for Fears and Phobias
Exposure Therapy has been shown to be the most
effective anxiety treatment for people with many
anxiety disorders. You might already know that it
involves practicing with what you fear, in order to
become less afraid. But how does it work?
Exposure Therapy helps you retrain your brain. It's
not just about "getting used to" the fear. It's about
retraining your brain to stop sending the fear
signal when there isn't any danger.
People struggle against anxiety attacks and
phobias because they recognize that their fears are
exaggerated and illogical. They try hard to talk
themselves out of the fear.
But that doesn't help. So they end up trying to
avoid the fear, and that, unfortunately, just
strengthens it.
Exposure Therapy will help you retrain your brain
to let go of phobias, anxiety attacks, and other
forms of anxiety disorders.
Let's see how Exposure Therapy works.
Fight or Flight
When your brain gets a signal of danger, it triggers
an immediate response, the familiar Fight or Flight
response. That's a good thing, because when we
face danger, we need to react quickly and
powerfully.
Humans evolved in a different world than the one
we inhabit today. It was a world full of predators,
without police or deadbolt locks. Our main job was
to get enough to eat each day without becoming
food for somebody else. We needed a good
emergency alert system to keep us out of the jaws
of predators.
If we had relied on the thinking, intellectual part of
our brain, called the cerebral cortex, to keep us
safe, we'd be extinct. It's too slow. It's good for
writing a speech, and figuring out your income tax,
but not for making snap decisions about danger.
The part of your brain that handles these Fight or
Flight responses is very different from the part of
the brain you're most familiar with.
The Amygdala
The Amygdala, a little almond shaped part of your
brain, is what makes these Fight or Flight
decisions. The Amygdala works quickly, without
your conscious awareness, because speed is vital
in protecting against threats. You only find out
what the Amydgala did when you feel its effects in
your body (all the familiar panic sensations) and in
your behavior (duck, run, escape).
Whenever we make a decision, there are two
possible kinds of errors. One is a false positive. If
you decide there's a tiger hiding in the tall grass,
when there isn't one, that's a false positive. When
you make a false positive error, you get afraid in
the absence of danger, but you don't get eaten.
The second type is a false negative. If you decide
there's no tiger hiding in the tall grass when there
really is one, that's a false negative. When you
make this false negative error, you feel okay, but
you're gonna get eaten.
Your Amygdala doesn't care how many times it
scares you unnecessarily. It just aims to keep you
alive. It doesn't want to make any false negative
mistakes.
If you experience phobias and anxiety attacks, and
want to overcome them, you need a form of
anxiety treatment which will retrain this part of
your brain. The most direct and systematic way to
do that is Exposure Therapy.
How Your Amygdala Works
Always Watching
Your Amygdala is always watching, passively, in
the background, for some sign of danger. When it
sees one, true or false, it presses the "fight or
flight" button and fills you with fear. When the
danger is real, that's a good thing. But your
Amygdala works like it's still 27,000 B.C., and will
often make the mistake of seeing danger when
there's none.
It Learns by Association, not Reason or Logic
When you run away from whatever the apparent
danger is, the Amygdala stands down and goes
back to quietly watching. If you ran away from a
mugger, that's a good thing. But if you ran away
from a grocery store, or a dog on a leash, that's a
bad thing. Now your Amygdala will be conditioned
to see the grocery store or the dog as dangerous,
and will make you afraid next time you see one.
The Amygdala learns by association. It associates
the crowded store, or the dog, with danger. It
doesn't learn by conscious thought. This is why
you can't simply talk yourself out of a phobia or
anxiety attack. The fear memory is stored as a
conditioned fear, and can only be relieved by more
conditioning, not discussion or reason.
It only Learns When You're Afraid
The Amygdala only learns when it's fully activated,
when it spots something it considers dangerous. It
only forms new memories and associations, new
lessons, when you've become afraid. The rest of
the time it's on autopilot, passively watching.
Do you see what this means? If you stay away
from what you fear, your Amygdala will keep on
"believing" the same old mistakes, without a
chance to learn anything new.
How Can You "Talk" to Your Amygdala?
Your Amygdala only learns from experience. If you
flee the scene every time you have an anxiety
attack, your Amygdala learns that you should leave
to be safe.
How can you get your Amygdala to learn
something new? You have to activate it by
exposing yourself to a trigger that gets you afraid.
If you have a dog phobia, that would be a dog. If
you have anxiety attacks on subways (or
highways), you need a subway (or a highway). And
you need to stay there with that fear until it gets a
lot lower.
That gives your Amygdala the chance to learn that
it got all worked up about nothing. That way, it can
learn that dogs (or highways) aren't the threat that
it had been conditioned to believe. And, with
repetition, it will develop a new memory, one that
lets you get on with your life without being
disrupted by phobias and anxiety attacks.
Retraining Your Amygdala
That's how Exposure Therapy works. Exposure
Therapy retrains your Amygdala.
You don't have to do this radically and quickly.
What you need to do is to continually arrange to
activate your Amygdala by exposing yourself to
what you fear, and then stay in place, making sure
that the fear leaves before you do. You can use a
variety of coping steps to help you do that, or you
can just "float", as Claire Weekes called it, and wait
for the fear to subside. Either way, Exposure
Therapy will enable you to retrain your Amygdala
with new learning in ways it can absorb.
I offer this treatment in the Chicago area, and if
you're looking for help here, you can contact me
by phone or e-mail. If you want to learn to do
some of this on your own, my Panic Attacks
Workbook will show you how.
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