By Joe Welch
Describing Fear and Anxiety
Fear and anxiety are natural and often helpful emotions that all humans experience. We feel fear when there is a real or imagined threat in our immediate environment and involves a change in our bodily functioning referred to as the “fight-or-flight” response. Fear prepares us to respond to the threat by urging us to take action and fight, avoid, or escape the threat to keep us safe. Without fear, we probably wouldn’t live very long. Anxiety, on the other hand, is focused on a perceived threat that may occur in the future. It’s usually experienced as worry, apprehension, or muscle tension. For example, we may feel anxiety when thinking about an upcoming meeting with our boss, preparing for a presentation, or wondering if our children are safe.
The Model for Clinical Fear and Anxiety
As noted above, fear and anxiety are important emotions for survival. However, they become a clinical problem when they’re triggered at inappropriate times and cause problems in our lives. When this happens, we fall into an emotional trap and may need professional help getting unstuck. A current understanding of how we become stuck in fear and anxiety involves a cycle of avoidance. We develop unhelpful beliefs about particular triggers for anxiety, so we do what anxiety tells us, avoid or escape the situation and try to feel better.
Avoidance works great when there is actual danger but when we’re dealing with clinical anxiety, avoidance becomes the problem. Avoidance prevents us from learning that the trigger is safe and that even intense anxiety can be tolerated and is not dangerous. Another problem is that it limits our lives and keeps us away from more rewarding and meaningful activities. For example, a person with a fear of dogs will never learn that dogs are safe if they don’t approach the fear and discover new information about the safety of dogs. They may also avoid valued areas of their life, like visiting a loved one with a dog, going places where dogs might be present, or simply experiencing the joy of a dog’s presence.
Overview of Exposure Therapy
Exposure therapy has been researched for decades and is a highly effective treatment for clinical fear and anxiety problems such as panic disorder, social anxiety, PTSD, generalized anxiety disorder, OCD, and phobias. Basically, exposure therapy involves, with the help of a therapist, systematically approaching triggers for fear and anxiety so that new learning can occur. Exposure is not a way to rid yourself of all fear and anxiety and should be viewed as a way to create a healthier relationship with such feelings and get back to living a fulfilling life, even with anxiety in it.
What to Expect
Assessment
Exposure therapy begins with a thorough assessment of your experience of fear and anxiety. This includes understanding your triggers, the feared consequences of making contact with those triggers, and avoidance behaviors, often called safety behaviors.
Exposure List
After assessment, you and your therapist will create a list of triggers that will be used to conduct exposure therapy. This list will include triggers that vary in situation and intensity. There are several types of exposure including exposure to real-life situations, imaginary scenarios, thoughts, and bodily sensations.
Conducting Exposures
Once the assessment is completed and the exposure list is created, it’s time to begin approaching anxiety to whatever degree you’re willing. An important note is that the effectiveness of exposure therapy is linked to the dose. This means more repetition often means more results. During exposures, your therapist will seek your commitment to approach your fear without engaging in your typical avoidance behaviors. For example, our client with a fear of dogs would encounter dogs and not engage in behaviors to feel safe, such as leaving the situation, carrying pepper spray, trying to relax, etc. If this sounds scary, well, it’s supposed to be. However, you have control over where you start and what exposures you choose to do. Think of it as an investment in anxiety now for an improved life and a better relationship with feelings of fear and anxiety going forward.
Taking the Next Step
If you’re interested in trying exposure therapy as a treatment for fear and anxiety contact MK Counseling to book an appointment or get more information.