By Todd Farchione, PhD, Research Assistant Professor at Boston University and the Director of the Intensive Treatment Program at the Center for Anxiety and Related Disorders at Boston University
We all experience fear. It’s a natural emotion that’s essential for our survival. Fear, and the emotional part of the brain from which it originates, is designed to protect us from danger. But even good emotions can sometimes go bad or run a little wild.
For some, fear occurs more frequently or intensely than it should, or it happens in situations where it’s less adaptive or just doesn’t seem to make sense. In some cases, fears can become problematic and even interfere with a person’s ability to live the life they most desire.
The treatment of choice for mastering fears and phobias is exposure. Exposure treatment can occur in different ways, and may be supplemented with other therapeutic techniques, but it always involves some level of prolonged confrontation with the feared object or situation. There’s some debate on why exposure treatment works, but what we do know from all of the research that’s been done is that it does work. It may take some time, but ultimately the fear will diminish. In accordance with this approach, here are 4 key steps you can use to face your fears:
1. Develop a “Fear Ladder”
Planning how you’re going to face the situation or object you’re afraid of, and that you’ve most likely been avoiding, is an important first step in overcoming your fears. Start by thinking about what you’re currently avoiding because of your fear and how much distress you might experience if you were to confront these situations.
Rank these situations in order based on the level of fear or distress you anticipate experiencing, putting the most frightening situation at the top of your list and the least distressing item at the bottom. You’ve now developed a “fear ladder” you can use to ease into facing your most frightening situations. So, if you have a fear of heights and are unable to go to the 50th floor of a high building, you can start with the 10th floor first, face your fear in that situation, and then move on to the 20th floor, and so on. Each step of the ladder can be broken up into smaller, more manageable steps, as needed.
Once you’ve laid out the specific tasks that need to be completed, I recommend actually scheduling the exposure task, specifying the exact day and time it will be completed. Remember to leave yourself enough time to complete the task and for your fear to reduce naturally in the presence of the feared object or situation. Usually about 20-30 minutes should be enough time to see a reduction in your fear, though more time may be needed.
2. Challenge Your Thoughts
Looking at your anxious and fearful thoughts and challenging them before, during, and after facing a frightening situation can be a good way to adaptively manage your emotions. When you look closely at how you’re thinking about a feared situation or object, or how you are describing it to others, you might notice that you’re overestimating the likelihood of something bad happening and/ or underestimating your ability to cope with an anticipated negative outcome. It can be useful to actually write your thoughts down so you can look at them more closely.
Once you’ve identified the thoughts, you can then work towards challenging them and put things more in perspective.
Ask yourself questions like: What evidence do I have for this fear or belief? What is the worst that could happen? How bad would that be? Work toward considering other alternative, less fearful outcomes, and look closely at the data to try to develop a more balanced perspective. Challenging your thoughts is also a useful strategy for building up your confidence to face your fears. It can essentially “set the stage” for the next step – changing your behaviors.
3. Change Your Behavior
This is the most important step to facing your fears. When something frightens us, the natural tendency is to run away and to then avoid the situation in the future. Unfortunately, research shows that when we respond to our fears in this manner, we can actually feed the fear and make it worse over time.
For situations that are dangerous (and should be avoided), this really isn’t a problem. In fact, it can be adaptive. But for fears that are less rational, or appear to be excessive or less adaptive given the nature of the situation, we need to respond differently. The emotional part of your brain is incorrectly responding as though something is dangerous, resulting in feelings of fear. The fear you’re experiencing is essentially a false alarm. And that’s exactly how you should try to respond to it. Changing behaviors is an effective way to “teach” the emotional part of your brain to settle down and ultimately lead to a reduction in your feelings of fear. There are two key behavioral changes you should try to make with regards to your fear.
First, try to adopt a pattern of approach, as opposed to avoidance. Avoidance can take on many forms. Sometimes it can be more obvious, while at other times, it can be much more subtle and difficult to identify. Try to consider the function of your behaviors. If you’re doing something as a way to prevent yourself from being afraid, it’s probably an avoidance behavior, and may be something that you’ll want to change.
Second, try to act in a way that is different than what your fear prompts you to do. If you have the urge to run away, then simply plant your feet. If you notice that you’re tensing your body, clenching your fists, or gripping tightly onto something for a sense of safety and support, try to relax your muscles, open your hands, and loosen your grip. Also, try to stay in the situation long enough for you to see some reduction in your fear. One of the worst things you can do is escape from a situation at the height of your fear response. If you leave or escape when the fear is greatest, you can actually strengthen the connection between the situation and your your feelings of fear
4. Reward Yourself
Facing your fears can be a very difficult process and when you do a good job of it, a reward is definitely in order. This can be something as simple as sharing your accomplishments with family or friends, having a nice dinner, or buying yourself something special. Of course, the greatest reward will come from being able to do the things that you were unable to do because of your fear. So if you overcome your fear of flying, you might just consider taking a nice trip to the Bahamas, Bermuda, or some other destination of your choice. If an exposure task doesn’t go the way you expected, try not to get discouraged. You can always try an earlier step on your fear ladder, break the task into smaller steps, or make some changes to the task that will allow you to more successfully face the situation in the future. Just keep chipping away at it. Before you know it, you’ll find yourself confronting situations in a way you never thought possible.
Fears and phobias can stop us from doing things that are important to us, and can prevent us from living to our potential. Mastering our fears can be a very difficult task but is well worth the effort. Through this process we become stronger and more confident. As we free ourselves from our fears, we become better able to live in accordance with our values, to explore new possibilities for our lives and to develop into the person we would most like to be.
For further reading, reference: Antony, M.M., Craske, M.G., Barlow, D.H. (2006). Mastering your fears and phobias: Client workbook (2nd ed.). New York: Oxford University Press.