This post is the transcript of Professor Stephens’ presentation at the STOICON 2017 conference. A videorecording of the talk will be available in the coming weeks.

My topic today is fear. My talk divides into four sections. First, I will present an enormous catalogue of phobias and then interpret them from a Stoic’s perspective. Second, I will report on the leading causes of death both in the United States and in the world. Those statistics will allow me to compare the number of deaths due to acts of terrorism since 2001 in the third section. This comparison, I will argue, sheds light on today’s political rhetoric about terrorism. I will conclude by explaining how the Stoics use reason to replace fear with the healthy psychological state called caution. My goal is to show how Stoic thinking can help us strive to achieve fearlessness in our lives.

Myriad Phobias

How many different fears have been named in English? The online phobia list names more than 530.[1] Relatively common disorders include fears of the dark, high places, air travel, open places, enclosed spaces, crowds, crossing bridges, darkness, public speaking, fire, needles, thunder, speed, and foreigners. Rarer objects of fear include bald people, bicycles, children, computers, dirt, heaven, light, long words, new things, old people, paper, string, teenagers, and being at home. Insects, insect stings, ants, bees, cockroaches, lice, mites, moths, spiders, tapeworms, wasps, worms, microbes, parasites, and germs all have named fears. So do bulls, horses, dogs, cats, mice, birds, bats, otters, fish, shellfish, frogs, toads, snakes, and sharks. The fear of animals is zoophobia. People with paraskavedekatriaphobia fear Friday the 13th. There are names for the fears of such activities as opening one’s eyes, defecating, bathing, drinking, undressing in front of someone, coitus, crossing the street, going to school, throwing things away, dancing, conversing over dinner, riding in an automobile, being stared at, sitting, walking, being tickled, stooping, stuttering, seeing oneself in a mirror, vomiting, and going to bed. There are named fears of eyes, hands, chins, beards, belly buttons, knees, hair, rectums, and genitals. There are names for the fear of each of the colors yellow, red, purple, black, and white, as well as for the fear of colors generally. There are names for the fear of each of the numbers 4, 5, 8, 13, and 666.

Whether a fear of illness, accidents, injury, fever, heart disease, diabetes, dentists, speed, or pain seems more or less justifiable will vary from person to person. Bad experiences in childhood no doubt have a lot to do with phobias. So do genetic predispositions. But what about fearing fog, ghosts, or being alone? Or fearing clouds, clothing, or nudity? Or the fear of blushing, trees, or clowns? Or the fear of puppets, body odor, or wealth? What of the fear of dolls, growing bald, or the moon? Or the fear of clocks or stars or books? Arachibutyrophobia is the fear of peanut butter sticking to the roof of your mouth. Could one reasonably justify even moderate worry about these things? To fear beautiful women is to suffer from caligynephobia. The fear of hearing good news is termed euphobia. Geliophobes fear laughter. Hedonophobes fear feeling pleasure. Ideophobes fear ideas. Pantophobes fear everything. The fear of fear itself is phobophobia.

How common are phobias? According to the American Psychiatric Association, phobias are the most common psychiatric illness among women and the second most common among men. The National Institute of Mental Health suggests that phobias affect approximately 19.2 million U.S. adults. These phobias typically emerge during childhood or adolescence and continue into adulthood. They also impact twice as many women as they do men.[2]

There are a number of explanations for why phobias develop, including evolutionary and behavioral theories. Phobias lead to marked fear and symptoms such as dizziness, nausea, and breathlessness. In some cases, these symptoms escalate into a full-blown panic attack.

Which phobias are the most common? The top ten appear to be Arachnophobia (spiders and arachnids), Ophidiophobia (snakes), Acrophobia (heights), Aerophobia (flying), Cynophobia (dogs), Astraphobia (thunder and lightning), Trypanophobia (injections), Sociophobia (social situations), Agoraphobia (open or crowded spaces), and Mysophobia (germs or contamination).

