Treating a phobia
It’s only natural to want to avoid the thing or situation you fear. But when it comes to conquering phobias, facing your fears is the key. While avoidance may make you feel better in the short term, it prevents you from learning that your phobia may not be as frightening or overwhelming as you think. You never get the chance to learn how to cope with your fears and experience control over the situation. As a result, the phobia becomes increasingly scarier and more daunting in your mind.
Overcome your fears, one step at a time
The most effective way to overcome a phobia is by gradually and repeatedly exposing yourself to what you fear in a safe and controlled way. During this exposure process, you’ll learn to ride out the anxiety and fear until it inevitably passes.
Through repeated experiences facing your fear, you’ll begin to realise that the worst isn’t going to happen; you’re not going to die or “lose it”. With each exposure, you’ll feel more confident and in control. The phobia begins to lose its power.
Successfully facing your fears takes planning, practice, and patience. The following tips will help you get the most out of the exposure process.
Climbing up the fear ladder
If you’ve tried exposure in the past and it didn’t work, you may have started with something too scary or overwhelming. It’s important to begin with a situation that you can handle and work your way up from there, building your confidence and coping skills as you move up the fear ladder.
Facing a fear of dogs: A sample fear ladder
1. Look at pictures of dogs.
2. Watch a video with dogs in it.
3. Look at a dog through a window.
4. Stand across the street from a dog on a leash.
5. Stand 10 feet away from a dog on a leash.
6. Stand 5 feet away from a dog on a leash.
7. Stand beside a dog on a leash.
8. Pet a small dog that someone is holding.
9. Pet a larger dog on a leash.
10. Pet a larger dog off leash.
Make a list.
Make a list of the frightening situations related to your phobia. If you’re afraid of flying, your list (in addition to the obvious, such as taking a flight or getting through takeoff) might include booking your ticket, packing your suitcase, driving to the airport, watching planes take off and land, going through security, boarding the plane, and listening to the flight attendant present the safety instructions.
Build your fear ladder.
Arrange the items on your list from the least scary to the scariest. The first step should make you slightly anxious, but not so frightened that you’re too intimidated to try it. When creating the ladder, it can be helpful to think about your end goal (e.g., to be able to be near dogs without panicking) and then break down the steps needed to reach that goal.
Work your way up the ladder.
Start with the first step (in this example, looking at pictures of dogs) and don’t move on until you start to feel more comfortable doing it. If at all possible, stay in the situation long enough for your anxiety to decrease. The longer you expose yourself to the thing you’re afraid of, the more you’ll get used to it and the less anxious you’ll feel when you face it the next time. If the situation itself is short (e.g., crossing a bridge), do it over and over again until your anxiety starts to lessen. Once you’ve done a step on several separate occasions without feeling too much anxiety, you can move on to the next step. If a step is too hard, break it down into smaller steps or go slower.
Practice.
It’s important to practice regularly. The more often you practice, the quicker your progress will be. However, don’t rush. Go at a pace that you can manage without feeling overwhelmed. And remember: you will feel uncomfortable and anxious as you face your fears, but the feelings are only temporary. If you stick with it, the anxiety will fade. Your fears won’t hurt you. If you start to feel overwhelmed… While it’s natural to feel scared or anxious as you face your phobia, you should never feel overwhelmed by these feelings. If you start to feel overwhelmed, immediately back off. You may need to spend more time learning to control feelings of anxiety (see the relaxation techniques below), or you may feel more comfortable working with your Psychologist.
Learn relaxation techniques
As you’ll recall, when you’re afraid or anxious, you experience a variety of uncomfortable physical symptoms, such as a racing heart and a suffocating feeling. These physical sensations can be frightening themselves—and a large part of what makes your phobia so distressing. However, by learning and practising relaxation techniques, you can become more confident in your ability to tolerate these uncomfortable sensations and calm yourself down quickly.
Relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation are powerful antidotes to anxiety, panic, and fear. With regular practice, they can improve your ability to control the physical symptoms of anxiety, which will make facing your phobia less intimidating. Relaxation techniques will also help you cope more effectively with other sources of stress and anxiety in your life.
A simple deep breathing relaxation exercise
When you’re anxious, you tend to take quick, shallow breaths (known as hyperventilating), which actually adds to the physical feelings of anxiety. By breathing deeply from the abdomen, you can reverse these physical sensations. You can’t be upset when you’re breathing slowly, deeply, and quietly. Within minutes of deep breathing, you will feel less tense, less short of breath, and less anxious.
Sit or stand comfortably with your back straight. Put one hand on your chest and the other on your stomach.
Take a slow breath in through your nose, counting to four. The hand on your stomach should rise. The hand on your chest should move very little.
Hold your breath for a count of seven.
Exhale through your mouth to a count of eight, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your hand on your chest should move very little.
Inhale again, repeating the cycle until you feel relaxed and centred.
Try practising this deep breathing technique for five minutes twice a day. You don’t need to feel anxious to practice. In fact, it’s best to practice when you’re feeling calm until you’re familiar and comfortable with the exercise. Once you’re comfortable with this deep breathing technique, you can start to use it when you’re facing your phobia or in other stressful situations.
Challenge Automatic Negative Thoughts (ANTs)
Learning to challenge unhelpful thoughts is an important step in overcoming your phobia. When you have a phobia, you tend to overestimate how bad it will be if you’re exposed to the situation you fear. At the same time, you underestimate your ability to cope.
The anxious thoughts that trigger and fuel phobias are usually negative and unrealistic. It can help to put these thoughts to the test. Begin by writing down any negative thoughts you have when confronted with your phobia. Many times, these thoughts fall into the following ANT categories:
Fortune telling
e.g., “This bridge is going to collapse;” “I’ll make a fool of myself for sure;” “I will definitely lose it when the elevator doors close.”Overgeneralisation
e.g., “I fainted once while getting a needle. I’ll never be able to get a needle again without passing out;” “That German Sheperd lunged at me. All dogs are dangerous.”Catastrophising
e.g., “The captain said we’re going through turbulence. The plane is going to crash!” “The person next to me coughed. Maybe it’s swine flu. I’m going to get very sick!”
Once you’ve identified your negative thoughts, evaluate them. Use the following example to get started.
Negative thought: “The elevator will break down and I’ll get trapped and suffocate.”
Is there any evidence that contradicts this thought?
▪ “I see many people using the elevator and it has never broken down.”
▪ “I cannot remember ever hearing of anyone dying from suffocation in an elevator.”
▪ “I have never actually been in an elevator that has broken down.”
▪ “There are air vents in an elevator which allow ongoing air flow.”Could you do anything to resolve this situation if it does occur?
▪ “I guess I could press the alarm button or use the telephone to call for assistance.”Are you making a thinking error?
▪ “Yes. I’m fortune telling, as I have no evidence to suggest that the elevator will break down.”What would you say to a friend who has this fear?
▪ “I would probably say that the chances of it happening are very slim as you don’t see or hear about it very often.”
It’s also helpful to come up with some positive coping statements that you can tell yourself when facing your phobia.
For example:
“I’ve felt this way before and nothing terrible happened. It may be unpleasant, but it won’t harm me.”
“If the worst happens and I have a panic attack while I’m driving, I’ll simply pull over and wait for it to pass.”
“I’ve flown many times and the plane has never crashed. In fact, I don’t know anyone who’s ever been in a plane crash. Statistically and rationally, flying is very safe.”
Adapted: helpguide.org
