Exposure Therapy for Specific Phobia

Facing fears in a gradual and consistent manner is the most effective way to overcome fears and phobias and is called “exposure”. This process involves gradually and repeatedly exposing yourself to the feared object or situation in a safe and controlled way. You learn to “ride out” the anxiety and distress until the anxiety passes.

This process requires courage and determination. Sometimes your anxiety is so high, that you cannot imagine resisting it. Anyone who decides to try exposing themselves to their fears needs to draw up a personal “training program”. This means working out where they are now, deciding where they want to be at the end, and fitting as many gradual “exposure” steps in between as they need. For more help, see Facing Your Fears: Exposure. For example, if Karen wanted to remain in a room with a dog without panicking, she may take the following steps:

  • Step 1: Draw a dog on a piece of paper.
  • Step 2: Read about dogs.
  • Step 3: Look at photos of dogs.
  • Step 4: Look at videos of dogs.
  • Step 5: Look at dogs through a closed window.
  • Step 6: Then through a partly-opened window, then open it more and more.
  • Step 7: Look at them from a doorway.
  • Step 8: Move further out the doorway; then further etc.
  • Step 9: Have a helper bring a dog into a nearby room (on a leash).
  • Step 10: Have the helper bring the dog into the same room, still on a leash.

If you have a fear of dentists, you might do the following steps:

  • Step 1: Walk in an out of the dentist's office with your partner.
  • Step 2: Walk in and out of the dentist's office alone.
  • Step 3: With your partner, sit in the waiting area for 10 minutes.
  • Step 4: Sit in the waiting area alone for 10 minutes.
  • Step 5: Make an appointment with the dentist just to talk for 10 minutes
  • (you can explain to the dentist what you are doing and ask for her support).
  • Step 6: Sit in the dentist's chair for 10 minutes, with your partner beside you.
  • Step 7: Sit in the dentist's chair alone for 10 minutes.
  • Step 8: Make an appointment for the dentist just to look in your mouth, and not do any work.
  • Step 9: Make an appointment to have your teeth cleaned only, with your partner staying in the room with you.
  • Step 10: Make an appointment for the dentist to do some work on your teeth, with your partner staying in the room with you.
  • Step 11: Repeat Steps 9 and 10 alone.

Through repeated experiences of facing your fears, you begin to realize that the situation, while possibly unpleasant, is not harmful. With each exposure, you will feel an increasing sense of control over your phobia. This sense of control over the situation is the most important benefit of exposure. As your anxiety gradually decreases, you no longer react with uncontrollable panic when confronted with it.

Use the Facing Your Fears Form to help track changes in your anxiety when completing the exercises.

KEYS TO MANAGING YOUR PHOBIA:

  • Stick with it! Do the exposure exercises as often as you can. You are trying to build up positive experiences to replace all the bad ones of being defeated by the phobia. Too long a gap between exercises makes this more difficult.
  • Recruit help! Enlist the help of family and friends. It can help to find someone to work with who can talk to you calmly and positively while you are doing the steps. Make sure the helper you recruit is not over-sympathizing or endlessly asking how bad you are feeling. This will make it harder for you to focus on the steps and to stay positive.