The great psychologist Ribot classifies fears into pain fears, and disgust fears. To quote from Ribot: “I propose to reduce them (fears) to two groups. The first is directly connected with fear and includes all manifestations, implying in any degree whatever the fear of pain, from that of a fall or the prick of a needle, to that of illness or death. The second is directly connected with disgust, and seems to me to include the forms which have sometimes been called pseudophobia (Gelineau). Such are the fear of contact, the horror of blood and of innocuous animals, and many strange and causeless aversions. Let us remark furthermore that fear and disgust have a common basis, being both instruments of protection or defense. The first is the defensive-conservative instinct of relative life, the second the defensive-conservative instinct of organic life. As both have a common basis of aversion, they show themselves in equivalent ways: fear of withdrawal, departure, flight, disgust by vomiting and nausea: The reflexes of disgust are the succedanea of flight;[348] the organism cannot escape by movement in space from the repugnant object which it has taken into itself, and goes through a movement of expulsion instead.”

I hesitate to accept Ribot’s classification, inasmuch as we have pointed out that fear is prior to pain. In most lower animals it is hardly probable that not having representations that there is present a fear of pain in advance of the pain itself. Fear under such conditions can only be awakened by an actual sensory experience whether it be painful or not. In fact Ribot himself agrees to the fact that “There is a primary, instinctive, unreasoning fear preceding all individual experience, a hereditary fear.”

Perhaps a word may be said in regard to the factor of disgust as having a common basis with fear. It is only by a stretch of imagination, if not by a stretch of words, that fear and disgust can be identified. There may be fear where there is no disgust, and there may be disgust where there is no fear. The two are independent variables, and can hardly be referred to as one and the same fundamental reaction, such as withdrawal and flight. The object of disgust does not preclude approach. The avoidance or aversion, the nausea and vomiting are all subsequent phenomena. Disgust may even follow after an abuse of food, of pleasant or necessary objects of nutrition, such as satiety.

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The reactions of the fear instinct run the contrary way, approach is precluded from the very start. Fear is not associated with useful objects or events, unless it be in morbid states of fear.

And still fear and disgust may become intimately associated when disgust and its objects awaken the fear instinct, and the fear becomes the fear of disgust or of the disgusting object. Disgust is more of a specialized character, and is associated with particular events or specific objects, while fear, in its primitive form at least, is more of a generalized character.

In the higher forms of life disgust may be so intimately related to fear that the two become synthesized, so to say, and are felt like one emotional state, the state becoming one of fear disgust. In such cases the fear instinct, fear disgust, is a determining factor of the morbid state. This is confirmed by clinical experience of the various cases of psychopathic functional neurosis and psychosis.

In the various morbid states of the depressive types fear is awakened long before any pain is actually suffered, or any particular cause is found by the patient to account for the terror that dominates his mental life. The fear comes first while the representative cause is assigned by the sufferer as the cause of the fear.

Similarly in the functional psychosis and neurosis the object, experience, event, may be quite ordinary[350] without any suggestion of pain or distress in it. In fact, the experience may be indifferent or even pleasant, but when associated with the fear instinct may become the nucleus of a very distressing pathological state. The experience is the occasion, while the fear instinct, the intimate companion of the impulse of self-preservation, is the only cause of functional psychopathic maladies.

The fear instinct in its primitive state is anterior to all experiences of danger, pain, and suffering, as is the case in most of the lower animals. In the higher animals where memory is developed, the fear instinct is associated with some form of representation, however vague, and then fear becomes posterior to experience. In man both forms of fear are present. The anterior form is specially found in children, while in adults the posterior form is, under normal conditions, predominating. The primitive anterior type of the fear instinct is by no means absent, in fact, it is more overpowering, its effects are overwhelming when it comes forth from the subconscious regions to which it is confined, and is manifested under conditions of lowered vitality.

When the strata of dynamic energies are passed and the strata of reserve energies are reached, the reserve energy not being accessible, the fear instinct is elemental, fundamental, while the fear of pain and of some definite representation of danger, or of suffering is a secondary consequence. People may suffer[351] from pain, disease, and even danger, and still have no fear, while others may have never experienced the pain or disease, and still be obsessed by intense pangs of fear. Fear is sui generis, it is at the foundation of animal life.

The fear instinct may be awakened directly by a sensory stimulus, when, for instance, one finds himself in darkness and feels some creeping, slimy thing, or when attacked suddenly with a club or a knife. The fear instinct may again be aroused by an expectation, by something to which his dynamic energies cannot respond adequately, while the reserve energies are in abeyance, such for instance as the expectation of some threatening event either to himself or to the objects bound up with his life existence. When one is threatened with some misfortune, with torture, death, or with a mortal disease, or with a serious operation, or when confronted with great danger against which his energies prove inadequate, in such cases the fear is ideational. These types of fear may in turn be either conscious or subconscious.

We may thus classify the fears as follows:
        { Conscious
I.    Sensory    {
        { Subconscious
 
        { Conscious
II.    Ideational    {
        { Subconscious

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The fear of the etherized or chloroformed patient is entirely of the subconscious type. It is the arousing of subconscious fear which, from the nature of the case, cannot be reached and alleviated that gives rise to functional psychosis and neurosis.

From this standpoint it may be said that psychopathic diseases are subconscious f............