The cognitive approach to phobias (Beck and Emery 1985) emphasizes the mediating role of thought patterns and mental images that allow individual adaptation to internal and external stimuli. Cognitions themselves are not considered a cause of anxiety and avoidance behavior but represent an intervening information-processing system whose dysfunction may result from the interaction of an innate biological vulnerability with a faulty cognitive learning history. Therapeutic reduction of fear and avoidance is thought to result from the modification of maladaptive conscious or unconscious thought patterns.