How Normal Are Anxiety and Fear?

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Abstract
In practice or in research, psychiatrists should confine their work to abnormal or pathological phenomena. To distinguish normality from abnormality, psychiatrists (often implicitly) test people's behaviour against the following criteria: suffering, loss of autonomy and unreality. The positive aspects of anxiety/fear will be discussed: in how far the phenomenon induces pleasure, enhances autonomy or is justified. This approach to the reality aspect is through an ethological focus on a specific form of fear — the fear of strangers in young children. The prevalence of abnormal fear and anxiety in similar populations is shown to be dependent on the way in which (ab)normality is operationalised. A qualitative individual-oriented approach yields considerably less anxiety than a quantitative group-oriented approach. In practice a careful assessment of (ab)normality will help the psychia trist to treat normal anxiety in an efficient and abnormal anxiety in an effective manner.