Anxiety sufferers employ countless strategies for trying to overcome their anxiety. I’ve found that many of these techniques go in one of two directions: either making symptoms less troublesome (such as medication, calming herbs, and relaxation techniques), or giving the body something it may need (vitamins and minerals, exercise, or more sleep, for instance). Both approaches are valuable, of course, and provide a key element in any anxiety treatment plan. But there is another crucial step you must take if you really want to beat anxiety – facing the fears and worries that cause your anxiety in the first place.
Whether you suffer from a specific phobia, struggle with obsessive compulsive disorder (OCD) or have general, persistent stress and worry over everyday things, fear has taken on a leading role in your life. And many of our responses to our anxieties — including compulsive behaviors, avoidance, and procrastination — come about from a desire to eliminate our fears without ever having to face them.
What is Exposure and Response Prevention?
Debra Kissen, a clinical psychologist who specializes in anxiety, describes the need to “put your anxiety monster on a diet.“ As Kissen says, “There is nothing this monster enjoys more than your avoidance of fears, reassurance that negative events will not occur, plus a whopping heap of compulsive behaviors.” Whether consciously or subconsciously, people cling to their anxieties believing that it is making them safe from the things they fear, but the opposite is true. Anxiety will keep demanding more of your time and energy and life if you don’t take control now.
Kissen advocates a technique called exposure and response prevention (ERP), which has been very successful in helping patients with OCD and phobias overcome their fears. ERP was born from cognitive behavioral therapy (CBT), a popular type of therapy that has been shown to be very effective in treating anxiety disorders. With ERP, patients learn that avoiding their fears or needing excessive reassurance simply perpetuates the cycle of anxiety.
Facing the fear head-on, however, has the opposite effect. While confronting your fear does not make you instantly “over it,” it does allow you to see that you actually are able to cope with the situation and any discomfort it may cause. And because a chief component of anxiety is the belief that we will not be able to handle whatever the fear is, seeing that we can indeed handle something frightening ultimately serves to decrease overall anxiety levels.
Recently, neuroscience has found supporting evidence for the effectiveness of ERP. In a report published in the journal Neuron, scientists reveal that they’ve identified the region in the brain related to courage — the subgenual anterior cingulate cortex (sgACC). The scientists found that the sgACC acts to silence the amygdala, which is the part of your brain responsible for fear. And the more a person activates the sgACC by facing a fear without succumbing to it, the stronger the sgACC response continues to be. I’m consistently fascinated at how our brain so often functions the same way muscles do – the more often you “work out” a certain area of your brain, the better it performs!
How to Face Your Fears
I encourage those with severe OCD or phobias who are interested in ERP to seek a skilled cognitive behavioral therapist to work with them on this process. However, I think that those who struggle with everyday anxiety can see a lot of benefit from practicing ERP techniques and facing their fears on their own. I’ve recently taken some steps toward doing just that and have already seen some success!
My anxiety tends to cause me to feel overwhelmed by everyday tasks and to procrastinate on little things – making phone calls, scheduling doctor’s appointments, beginning projects at work, etc. My anxious voice tells me that I just “won’t be able to handle it” and then I become fearful of tackling responsibilities. But with this new research in mind, I made a list of all the unfinished and not-yet-started tasks that had been causing me to lose sleep at night. Next, I wrote down a specific action or actions next to each one that I could take to face the problem.
Each day, I’ve chosen the task I want to zero in on, and forced myself to take the action or actions I outlined. So far I have made many of those phone calls, scheduled appointments, and began tackling several projects at work. And you know what? While my heart may have been racing and my hands shaking prior to taking each step, ultimately, I slept easier that night knowing that I’d faced the fear and the task was done.
Avoiding and procrastinating had led me nowhere except toward more anxiety, but facing these fears has given me a wonderful sense of accomplishment and belief in my ability to handle the things I’ve been telling myself I couldn’t.
In a series of articles for the Huffington Post, Kissen describes how to apply ERP to your life. I highly encourage everyone to read what she has to say, but to get you started here are some steps she recommends toward facing your fears to beat anxiety:
Take baby steps. You are more likely to see success if you take baby steps rather than trying to tackle everything all at once. With each small victory, you will gain confidence and momentum. Set the bar too high and you run the risk of self-criticism, increased anxiety, and the desire to give up.
Set daily goals. I recommend making a list like I did and checking the items off one day at a time. If your fear is BIG – say, you’re terrified of heights – weekly or even monthly goals may be a better approach. For instance, going up one floor higher in a tall building each week until you finally make it to the top floor.
Avoid all-or-nothing thinking. It is unrealistic to expect to banish all your fears overnight or even in a month. If your fears have been around for a long while, expect it to take quite a bit of time and dedication to overcome them. Don’t be discouraged or give up when you have setbacks – remember, you have begun to actively face your fears, and that is the most important step. Keep “exercising” that part of your brain, and eventually it will become easier and easier.
Finally, I believe it’s very important to take steps not only toward facing your fears, but also toward building positivity in your life too. Learn to identify and put a stop to negative self-talk, and practice visualizations and positive affirmations to further boost your confidence and coping abilities.