Overcoming Specific Phobias with Exposure Therapy

Written by Regine Galanti

While most individuals display some anxiety when facing certain situations, such as spiders, insects, driving, heights, or closed spaces, among others, most of these fears are relatively benign and don’t affect an individual’s functioning. Many people, however, do suffer from these seemingly benign fears: The boy who avoids going to camp because he might see a spider, the woman who walks up 15 flights of steps to avoid the elevator, or the man who takes public transportation (despite having a car and driver license) in order to avoid driving over a bridge. These examples are just some of the ways that specific phobias manifest – almost any specific fear that causes an intense reaction that is disproportionate to the actual level of threat and interferes with an individual’s daily functioning, meets criteria for specific phobia, and is worthy of treatment. Everyone knows someone who suffers from a specific phobia, as these are some of the most prevalent mental health problems, affecting 1 in 8 people over the course of a lifetime.

That was the bad news. Here’s the good news: Exposure Therapy – a variant of Cognitive Behavior Therapy (CBT) – is a remarkably effective and relatively low-cost treatment for these types of phobias. In fact, intensive or even single-session exposure therapy treatments can be completed in as little as a single day, and provide long-lasting effects in reducing fear.

Phobic responses involve three parts: (1) A physiological fear response (the fight or flight response), (2) Cognitive appraisals (“this fear is dangerous”), and (3) Behaviors such as avoiding or escaping the feared situation. Take, Sally, for example, who is afraid of riding in elevators. When standing in front of an elevator, Sally notices muscle tension, and her hands begin to shake (the physiological response). She thinks to herself, “that machine is a deathtrap, it can’t be safe,” (cognitive response) and she decides that the best course of action is to take the stairs (behavioral avoidance).

Exposure therapy for specific phobias helps individuals by targeting all three parts of this phobic response. In particular, exposure therapy helps people recognize the role of their avoidance in maintaining their anxiety. Because Sally takes the stairs, she never actually gets to experience what happens if she did go in an elevator, and she therefore never gets to learn new information that would change her cognitions and physiology. It’s true that the elevator might get stuck, or plunge 20 feet, but the much more likely scenario is that the elevator rises as planned and Sally finds out that the catastrophic event she predicts will not happen. By riding the elevator, repeatedly, Sally also learns that her physiological response to fear is a “false alarm,” telling her something is wrong, when that is not true. Sally therefore learns that she can tolerate her physical symptoms, even though they are uncomfortable. By facing her fear rather than avoiding it, Sally’s fear response eventually decreases.

This type of approach, which involves confronting the feared stimulus in real life, is called in vivo exposure. As noted above, exposure therapy is highly effective for specific phobias, and can sometimes be completed start-to-finish in one session. Yet, many people live their whole lives in fear of something that they could overcome in a single day!

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I came to the Center for Anxiety for help in dealing with a family member who suffered from extreme anxiety. But I ended up getting a serious illness two months later and started having my own sessions. With the help of my therapist I got through my illness, learned to understand my habits that were making my major life stresses worse, learned to communicate better, taper my anger, and surprisingly I became more calmer even though my hardships in life worsened. Therapy is a lot of work and not easy, but nothing in life comes easy! I became a better and softer mom and (when I practice what I learned) and my kids and home are calmer and happier. I am still a work in progress and have more to work on, but I know I am on the right path. I wish I knew before how my communication style and anger were really impacting my life, how being softer you can accomplish way more then being harsh. I have been to other therapists in the past and I can hands down say that the Center for Anxiety’s approach is really effective. I have even referred a bunch of people to the Center and they have been really happy with the therapists and how much they really care for their patients.
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When I first came to the Center for Anxiety, my list of anxieties/fears was long! I was scared of getting sick, getting stranded, driving, flying and more. With the help of my therapist, I immediately got to work and tackled every one of my fears. Now the world is open to me and I feel free! I can dream big and accomplish whatever I set my mind to! I am especially grateful that I was able to do all this without having to rely on medication. It was hard work – grueling at times! – but now I have the coping tools within me for life. In fact a family member recently said to me “You are awesome. You can accomplish anything you set your mind to because you don’t let fear stop you! ” Thank you Dr. Rosmarin and the Center for Anxiety staff for helping me get here. My fears no longer limit me and I love my life. Try it, it might turn your life around too!
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When I sought treatment at the Center for Anxiety, the clinic was is in its incipient stages. However, by the time I successfully finished treatment, the Center for Anxiety grew and flourished into a world-class treatment center, offering cutting-edge, evidence-based treatment to countless individuals. The continued success of the Center for Anxiety comes as no surprise to me, with a team that contains such highly skilled professionals who display clinical acumen, empathy, and compassion. When I first entered treatment I was concerned that therapy would be similar to the experiences with past psychologists: a seemingly bottomless pit with no reductions in my anxiety symptoms, but was so relieved when I started to feel less anxious after only a handful of sessions. My therapist created a treatment plan that was tailored exactly to my needs and taught me practical skills to help me work through my anxiety that I still use and practice to this very day.
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When I first came in, I was struggling with panic disorder and didn’t even know it, which only made dealing with it that much more difficult. After my first time sitting down with my therapist, however, I instantly started to gain perspective and look at the difficult situation in a different light. Our meetings helped me conquer the issue step by step and get my life back on track. I’d strongly recommend that anyone dealing with anxiety in a way that impacts their day to day life should visit the Center for Anxiety! I know it helped me tremendously.
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When I woke up one morning last June and didn’t want to get out of bed, I knew I needed help. The thought of getting through another day with all my anxieties, obsessions and rituals was just too overwhelming. After feeling stuck for years, I just couldn’t anymore. Thankfully, that’s when I found the Center for Anxiety. Dr. Rosmarin and his staff are experts at what they do, kind and professional. After just several weeks I accomplished my initial targets. The change I experienced in such a short amount of time was astounding that I stayed on for a while longer to work on more complex goals. I soon achieved those too. Now, I am free of my obsessions, know how to manage my anxiety, and love my life. My only regret: not having done this sooner. I wish I had known that you don’t have to wait to hit rock bottom to get help.
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I’m 26 years old and I’ve been suffering from terrible depression for 7 years. In the throws of my sadness I literally wanted to die. Soon after starting therapy at the Center for Anxiety, my depression lifted. My suicidal thoughts began to dissipate. I remember the feeling that came over me as soon as the dark cloud above me left. It was the most liberating feeling I have ever experienced. I actually shouted to my friends, family and anyone nearby me “I’m Happy! I am Happy!” I felt free.
Over the course of four years I developed anxiety-like symptoms (tightness in chest, gut, back) that slowly but surely increased in duration and severity. The EXTREMELY uncomfortable nature of the symptoms notwithstanding, I still continued and managed to function. The effort required to do so, however, left me utterly drained. Having always been a very spiritual person I strongly felt that a course of therapy incorporating a spiritual component could potentially work well for me and decided to give the Center for Anxiety a try. Happily, I have achieved significant symptom reduction, tremendously improved emotional/mental health, and above all, Connection. Medication free. I’m no longer just existing, I’m LIVING. I’ve been given a second chance to become the unique human being that I was meant to be.
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