A modern conceptualization of phobia in al-Balkhi’s 9th century treatise: Sustenance of the Body and Soul

• Al-Balkhi was one of the earliest to conceptualize phobias as separate diagnostic entity.
• Al-Balkhi’s description of phobias closely matches the DSM-5: a primary psychological disorder that sometimes manifests with physical symptoms.
• A behavior management therapy, similar to modern CBT, was suggested for treatment of phobias.
• The Islamic Golden Era (9th–12th centuries) contributed to the evolution of the field of mental health.

Morbid fears and phobias have been mentioned in religious, philosophical and medical manuscripts since ancient times. Despite early insights by the Greeks, phobias did not appear as a separate clinical phenomenon in Western medicine until the 17th century and has evolved substantially since. However, robust investigations attempting to decipher the clinical nature of phobias emerged in pre-modern times during the oft-overlooked Islamic Golden Era (9th–12th centuries); which overlapped with Europe’s medieval period. An innovative attempt was made by the 9th century Muslim scholar, Abu Zayd al-Balkhi, in his medical manuscript “Sustenance of the Body and Soul,” to define phobias as a separate diagnostic entity. Al-Balkhi was one of the earliest to cluster psychological and physical symptoms of phobias under one category, “al-Fazaá”, and outline a specific management plan. We analyze al-Balkhi’s description of phobias, according to the modern understanding of psychiatric classifications and symptomatology as described in the DSM-5.