One source reports that the fear of arachnids affects women four times more than it does men (48% women and 12% men). Another source reports that Arachnophobia affects as many as 1 in 3 women and 1 in 4 men. So why are so many people terrified of arachnids? While there are an estimated 35,000 different spider species, only about a dozen pose any type of real threat to humans. A common explanation for this and similar animal phobias is that arachnids, insects, snakes, and similar creatures once posed a considerable threat to our ancestors who lacked the medical knowledge and technological tools to treat bites from animals and insects. Thus, evolution contributed to a predisposition to fear these animals and insects.

Ophidiophobia (fear of snakes) is quite common. “In a study of 35 snake-fearful participants, however, researchers found that only three of these individuals had ever been bitten by a snake. The majority of the participants had little or no direct experiences with snakes in any capacity. Another theory suggests that the fear of snakes and similar animals might arise from an inherent fear of disease and contamination. Studies have shown that these animals tend to provoke a disgust response, which might explain why snake phobias are so common yet people tend not to exhibit similar phobias of dangerous animals such as lions or bears.”[3]

Acrophobia (the fear of heights) afflicts an estimated 23 million adults. Aerophobia (the fear of flying) affects an estimated 8 million U.S. adults despite the fact that airplane accidents are actually very uncommon. About one out of every three people has some level of fear of flying. Common symptoms associated with aerophobia include trembling, rapid heartbeat, and feeling disoriented.

Cynophobia (the fear of dogs) is often associated with specific personal experiences such as being bitten by a dog during childhood. Such events can be quite traumatic and can lead to fear responses that last well into adulthood. Cynophobia can be quite common. Some estimates suggest that as many as 36 percent of all individuals who seek treatment for a specific phobia have this severe fear of dogs.

Astraphobia (the fear thunder and lightning) is relatively common. Understandably, astraphobes also tend to develop an excessive preoccupation with tracking weather forecasts. In some instances, astraphobes may become agoraphobes when they are so afraid of encountering lightning or thunder that they are unable to leave their homes.

Trypanophobia (the fear of injections) is a condition that can sometimes cause people to avoid medical treatments and fear doctors (Iatrophobia). Estimates suggest that as many as 10 percent of people in the U.S. are trypanophobic. Sociophobia (fear of social situations) often includes fear of being watched (Scopophobia) or humiliated in front of others. The most common form of Sociophobia is Glossophobia (fear of public speaking).

Agoraphobia involves a fear of being alone in a situation or place where escape may be difficult. This type of phobia may include the fear of crowded areas or open spaces. Agoraphobia usually develops sometime between late-adolescence and mid-30s. The American Psychiatric Association reports that two-thirds of people with agoraphobia are women.

Mysophobia, or the excessive fear of germs and dirt, can lead people to engage in extreme cleaning, compulsive hand-washing, and even avoidance of things or situations perceived as dirty. In some instances, this phobia may be related to obsessive-compulsive disorder.

We might be tempted to think that our own phobias are reasonable, whereas the phobias of other people are kind of silly. This temptation to discount the seriousness of phobias that we don’t share with others is probably stronger in the case of especially exotic phobias. But we should remember that phobias are serious problems for those afflicted by them. Phobias are debilitating and undermine our capacity to live our lives with a feeling of safety.

How did the Stoics conceive of phobias? First, the Stoics distinguished between the immediate involuntary physiological response to the appearance of an unwelcome thing and the voluntary, deliberate cognitive judgment that that unwelcome thing is dangerous and bad. The former the Stoics called propatheia, “pre-emotions” or “proto-passions.” Examples include being startled and flinching when hearing a sudden loud and unexpected noise. Shivering when sprinkled with cold water, the feeling of disgust when touching something slimy, the feeling of vertigo caused by heights, hair bristling upon hearing bad news, and blushing at obscene language are other examples Seneca gives of pre-emotions. Since these physiological responses happen without our consent, we are not responsible for them, according to the Stoics.

But after these proto-passions occur, it is up to us whether we judge the presence of the unwelcome thing as bad. If we have a few moments to think about it, and then we voluntarily decide that the unwelcome thing is truly bad, then we experience real fear. But the Stoics insist that a real fear response is the result of a mental judgment we make consciously. We control our power of assent to the proposition, for example, that “This slimy thing is truly bad and truly scary.” If we don’t assent to this proposition, then we won’t be afraid. Thus, the Stoics conceive of fear as the consequence of a voluntary cognitive act, not a brief, involuntary physiological reaction.

