Existential

Existential relates to fear(s) associated with our fundamental existence. Examples include fear of death, meaninglessness, isolation and/or freedom.  These fears are easily activated in transitions in life, crises or times of existential consideration. Clients may present as depressed or anxious, hiding existential fears deeper down such as fear of living a meaningless life or facing their own mortality.

Intrapersonal

Intrapersonal relates to fear(s) around our own self-concept. Examples include fear of not being competent, feelings of shame, inadequacy and/or emotional overwhelm. Frequently associated with internalised beliefs and self-conception.  For instance, a client who does not advance in their career because of a fear of being incompetent as a result of early criticism.

Interpersonal

Interpersonal relates to fear(s) around our relationships with others. Examples include fear of rejection, abandonment, conflict and/or relational breakdown.  Such fears are at the core of attachment functioning and frequently characterise patterns of retreat, people-pleasing or hypervigilance.  For instance, a client might not express needs in intimate relationships for fear of being seen as demanding or unlovable. 

Systemic

Systemic relates to fear(s) associated with the external structures of society around us. Examples include fear of stigma, injustice, instability and/or cultural threat.  Systemic fear is not usually addressed in individualised models, though has a significant impact upon identity, behaviour and emotional wellbeing. Clients from oppressed groups through lived experience may bring an acute fear of discrimination, economic vulnerability or institutional betrayal.  For instance, a transgender client might fear walking into a hospital or doctors surgery due to a previous experience of transphobia. 

Examples

Intrapersonal

Fear of failure, shame, inadequacy, emotional overwhelm

Avoidance of career advancement due to fear of incompetence

Interpersonal

Fear of rejection, abandonment, conflict, relational rupture

Withholding needs in relationships due to fear of being perceived as needy

Systemic

Fear of stigma, injustice, instability, cultural threat

Avoidance of healthcare due to prior experiences of discrimination

Existential

Fear of death, meaninglessness, isolation, freedom

Anxiety masking deeper fears of purposelessness or mortality

Four domains in practice

These four types represent an integrative overview of how fear functions along the entire range of human experience.  They allow therapists to evaluate fear in a holistic manner, develop its effect upon wellbeing and target and individualise client interventions supporting integration rather than avoidance.