Some writers in the newsgroup rec.bicycles.soc say that the cyclist-inferiority phobia does not exist. However, they have not explained why they hold this opinion. They may believe that American cycling opinion does not overexaggerate the fear of motor traffic from behind and drive American cycling policy in unwise directions. Alternatively, they may believe the facts but deny that these facts characterize a phobia.
I first post the official description of the condition of Simple Phobia, and follow it with my comments about the relevance of that description to the facts about typical American cycling opinion. Those who hold that the theory of the cyclist-inferiority phobia (when in less intensity, a complex or superstition) is inaccurate should address the following material and whatever other knowledge of cycling they care to bring to the discussion.
The essential feature of this disorder is a persistent fear of a circumscribed stimulus (object or situation) other than fear of having a panic attack (as in Panic Disorder) or of humiliation or embarrassment in certain social situations (as in Social Phobia). Simple Phobias are sometimes referred to as "specific" phobias. The most common Simple Phobias involve witnessing blood or tissue injury (blood-injury phobia), closed spaces (claustrophobia), heights (acrophobia), and air travel.
During some phase of the disturbance, exposure to the simple phobic stimulus (or stimuli) almost invariably provokes an immediate anxiety response. Thus, for example, a person with a Simple Phobia of cats, when forced to confront a cat, will almost invariably have an immediate anxiety response, such as feeling panicky, sweating, and having tachycardia and difficulty breathing. Anxiety increases or decreases in a fairly predictable manner with changes in the location or nature of the phobic stimulus (e.g., height of the building, nearness of the cat,, size or behavior of the dog).
Marked anticipatory anxiety occurs if the person is confronted with the necessity of entering into the simply phobic situation, and such situations are therefore usually avoided. Less commonly, the person forces himself or herself to endure the simple phobic situation, but it is experienced with intense anxiety. Invariably the person recognizes that his or her fear is excessive or unreasonable.
The diagnosis of a Simple Phobia is made only if the avoidant behavior interferes with the person's normal routine or with usual social activities or relationships with others, or if there is marked distress about having the fear.
There follow notes about age of onset, etc, that are not important to this discussion.
One of those notes is significant:
Course. Most simple phobias that start in childhood disappear without treatment. However, those that persist into adulthood rarely remit without treatment.
A: A persistent fear of a circumscribed stimulus (object or situation) other than fear of having a panic attack (as in Panic Disorder) or of humiliation or embarrassment in certain social situations (as in Social Phobia).
B: During some phase of the disturbance, exposure to the specific phobic stimulus (or stimuli) almost invariably provokes an immediate anxiety response.
C: The object or situation is avoided, or endured with intense anxiety.
D: The fear or the avoidant behavior significantly interferes with the person's normal routine or with usual social activities or relationships with others, or there is marked distress about having the fear.
E. The person recognizes that his or her fear is excessive or unreasonable.
F: The phobic stimulus is unrelated to the content of the obsessions of Obsessive Compulsive Disorder or the trauma of Post-traumatic Stress Disorder.
Is fear of motor traffic from behind a "persistent fear of a circumscribed stimulus?" Yes, it is. The victim fears a specific situation, motor traffic from behind while riding a bicycle. The victim does not fear getting a wheel caught in a slot in the roadway, or motor traffic from stop signs, or motor traffic coming in the opposite direction, or erratic dogs, or any of the other hazards that far more frequently cause accidents to cyclists, and the victim does not fear motor traffic from behind when driving a car.
Does exposure to motor traffic from behind, while riding a bicycle, almost invariably provoke an immediate anxiety response. Certainly it does, and even contemplating the exposure of others to the stimulus causes anxiety response, as when people organize political committees to obtain protection from the condition that they fear.
The victims avoid motor traffic from behind either by not cycling or, if they
do cycle, by going out of their way to avoid streets with more of such traffic,
and when they have to endure more than the minimum of motor traffic from behind
they complain of how dangerous it is and wish they were not there, and the like.
Because of their fear of motor traffic from behind, the victims avoid the useful, economical, healthful, and enjoyable activity of cycling. They either stay home or they go to the expense of motoring instead.
