we experience our relationship with the environment and also its effects on us, as we sharpen our sensitivity and open ourselves to abstract and immaterial concepts.

Something similar to what Maslow (1954) described regarding needs occurs. According to the American psychologist, needs are structured in degrees, connected in a hierarchy of relative prevalence according to the following scheme:

• physiology
• safety
• belonging
• esteem
• self-realization

Thus, the first needs perceived are those related to survival, such as hunger, thirst, sleep, and all other physiological needs. Once these are satisfied, the person can devote themselves to subsequent needs, such as health, family, physical safety, and finally, in this scale of succession, reach the highest level, where we find needs related to creativity, morality, spontaneity, etc.

Something very similar happens with fear, in that at the beginning of life, newborns are almost exclusively connected to risks related to their own survival, due to their capacity for understanding themselves in the world. Therefore, they react with fear to sudden noises, bright lights, screams, and other similar phenomena. As they grow and develop, their mental abilities increase, their sociability increases, they come into contact with the complexity of relationships, and they become increasingly attuned to more abstract levels of existence, which acquire ever-increasing importance, so much so that they can elicit fear, precisely if something happens at these levels too. Consider the fear of failure, or of being excluded from a group, or of not finding meaning in one’s life. All these fears are very different from the primordial fears of fire and thunder!

This doesn’t mean that as we grow older, we stop fearing threats to our survival, placing value only on “higher,” more evolved issues. Indeed, our attention to these phenomena remains, and as we continue to develop, as cognitive skills develop, we add factors that can elicit fear, in a cumulative and summative manner. Naturally, we also develop the skills that allow us to cope with potential dangers. So, for example, if we see a storm coming, we aren’t frightened by lightning or thunder. However, if a sudden, very loud clap of thunder strikes in the silence, our initial reaction may be one of fear, but then this gives way to rationalization and understanding of what happened, which restores us to a state of calm.

This example highlights another characteristic of fear and emotions in general, namely their immediacy: when a disturbance occurs in the environment, we instantly react with emotional activation in response to the effect the phenomenon has on us. Only later, a few milliseconds later, does cognition and its comprehension mechanisms kick in (Tommasello, 2019).

In light of what has been written so far by way of example, we will now illustrate, through the description of a clinical case, how fear presents in children and one possible approach to working on this topic.

Fear in children

B. is a six-year-old boy who comes to the therapist because for a few weeks he has been more nervous than usual, no longer willingly going to school, often reacts irritably to restrictions, struggles to fall asleep, and sometimes wakes up at night and asks to stay in bed with Mom and Dad. His parents are worried to see their child unwell and want to understand what is happening to him. It is immediately clear that they speak of B. in individual and symptomatic terms, not connecting what the child is expressing to possible situations in the environment, nor to themselves. This is the first point made by explaining that emotions are ways of responding to environmental influences, profoundly relational and therefore to be understood within relationships and not in a solipsistic way. Thinking that the emotions expressed belong exclusively to B. and that the environment around him, including his parents, do not play a role in fueling his discomfort and therefore, can also play a role in promoting his well-being, creates a dynamic of progressive isolation that increases, rather than decreases, B.’s currently counterproductive attempts to satisfy his own needs.

A young child is often able to express their emotions, but is less able to define them, explain them, and connect them to their environment. This is why it is important for parents to be aware of this. As caring adults, they can make that connection and construct meaning, something practically impossible for a child, in order to restore clarity and understanding to themselves and their child.

From the first meeting, it becomes apparent that B. is able to build a relationship with the therapist in an autonomous and healthy manner, balancing his volitional impulses with the ability to comply, moving flexibly between the roles of leader and follower. When faced with limitations and rejections, he initially resists, but manages to modulate them, resulting in a balanced encounter with the difference in style and choice. Emotionally, from the activities he engages in with the therapist, an initial anger toward certain situations or people emerges—an emotion that at the time of the initial meeting was the one most frequently reported by the parents when describing B.’s emotional expressions and tone—but as we delve deeper, it becomes clear that both the aggressive impulse and the emotional energy needed to sustain the exaggeration and symbolization of these aspects are lacking. The suspicion arises that there is more to the story, or rather, that the anger is a cover-up emotion. Thus, by proposing projective-expressive activities, another emotion emerges: fear. Initially, it was unstructured, unrelated to an event and therefore not traumatic. The work aimed to allow B. to experience it, see it, play with it, and, above all, not be left alone with this emotion.

Talking with his parents revealed that in the past, when B. said he was afraid—for example, when he woke up during the night or at other times of the day because of something happening—they would react by rationalizing and minimizing the incident, saying, “You don’t have to be afraid, nothing happened,” “Don’t be afraid, just a motorcycle passed by,” or by distracting him and making him laugh when he was about to cry. In this way, B. implicitly received the message that he wasn’t allowed to be afraid, and, as often happens with children who, in order to conform to their parents’ expectations, put their own integrity aside (Juul, 2001), B. began to hold back when he felt afraid, not only accumulating tension and unexpressed emotion but also avoiding developing the skills to understand himself from this perspective and to manage and use fear itself.

