Overcoming Phobias

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Phobias and Anxiety

All phobias have anxiety as their root. The car (phobia) might look different but the engine (anxiety) is always the same. So regardless of the phobia in question what we’re really dealing with is an anxiety disorder, a disorder that has crystallized around this or that terrifying object or activity.

The good news is that while phobias are debilitating they’re also treatable. It’s possible to get movement a lot faster than you might think once it’s clearly understood that the problem to solve isn’t the phobia itself but rather the level of anxiety attached to it.

The Behavioral Approach to Phobias

The tried and true method for overcoming any phobia is a stair stepping model of exposure. Let’s say the phobia in question is a fear of heights. The first step might be simply visualizing a climb with steep drop offs on both sides and describing the ascent in as vivid detail as possible to the therapist. The next step might be finding and watching youtube videos of climbers confronting heights with scary drop offs. The next step might be going somewhere like the top of a tall building or a lookout with plenty of safety precautions in place like railings and fences. The next step might be traversing an area with steep drop offs on both sides but plenty of space in between. The final step might be actually doing a hike with real heights.

Now, the key to making this work is helping the person with the phobia find the appropriate step where anxiety is strong but not completely debilitating. It really doesn’t matter where someone lands on the staircase, only that the correct level of exposure is found, at which point conversations and activities are geared around repeated contact until a certain comfort level is built up so that anxiety is reduced to acceptable levels, at which point the next step up the staircase is taken. A more intense level of exposure will mean increasing anxiety, but then new conversations and activities will again build up the comfort level and reduce that anxiety, and so on until what once upon a time seemed utterly terrifying and impossible to overcome can be faced squarely.

Existential Considerations of Anxiety

In an existential sense the name of the game is not eradicating anxiety but bringing it down to reasonable levels. What’s considered ‘reasonable’ might differ from person to person but a good rule of thumb is ‘sometimes painful but never debilitating’. We’ve got to remember that anxiety is our friend, not our enemy. It exists to give us immediate, visceral feedback about some danger in our environment that could threaten our survival. And indeed when we think about the content of various phobias they do have real danger there. Snakes and reptiles, heights, flying, enclosed spaces, dark places, all of these and more pose real existential threats. Think about that guy at the national park who brazenly stands on some outcropping with a hundred foot drop below and nothing to support him, wind swirling about him. That guy is, in our opinion, an idiot who is subjecting himself to unnecessary risk precisely because he’s not feeling the adequate amount of anxiety.

The Real Question to Ask Yourself About Your Phobia 

So the real question to ask yourself about your phobia is if the safety tradeoff is worth whatever you’ve been missing out on. Has your phobia become debilitating to the point where your quality of life is really suffering? Where you can’t do the things you really want to do? If the answer is yes then it’s probably time to make a change. Just remember that while the phobia itself might be irrational a healthy respect and a moderate amount of anxiety around the object of that phobia is not just reasonable but in your best interests. The idea behind the stair stepping approach is to make the irrational fear subside not to make the rational, healthy fear disappear completely. The endgame is the ability to interact with the object of the phobia without debilitating anxiety but with a reasonable amount of anxiety.