Coastal Center for Anxiety Treatment

Name card of Dr. Eric goodman.

Step 8: Facing your fears the right way

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If you’ve read through the educational material on anxiety disorders and OCD, one thing is perfectly clear:

In order to cope and thrive with an anxiety disorder or OCD you need to shift from anxious avoidance to a courageous approach. In other words: face your anxious fears.

You may also recall that it is not enough just to come face to face with your anxiety triggers, but you must do so without compulsions, safety behaviors, or emotional numbing out.

This is called “Exposure with Response Prevention” or ERP.

Tips and Strategies to Help You Face Your Anxious Fears

1: You need a good defense and offense in order to win the game

Your defensive strategy is how you handle triggers that spontaneously arise, for example:

  • Turbulence on your flight
  • Your boss suddenly asks to meet with you
  • Being called on in class or during a meeting
  • An attractive person says “hello” to you at a party
  • You get invited to a social event where you may not know a lot of people
  • A spider walks across your kitchen counter

Each spontaneous trigger offers you an opportunity to face your fear and cope adaptively.

Your offensive strategy, on the other hand, involves you intentionally seeking out triggers so you can practice coping adaptively.

2: Set your pace

You can choose to face a fear for five minutes, every other Wednesday for the next thirty-five years and have limited success or you can set a pace that keeps you moving forward and making progress steadily.

Research shows that planning frequent, longer exposures, are much more likely to lead to real progress in a shorter period of time compared with less frequent and shorter exposures.

3: Break your challenges up into small concrete steps

If social anxiety is interfering with your ability to form a romantic relationship, for example, you could try:

  • Being around more people—walk around the block, go to the grocery store, head to the local farmers market, and so on.
  • Do those things, but make eye contact
  • Now add smiling
  • Say “hello” to increasing numbers of people
  • Make brief small talk (or learn and practice small talk skills first)
  • Now, go to where you will see the same people more often (gym, clubs, church, classes, volunteering, etc.)
  • Practice friendliness skills in those situations
  • Ask someone to meet for coffee before or after
  • …and so on

4: Set up behavioral experiments

Behavioral experiments test out phobic concerns. These experiments are especially useful for testing out social anxiety concerns.

Let’s look at some examples:

  • Predicted Outcome: If I talk to the attractive person at the party, she will reject me.
  • Actual Outcome: We had a pleasant five-minute interaction.
  • Reasonable Conclusion: Maybe attractive people at parties are regular people too!

 

  • Predicted Outcome: If I volunteer to do a presentation at the next meeting, I’ll screw it up and people will laugh at me!
  • Actual Outcome: I gave a talk and even though I couldn’t figure out how to project the PowerPoint presentation someone helped me and it went fine.
  • Reasonable Conclusion: Maybe public speaking isn’t as risky as I thought.

 

  • Predicted Outcome: If I disclose to my friends that I am dealing with an anxiety disorder, they will no longer want to be my friends.
  • Actual Outcome: Two of them shared that they also deal have had panic attacks. My friends were very supportive.
  • Reasonable Conclusion: Being a bit vulnerable among my friends may actually deepen my friendships rather than end them as I feared.

Through repeated experimentation you can get a better idea of how things actually are, rather than how anxiety says that they are. If anxiety does turn out to be correct (e.g. I get rejected), then you can see that it likely is not as CATASTROPHIC as anxiety said and you can learn from the experience (perhaps learn and practice new social or vocational skills) in order to have a different outcome in the future.

5: Building up anxiety and uncertainty tolerance muscles

Repeatedly exposing yourself to your anxiety triggers (that are safe, but trigger anxiety and uncertainty), while softly opening up to the thoughts and sensations generated is a good way to build up your ability to tolerate anxiety and uncertainty.

It is like going to the gym. If you are consistent and slowly increase the challenges as your muscles develop then you get stronger.

6: Designing values-consistent exposures

It is always nice if facing your fears leads to concrete movement towards a “well-lived life.”

Ask yourself what is truly important to you. At the end of a well-lived life, what will have mattered to you? For example:

  • Family
  • Friendship
  • Career
  • Service towards others
  • Spiritual pursuits
  • Exciting experiences

Try to come up with anxiety challenges that further you in your preferred directions. If family is important, perhaps you need to:

  • Pursue dating so you can move towards marriage and children
  • Perhaps you need to overcome a fear of flying so you can visit relatives on the other side of the country
  • Maybe you need to practice facing social fears so you can be better willing and able to talk with family over the phone
  • It could be that you need to manage your panic disorder or agoraphobia so you can take a family vacation
  • …and so on.

After all, if facing your fears isn’t leading you in the direction of a better life…what’s the point?

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