By being able to talk about fear, draw it, invent scary stories, and create scenarios in which they took turns being scared and caring for each other, B.’s irritation and opposition decreased. Furthermore, by discussing all this with his parents and providing them with guidance on how to provide emotional support, not only did their relationship improve, but also their sense of efficacy, as they were now able to jointly construct a sense of what was happening. Becoming part of their son’s struggle made them understand how they could help him by moving beyond the guilt of not being good parents, thus increasing their relational investment, rather than distancing themselves and minimizing the manifestations so as not to feel involved.

Regarding B.’s fear, as already mentioned, no triggering event emerged, nor did any particular episodes emerge, and it is not uncommon that when working on emotional blocks with children, with the exception of traumatic situations, the therapeutic action is not the discovery of the origin but rather the creation of the possibility of chewing over and then assimilating the emotion itself.

In conclusion, the symptom a child develops is useful because it allows the family to recognize a difficulty and seek help. In the therapeutic relationship, however, the work is not focused exclusively on the symptom; what is important is supporting the gestalt formation process, so that the blocked excitement causing the symptom is released and the person is finally free to move through the world, drawing nourishment for their growth (Perls, 1995). In this process, it is important to offer children new experiences and provide them with the necessary support so they can recognize, contextualize, and express their emotions, which sometimes overlap, as in the case of B., where fear was actually masked by anger.

Bibliography

• Ekman, P. & Friensen, W. V. (2007) Giù la maschera. Come riconoscere le emozioni dall’espressione del viso. Trad. it di G. Noferi. Milano: Giunti.
• Galimberti, U. (a cura di). (2018). Nuovo Dizionario di Psicologia. Psichiatria, Psicoanalisi, Neuroscienze. Milano: Feltrinelli.
• Juul, J. (2001). Il bambino è competente. Milano: Feltrinelli.
• Kepner, J. J. (1997). Body Process. Il lavoro con il corpo in psicoterapia. Trad. it di G. Iaculo. Milano: Franco Angeli.
• Maslow, A. (1954). A theory of human motivation. Hawthorne: BN Publishing.
• Oaklander, V. (2015). Il gioco che guarisce. La psicoterapia della Gestalt con bambini e adolescenti. Trad. it di I. Sampognaro. Catania: Edizione Pina Catania.
• Oaklander, V. (2006). Hidden treasure. A map of child’s inner self. Karnac Books: London.
• Oatley, K. (2004). Breve storia delle emozioni. Bologna: Il Mulino.
• Panksepp, J. (1998). Affective Neuroscience: the foundations of human and animal emotions. Oxford: Oxford University Press.
• Panksepp, J. (2001). The neuro-evolutionary cusp between emotions and cognitions: implications for understanding, consciousness and the emergence of a unified mind science, in «Evolutions and Cognitions», 7, pp. 141-163.
• Perls, F. (1995). Io la fame, l’aggressività. L’opera di uno psicoanalista eretico che vide in anticipo i limiti fondamentali dell’opera di Freud. Trad. it di M. Polito & M. C. Fabris. Milano: Franco Angeli.
• Perls, F. & Hefferline, R. F. & Goodman, P. (1997). La terapia della Gestalt. Vitalità e accrescimento nella personalità umana. Trad. it di J. Sanders & F. Liuzzi. Roma: Astrolabio.
• Robine, J. M. (2014). L’ansia nella situazione: disturbi nella formazione della Gestalt. In G. Francesetti, M. Gecele, J. Roubal (a cura di), La psicoterapia della Gestalt nella pratica clinica. Dalla Psicopatologia all’estetica del contatto (523-538). Milano: Franco Angeli.
• Salonia, G. (2001b). Tempo e relazione. L’intenzionalità relazionale come orizzonte ermeneutico della psicoterapia della Gestalt. In Salonia, G. (2014). La psicoterapia della Gestalt con gli stili relazionali fobici-ossessivi-compulsivi.In G. Francesetti, M. Gecele, J. Roubal (a cura di), La psicoterapia della Gestalt nella pratica clinica. Dalla Psicopatologia all’estetica del contatto (555-584). Milano: Franco Angeli.
• Spagnuolo Lobb, M. (2007). Il permesso di creare, l’arte della psicoterapia della Gestalt. Milano: Franco Angeli.
• Spagnuolo Lobb, M. (2010). (a cura di), Psicoterapia della Gestalt. Ermeneutica e clinica (65-85). Milano: Franco Angeli.
• Spagnuolo Lobb, M. & Amendt-Lyon, N. (2007). Il permesso di creare. L’arte della psicoterapia della Gestalt. Milano: Franco Angeli.
• Tommasello, M. (2019). Diventare umani. Milano: Raffaello Cortina.