The most commonly used therapeutic treatment for phobias is cognitive behavioral therapy (CBT). Phobias can be minimized and even eliminated with CBT. The basic idea of CBT originated with the ancient Stoics. What did the ancient Stoics regard as the most popular and most troubling fear? Unsurprisingly, it is the fear death. Most people today, I expect, believe that the fear of death—called thanatophobia—is very reasonable and quite justified. So, let’s now look at the top ten causes of death.

The Top Ten Causes of Death

The Centers for Disease Control and Prevention report that in the U.S. in 2013, the leading causes of death were heart disease (611,105), cancer (584,881), chronic lower respiratory diseases (149,205), accidents, i.e. unintentional injuries (130,557), stroke (128,978), Alzheimer’s disease (84,767), diabetes (75,578), influenza and pneumonia (56,979), and nephritis, nephrotic syndrome, and nephrosis (47,112).[4] Suicides (41,149) outnumbered motor vehicle deaths (32,719),[5] which outnumbered firearm homicides (11,208).[6]

Leading causes of death in the U.S. in 2013 — The Centers for Disease Control and Prevention

Cause of death Deaths Heart disease 611,105 Cancer 584,881 Chronic lower respiratory diseases 149,205 Accidents, i.e. unintentional injuries 130,557 Stroke 128,978 Alzheimer’s disease 84,767 Diabetes 75,578 Influenza and pneumonia 56,979 Nephritis, nephrotic syndrome, and nephrosis 47,112 Suicides, i.e. intentional self-harm 41,149 Motor vehicle deaths 32,719 Firearm homicides 11,208

The World Health Organization (WHO) reports that in 2012 the top ten causes of death worldwide were ischemic heart disease (7.4 million), stroke (6.7 Million), chronic obstructive pulmonary disease (3.1 million), lower respiratory infections (3.1 million), lung, trachea, and bronchus cancers (1.6 million), HIV/AIDS (1.5 million), diarrheal diseases (1.5 million), diabetes mellitus (1.5 million), road injuries and car crashes (1.3 million), and hypertensive heart disease (1.1 million).[7]

Top ten causes of death worldwide in 2012 — the World Health Organization (WHO)

Cause of death Deaths Ischemic heart disease 7.4 million Stroke 6.7 million Chronic pulmonary disease 3.1 million Lower respiratory infections 3.1 million Lung, trachea, and bronchus cancers 1.6 million HIV/AIDS 1.5 million Diarrheal diseases 1.5 million Diabetes mellitus 1.5 million Road injuries and car crashes 1.3 million Hypertensive heart disease 1.1 million

The United Nations Food and Agriculture Organization estimates that about 805 million people of the 7.3 billion people in the world, or one in nine, were suffering from chronic undernourishment in the years 2012 to 2014. The vast majority of these hungry people live in developing regions. Approximately 3.1 million children die from hunger each year.[8] The WHO estimates that there were 627,000 malaria deaths worldwide in 2012, making mosquitos, which also carry the viral infection dengue,[9] the most dangerous animal in the world.

2014 Causes of Death in the U.S. — National Vital Statistics Reports, Vol. 65, No. 5, June 30, 2016

Causes of death Rank Deaths Percent of total deaths All causes — 2,626,418 100.0 Diseases of heart 1 614,348 23.4 Malignant neoplasms 2 591,699 22.5 Chronic lower respiratory diseases 3 147,101 5.6 Accidents (unintentional injuries) 4 136,053 5.2 Cerebrovascular diseases 5 133,103 5.1 Alzheimer’s disease 6 93,541 3.6 Diabetes mellitus 7 76,488 2.9 Influenza and pneumonia 8 55,227 2.1 Nephritis, nephrotic syndrome and nephrosis 9 48,146 1.8 Intentional self-harm (suicide) 10 42,773 1.6 Firearms (inside U.S.) — 33,599 — Terrorism (inside U.S. and abroad) — 32 —

In 2014, motor-vehicle traffic-related inju­ries resulted in 33,736 deaths, accounting for 16.9% of all accidental (unintentional injury) deaths. Thus, there is far greater statistical justification for amaxophobia (the fear of riding in a car) than for fearing a terrorist attack.

