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Facing Fears Through Exposure Therapy

Many psychologists believe that humans have nine basic emotions: joy, fear, anger, shock, love, disgust, sadness, guilt, and curiosity. We are taught from an early age that some emotions are “good”, and some are “bad”. Oftentimes, the feelings that are thought of as bad (fear, anger, shock, disgust, sadness, and guilt) are the ones that we try to get rid of or avoid. It is normal to want to avoid tough emotions, but have you ever noticed that that the more you try not to feel them, the more intense they can become?

I have selected one of the basic emotions to dive a little deeper into for this blog post, one that many people work hard to avoid: FEAR. Fear is based on an expectation that something is dangerous. When we face a scary situation and nothing bad actually happens, our brains acquire new information about the situation. This way, when we face our fears, they diminish.

Exposure therapy is a psychological treatment that was developed to help people confront their fears. When people are fearful of something, as outlined above, they tend to avoid the feared objects, activities, or situations. Although this avoidance might help reduce feelings of fear in the short term, over the long term it can make the fear become even worse. Engaging in exposure therapy with a trained professional can help people break patterns of avoidance. Exposure therapy has been scientifically demonstrated to be a helpful treatment or treatment component for a range of conditions, including Specific Phobias, Panic Disorder, Social Anxiety Disorder, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, and Generalized Anxiety Disorder. There are several variations of exposure therapy. It is important to discuss specific approaches with a professional.

In my practice, I enjoy creating exposure hierarchies with clients. With younger children and adolescents, we might call this a “Fear Ladder”. This process involves working collaboratively to develop a list of fear-inducing activities and ranking them according to how much distress they cause.  The list is then arranged in a hierarchy that can be worked through progressively. Below are a few important points to consider when facing fears:

Be Intentional: Choosing to face our fears is more effective than facing them against our will or with limited choice in the matter. Forcing someone to face their fears is not effective and can do more harm than good.

Repeat as Needed: Doing something once is courageous, but generally speaking, our nervous systems don’t stop being afraid of a situation after facing it only once.

Stay Through the Discomfort: If we run away from the first feeling of discomfort, we’ll be reinforcing our avoidance behavior.

Embrace Discomfort & Uncertainty: When we accept that something is going to be scary, the fear has less power over us. We can also lean into uncertainty just as we lean into discomfort. We can tell ourselves: “I don’t know what will happen, and I’m willing to do it anyway.”

“Courage is not the absence of fear, but rather the judgment that something else is more important than one’s fear”- Ambrose Redmoon

 

Written by Kerri Hill, Registered Psychologist with Wildflowers

Sources: American Psychological Association (2017) https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

Gillihan, S.J (2016). Retrain your brain: Cognitive behavioral therapy in 7 weeks. Althea Press.

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