This is the one instance in which victims of the cyclist-inferiority phobia fail to meet a criterion. The fear is unreasonable because motor traffic from behind causes only a very small proportion of casualties to cyclists, about 0.3%. Yet the victims not only fail to consider that their fear is unreasonable, they insist that the fear represents something like a law of nature. They believe that the cyclist who rides in traffic will either slow down the cars or, if the cars don't choose to slow down, will be crushed. Because this is the prevailing opinion, held my the great majority of Americans, they see no reason to recognize that their fear is unreasonable. When nearly everybody suffers from one specific phobia, that phobia becomes invisible.
Because very few victims of this phobia have been involved in the type of accident that they fear, this cannot be a Post-traumatic Stress Disorder. It is not associated with Obsessive Compulsive behavior.
"Those that persist into adulthood rarely remit without treatment." We have found that informing those with the disorder of the facts about the dangers of cycling does not change their opinion about those dangers and the appropriate political measures concerning cycling. The only effective treatment that has been found for the cyclist-inferiority phobia is repeated successful experience of cycling in traffic of gradually increasing intensity. In other words, even mild treatment, being informed of the facts, does not change people's opinions. It requires the standard treatment for phobias to create change.
The description of the facts fits the diagnostic criteria in all ways but one. That one is the prevalence of the disorder. The APA considers that phobias must be rare, affecting only a small proportion of the population, so that the victim recognizes that his or her fear is unusual. This criterion serves to distinguish simple phobias from other disorders in which the victim believes that his or her condition is the universal state of mankind. A victim of paranoia may believe that he or she is the only person targeted by a particular evil entity (or believe that all persons of some class are so targeted), but he or she believes completely in the existence and danger of that evil entity. On the contrary, the person with the typical simple phobia, say of air travel, as in one of the examples given, has to recognize that most people do not fear air travel because air travel is the most frequently used form of long-distance travel, in which typical people complain of missed connections, lost baggage, and inconvenient travelling hours, but do not complain of being afraid. The distinction between a condition in which the victim recognizes the atypical nature of his or her fear and one in which the victim believes absolutely in the danger of the object feared is vital to making a correct diagnosis and undertaking the proper treatment.
However, the APA probably has never had to consider that a particular phobia is held by the great majority of the population. There is no theoretical reason why a condition that fits all the other diagnostic criteria for a phobia should not affect the majority of the population. However, if the great majority of the population suffer from a particular phobia, there is no means by which any victim can conclude that their fear is atypical. Under this condition, it is in fact typical. The only means by which a person who suffers from this condition can determine whether it is a phobia is by knowing whether or not the facts agree with reality, and it is recognized that knowing the facts does not cure phobias. That is, the fact that the person who fears air travel recognizes that air travel is not very dangerous (Diagnostic Criterion F), because most people do not fear air travel, does not cure the fear. The persistence despite accurate knowledge is what makes it a phobia. Only successful experience of the conditions of air travel (starting by visiting planes that will not take off) has been found to cure the disorder.
Under the condition of near universal phobia, which is the condition of the cyclist-inferiority phobia, the phobia appears to be a fact of existence, a law of nature. The inaccuracy of this opinion is obvious to persons who have grown up in a society in which this fear is very rare and, if it does exist at all, is considered a phobia. Such a person, as I am, is well placed to note the peculiar opinions of the society which suffers such a mass phobia, because they contrast with his own knowledge.
Of course, it is possible that the apparent phobia is not a phobia at all but a reflection of the facts, and the stranger suffers from some other condition as a result of being brought up in a different society. The only way to resolve this question is by examining the facts. The relevant question is whether or not the facts truly support the fear. On this question, as I wrote before, being hit by a motor vehicle from behind while riding a bicycle in the proper manner causes only 0.2% - 0.3% of accidents to cyclists under daylight, urban conditions, which is the place and time of most cycling transportation and for which the bicycle advocates who most strongly suffer from the disorder are trying to make government take action to protect them from overtaking motor traffic. There are many other facts that support this position; I have just mentioned the one that is simplest to explain.