Terrorism by the Numbers

That brings us to terrorism. According to the Centre for Research on Globalization, the number of Americans who died worldwide in terrorist attacks in 2013 was eight, whereas the number who died after being struck by lightning was twenty-nine.[10] This source asserts that the U.S. State Department reports that in 2011 only seventeen U.S. citizens were fatal victims of terrorism worldwide, including in Afghanistan, Iraq, and all other theaters of war. The Canadian Global Research Centre calculates that Americans are more than 35,079 times more likely to die from heart disease, 33,842 times more likely to die from cancer, and 4,706 times more likely to die from excessive use of alcohol than from a terrorist attack.

In an Oct. 3, 2016 article CNN compares the number of Americans killed by acts of terrorism to the number of Americans killed by gun violence. Consider the year 2014. For every one American killed by an act of terror in the United States or abroad in 2014, more than 1,049 died because of guns. Now consider the period from 2001 to 2014. Using numbers from the Centers for Disease Control and Prevention, CNN found that from 2001 to 2014, 440,095 people died by firearms on US soil. (2014 is the most recent year for which the CDC has data for deaths by firearms.) This data covered all manners of death, including homicide, accident, and suicide.

How does that compare to deaths resulting from acts of terrorism? According to the U.S. State Department, the number of US citizens killed overseas as a result of incidents of terrorism from 2001 to 2014 was 369. Inside the United States CNN found that between 2001 and 2014, 3,043 people were killed in domestic acts of terrorism.[11] This brings the total to 3,412.

This graph clearly suggests that passing effective gun control laws is far more urgent than the chances of terrorist attacks.

The U.S. State Department Bureau of Counterterrorism compiled statistics displaying terrorism related deaths, injuries, and kidnappings of private U.S. citizens from 2010 through 2015. Over these six years, the average number of deaths related to terrorism is 17, with as few as 10 in 2012 and as many as 24 in 2014. The number of injuries related to terrorism during this period is also remarkably low and quite steady—averaging 10.33 per year. Kidnappings related to terrorism are even less common.

What about other causes of death? Consider hurricanes. The New York Times reported on September 1, 2017 that Hurricane Harvey had caused 1,833 deaths. Obviously, Harvey was far more lethal than all the terrorist attacks worldwide combined over the last year. Hurricane Irma was the most powerful hurricane ever recorded in the open Atlantic Ocean. Irma killed between 70 and 80 people in the Caribbean and the southeastern U.S. The death toll in Puerto Rice from Hurricane Maria is disputed. Current estimates range from 45 to more than 450.[12] Hurricane Katrina was responsible for 1,836 fatalities in 2005.[13] Consequently, the direct and indirect deaths due to this year’s hurricanes Harvey, Irma, and Maria exceed the 2,996 lives lost in the attacks on the World Trade Center in New York City and the Pentagon on September 11, 2001.[14]

Politicians are notorious for manipulating voters by using rhetoric that plays on their fears. Media sources routinely report bombings and mass shootings while pundits debate whether each attack is an act of terrorism or not. But the most common causes of death receive little notice by major media outlets. Easy to find statistics correct such a distorted accounting of the relative risks of fatality in North America.

How Stoics Replace Fear with Caution

Are Stoics free of all phobias? Interestingly, the Stoic Epictetus was not. He confesses to having thalassophobia, the fear of the sea:

Whenever I go to sea, as soon as I gaze down into the depths or look at the waters around me and see no land, I am beside myself, and imagine that if I am wrecked I must swallow all that sea; nor does it once enter my head that three pints are enough. (Disc. ii.16.22)

Similarly, in an earthquake he imagines that the city is going to crash down on him, but realizes that one little stone is enough to knock his brains out (Disc. ii.16.23). What causes the alarm is not the sea or the earthquake but the judgment that one will be permanently separated from one’s companions, familiar places, and social relations coupled with the false judgment that such separation is evil. To the contrary, Epictetus argues that it does not matter whether one dies from an accident, through human agency, or even being frightened by a mouse. Death results from all these many causes, so no one cause of death is scarier than any other.

