On facing your fears: how to do it in a way that helps

“Face your fears” is more than a nice phrase, it is actually a very effective way of dealing with anxiety. The term we use in CBT is “Graded Exposure” (a fancy way of saying gradually facing your fears) and it has a strong evidence base for dealing with all types of anxiety.

Whether it is germs, making mistakes, public speaking, saying no, heights, flying, or anything else, this approach can actually be used to get to a point where this thing is just not so scary any more. Let’s talk about how.

My favourite way of explaining the intention of graded exposure is this: for whatever reason (usually experience) your mind is currently flagging this thing up as dangerous and something that must be avoided. It might be that in your head you keep telling yourself that it is OK, that it’s not as scary as it seems, but perhaps that isn’t making as much of a difference as you would like.

It isn’t your “logical,” “detached”, or “reasonable” part of your mind that needs convincing. It’s the older, animal part of your mind which takes care of keeping you safe.

It’s like if there was an animal which was afraid of humans: you can’t explain to it that these particular humans are safe. You have to let it spend time around them. Initially, it will be very afraid, but over time it might be able to let its guard down.

That is what we are doing in graded exposure.

Habituation

The intention is to keep “exposing yourself” (steady now) to the thing that scares you, and then staying there long enough for the anxiety to rise all the way up, and come back down on it’s own. Usually, if something scares us, once the anxiety comes up, we find a way to escape or make the anxiety go away.

Of course we do. Why wouldn’t we? However, while that solves the anxiety in the short-term (I’m not scared any more because I have run away), it means that the next time it comes up, I’ll feel the same level of anxiety and have to do the same thing again.

So, what happens if we don’t run away? What happens if we face the fear, and then we just stand there? The anxiety will come up, and it will stay high. But, after a little while, it will start to come down of its own accord.

This is basically your mind going: “Aaaaargh! Danger! Danger! We are going to come to harm! Aaaaaargh!….Hold on…why hasn’t anything terrible happened?… Stay alert, I’m sure something is going to happen…Hmm….maybe we can take this down a notch or two…Ok folks, it does look like the coast is clear…keep your eye out but we don’t need to be on full alert you know.”

And that is called “habituation.”

When it doesn’t work

Now, there will be some things you have faced which haven’t got any easier. When this is the case, or when you are thinking about working on something and want to make sure it is actually worth it, bear in mind these four principles of what makes graded exposure actually work:

Is it long enough?

In order for this to be effective, ideally you stay in the situation and sit with the anxiety long enough to feel it start to come down of it’s own accord. Sometimes that’s not possible, and it doesn’t mean it won’t be effective at all, but the more you can try to do this, the better.

Don’t run off or make it go away. Face the thing that scares you and then sit with that fear until it starts to come down.

Then you can go and do whatever you like.

Am I distracted?

Sometimes when we face a fear and we don’t run away, we still manage to escape the feeling by distracting ourselves, or mentally escaping.

While you are purposely facing your fear, try not to run off and distract yourself with jobs or cleaning or whatever it might be. Try to just sit with it.

Repeated

This is the one, usually. The evidence base suggests that the more often you face the fear, the more likely you are to see some progress. At least three times a week is what we are after. This is, I reckon, the main reason people find it hard to get over a fear of flying!

Graded

The final thing and in my eyes, a massively overlooked one, is that it works best when you take small steps.

With a fear of heights, you don’t start with the empire state building: you start with a ladder. You find the rung where you start to feel scared and you stop there.

You face that height over and over and over again until eventually, your mind stops flagging it as quite so dangerous and you just don’t get as anxious any more. Then you can try the next rung.

You don’t have to dive in with the scariest thing you can think of. The sweet spot is something that scares you but you reckon you can give a go. This approach means that it’s gradual but effective progress. Here’s some ideas of just how small you can start:

• Saying no: start by saying no to small things and to people you trust
• Public speaking: start with speaking in front of one or two trusted people
• Tolerating imperfection: start with not correcting your spelling in messages
• Germs: start with washing your hands for just 5 seconds less than usual

I hope that gives you the idea of it.

Thanks for reading. Until next time,

Ted

P.S.