Where is the hardship when something that was born is destroyed? The instrument of destruction is either a sword, or a wheel, or the sea, or a tile, or a tyrant. And what does it matter to you by what way you descend to Hades? All roads are equal. But, if you want to hear the truth, the one that a tyrant sends you along is shorter. No tyrant ever took six months to cut someone’s throat, but a fatal fever often lasts a year. All these things are meaningless noise and the boasting of empty names. (Disc. ii.6.17-19)

‘All roads to death are equal’ means that they are all equally indifferent because they all lead to the very same destination. The phrase ‘descent to Hades’ is simply Epictetus’ concession to a popular religious reference to death. Stoics reject the possibility of an afterlife.[15] Epictetus defuses the threatening sounding names — decapitation by a sword, being broken on a wheel, etc. — by recasting them as inarticulate noise, mere static hiss from the mouths of non-Stoics who don’t understand death. They boast about the horrors of various gruesome executions a tyrant could command, but this is vacuous clamor. All paths to death lead to the same destination, so every manner of death is equally indifferent to a Stoic.

Epictetus thinks that Socrates was wise to call death and all such things that non-Stoics foolishly fear ‘bugbears’ (mormolukeia).

For just as masks seem fearsome and terrible to children because of their inexperience, we are affected in a similar manner by events for much the same reason as children are affected by bugbears. For what is a child? Ignorance. What is a child? Lack of instruction. For where a child has knowledge, he is no worse off than we are. What is death? A bugbear. Turn it around and see what it is. See, it does not bite. (Disc. ii.1.15-17)

Stoics have examined death and understand it, and so they fear it no more than adults who have examined Halloween monster masks and see that there is nothing scary behind them.

Death, Stoics believe, is not what motivates shameful deeds. Rather, the fear of death drives us to abandon our duties, betray our comrades, and act as cowards in order to save our hides. Epictetus says: “It is not death or pain that is to be feared, but the fear of pain or death” (Disc. ii.1.13). In effect, he recommends that we adopt a savvy phobophobia: “If, instead of death or exile, we feared fear itself, we would practice avoiding those things that appear to us to be evil” (Disc. ii.16.19). So, Epictetus insists that our confidence should be directed toward death, whereas our caution should focus on the false judgment that death is fearful (Disc. ii.1.13-14).

Death cannot rob us of our moral integrity, but fear can when, out of fear, we disgrace ourselves. Epictetus asks his students:

Will you, then, realize that this epitome of all human evils, and of meanness, and of cowardice is not death, but rather the fear of death? Against this, then, discipline yourself, toward this let all your reasonings, your exercises, your readings tend, and you will know that only in this way are human beings liberated. (Disc. iii 26.38-39)

Stoics believe that all phobias result from habitually making irrational judgments. Those who fear death fail to fully understand and accept the fact that all living things are mortal. For Stoics, death is nothing tragic, nothing shameful, and so nothing evil (Disc. iv.1.42). Death is not dreadful, according to Stoics. Only dying shamefully is dreadful. Epictetus thinks that removing the fear of death removes not only the greatest obstacle to a happy life, it also undermines all lesser fears.

Now one may object that since Stoics think we should try to become totally fearless, this will lead to utter recklessness. But this objection fails. The Stoics in fact advise that the proper mental disposition to maintain when facing dangerous circumstances is caution. The Greek word is eulabeia. The Stoics advise us always to look before leaping. We ought to be circumspect, consider our options, and then act with care. This thoughtful wariness involves no worry, no anxiety, and no fear. Stoic fearlessness consists in caution, not recklessness.

Stoic thinking about fear can help us in at least three ways. First, Rational Emotive Behavior Therapy and Cognitive Behavior Therapy, both inspired by Stoic exercises, empower us to rid ourselves of specific phobias. Second, knowing some facts about likely causes of death can protect us from alarmists whose political rhetoric wildly distorts the dangers of harm from acts of terrorism. Third, knowing some facts about the diseases that are the leading causes of death may inspire us to healthier eating habits, drinking plenty of water, daily exercise, and getting quality sleep. Such knowledge could also move us to work to aid those vulnerable to premature death due to poverty. Stoicism both dispels fallacious appeals to fears about terrorism and sweeps away the phobias that block us from living happily.

[1] http://phobialist.com/. Accessed 31 May 2017.

[2] https://www.verywell.com/most-common-phobias-4136563 by Kendra Cherry, reviewed by a board-certified physician. Updated April 24, 2017. Accessed 5 June 2017.

[3] Ibid.

[4] http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed 1 Nov. 2015.

[5] https://en.wikipedia.org/wiki/List_of_motor_vehicle_deaths_in_U.S._by_year. Accessed 1 Nov. 2015.

[6] http://www.cdc.gov/nchs/fastats/homicide.htm. Accessed 1 Nov. 2015.

[7] http://www.who.int/mediacentre/factsheets/fs310/en/. Accessed 1 Nov. 2015.

[8] http://www.worldhunger.org/articles/Learn/child_hunger_facts.htm. Accessed 1 Nov. 2015.

[9] See http://www.who.int/mediacentre/factsheets/fs117/en/. Accessed 1 Nov. 2015.

[10] http://www.globalresearch.ca/the-terrorism-statistics-every-american-needs-to-hear/5382818. Accessed 1 Nov. 2015. The article was first published 19 May 2014.

[11] This includes the following domestic terrorism incidents:

September 11 attacks (NY, DC, PA) 9/11/01

2001 Anthrax attacks (DC, NY, CT, FL) Oct., Nov. 2001

El Al counter shooting (California) 7/4/02

Beltway sniper attacks (DC, Mid-Atlantic) Oct. 2002

Knoxville church shooting (Tennessee) 7/27/08

Pittsburgh police officers killed (Pennsylvania) 4/4/09

Tiller abortion clinic (Kansas) 5/31/09

Holocaust Museum shooting (DC) 6/10/09

Fort Hood shooting (Texas) 11/5/09

Plane crash into Austin IRS building (Texas) 2/18/10

Fort Stewart Army base killing (Georgia) 12/10/11

Sikh Temple Shooting (Wisconsin) 8/7/12

St. John’s Parish police ambush (Louisiana) 8/16/12

Boston Marathon Bombing (Massachusetts) 4/15/13

LAX Shooting (California) 11/05/13

2014 additions:

Overland Park Jewish community center (Kansas) 4/13/14

Isla Vista shooting (California) 5/23/14

Las Vegas shooting (Nevada) 6/8/14

Killing of state trooper in Blooming Grove (Pennsylvania) 9/12/14.

[12] https://www.vox.com/science-and-health/2017/10/11/16424356/puerto-rico-official-hurricane-maria-death-toll. Accessed 11 Oct. 2017.

[13] https://en.wikipedia.org/wiki/Hurricane_Katrina . Accessed 11 Oct. 2017.

[14] https://en.wikipedia.org/wiki/Casualties_of_the_September_11_attacks . Accessed 11 Oct. 2017.

[15] See Disc. ii 5.12–13 and iv 7.27; ii 9.1–2, iii 1.25–26, iv 1.104; iv 1.105–110; i 27.7–9; ii 6.11–14; iii 24.94; iii 13.14–15.

William O. Stephens is Professor of Philosophy and Classical Studies at Creighton University. He is also President of the Beta Chapter of Nebraska Phi Beta Kappa Society. He is the author of Marcus Aurelius: A Guide for the Perplexed. Stoic Ethics: Epictetus and Happiness as Freedom, and The Person: Readings in Human Nature, and the translator of Adolf Bonhöffer’s The Ethics of the Stoic Epictetus. He has published many articles on such topics as Star Wars and Stoicism, the film Gladiator (2000) and Stoicism, Stoic views of love, death, animals, sportsmanship, travel, and ecology, and on philosophical vegetarianism.