Exposure Therapy: How To Prevent Fear From Ruining Your Life

From a young age, Howard Hughes showed incredible potential for success. Before his thirteenth birthday, Hughes built a motorized bicycle out of spare parts from a steam engine and created the first wireless radio transmitter in Houston, Texas. ¹

Sadly, Hughes lost his mother when he was 16 and then his father only two years later. His parent’s death made Hughes the owner of the family tool company and an estate worth close to $1 million.

Because he was uninterested in managing the business, Hughes hired accountant Noah Dietrich for the job. In just five years, Dietrich grew the estate to an astonishing $75 million. ²

Over the next two decades, Hughes’ meteoric rise to prominence continued. First, he became a notable Hollywood film producer and the winner of an Academy Award. Then, he built the Hughes Aircraft Company and became a key player in the birth of the aviation industry.

By the age of 60, Hughes was the world’s richest man, but his life had taken a tragic turn by that point.

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In his later years, Hughes developed an irrational fear of germs that took over his life. ³

To avoid germs, Hughes isolated himself in sealed-off hotel rooms for months at a time. He lived naked to avoid contact with clothing that might contain germs and wore Kleenex boxes on his feet to prevent contact with the floor.

Near the end of his life, Hughes avoided contact with everyone except his security guards and doctors. Even his wife Jean Peters had not seen Hughes for years before filing for divorce.

Learning From Hughes

The story of Hughes contains an important lesson. That is, fear can impact the quality of your life.

While most will never experience the crippling level of fear felt by Hughes, many will be affected by fear in some way. For example, you might never get ahead in your career if the fear of rejection keeps you from asking for a promotion.

In this article, I’ll explain how you can prevent fear from taking over your life by giving you a framework for overcoming fear.

Understanding The Two Types Of Fear

Before you can manage your fear, you must understand the distinction between rational and irrational fear.

Rational fear is an appropriate level of fear linked to a specific object or event. An example of a rational fear is the fear you would feel if you were attacked on the street.

Rational fears act as helpful warning signs that have kept humans alive for millions of years.

Irrational fear is an unrealistic level of fear linked to a specific object or event. These fears exist because your brain believes something is more threatening than it is. An example of irrational fear is dentophobia—the fear of visiting the dentist.

Irrational fears are false alarms that can affect your life in many ways. Here are two examples.

First, irrational fears might cause you to avoid things that improve your life. For example, you might avoid going on a date because you have an irrational fear of rejection.

Second, irrational fears can reduce your ability to make logical decisions. That’s because irrational fears activate the fight or flight response which inhibits the part of your brain responsible for logical thinking.

A Secret Weapon For Dealing With Irrational Fear

One of the most effective ways to manage irrational fear is using exposure therapy. One study following patients for an average of 4 years post-treatment showed that a single session of exposure therapy significantly reduced fear, avoidance, and impairment in 90% of patients and completely eliminated phobias in 65% of patients. ⁴

Here’s how exposure therapy works.

Someone with claustrophobia—a fear of confined spaces—might have an irrational fear of getting trapped in an elevator. This irrational fear exists because their brain has created an irrational association that says, “if I use an elevator, I will get trapped inside.” As a result, they avoid elevators at all costs.

In reality, the chances of getting trapped inside an elevator are extremely rare. According to elevator experts Elevating Studio, the odds of getting trapped inside an elevator during any single trip is 1 in 1,000,000. ⁵

Exposure works by turning irrational associations into rational associations. Here’s how the process works.

Research by Joseph LeDoux explains that when you repeatedly show your brain that something isn’t actually threatening, your brain rewires a new association. As a result, the false alarm stops ringing. ⁶

To convince your brain that elevators aren’t threatening, a person might:

• Read about the reliability of elevators
• Watch others use elevators without getting trapped
• Use an elevator themselves

After this series of exposures, the association, “if I use an elevator I will get trapped inside,” might become, “if I use an elevator I could get trapped inside, but that is highly unlikely.”

The Benefits Of Exposure Therapy

Exposure therapy has four main benefits.

1. Clear thinking. When you turn off the false alarm, you also turn off the fight or flight response. As a result, your brain chemistry returns to normal, and you regain the ability to think logically.

2. Beneficial behavior. When fear no longer prevents you from taking action, you can do the type of things that improve your life. For example, your relationships improve when you feel comfortable speaking up for yourself. And your professional life gets better when the fear of rejection doesn’t prevent you from applying for a new job.

3. Less fear. Those who practice exposure therapy often report feeling less fear. However, I say this with a warning. You should never expect to control your emotions because they are largely out of your control. Doing so is a form of avoidance that typically makes them worse.

So, if you experience less fear after practicing exposure therapy, consider that an added benefit, not an expected outcome.

4. More control. Ultimately, exposure therapy teaches you that you can take positive action despite feeling fear. Facing your fears isn’t easy, but if you have courage, you can regain control of your life.

How To Use Exposure Therapy To Overcome Fear

You can use the following steps to practice exposure therapy. ⁷

1. Identify What You’re Avoiding

Before you practice exposure therapy, you first have to identify what you’re avoiding. Many people struggle with this step because identifying your problems takes a considerable amount of self-awareness—a skill that many people lack. You can help yourself overcome this problem by asking yourself a simple question.

What do I wish I could do?

For example, you might wish that you could ask someone for a date, say no to your friends, or start a YouTube channel.

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2. Write Down What You Expect To Happen

Once you’ve identified what you wish you could do, ask yourself what you think will happen if you do it.

You might think that asking for a date will end with someone laughing in your face. Maybe you think your friends will never speak to you again if you say no. Or, perhaps you believe that people will criticize your ideas if you start a YouTube channel.

3. Start Small

Some people practice exposure therapy using a technique called flooding. With flooding, you begin treatment by exposing yourself to the largest stimulant possible. So, if you’re afraid of spiders, flooding is the equivalent of covering yourself in tarantulas on day one.

While there is evidence that flooding works, most therapists avoid it because patients find the treatment extremely uncomfortable. ^{8 9}

A better approach is a technique called graded exposure. With graded exposure, you start with a small stimulant and build to larger stimulants.

Here’s an example of a graded exposure progression for addressing the fear of spiders.

1. Look at pictures of spiders
2. Watch videos of spiders
3. Look at dead spiders
4. Look at live spiders in a cage
5. Hold a spider

Each step in a graded exposure progression is designed to produce the highest amount of fear that you can tolerate at that time. I’ll use the spider progression from above to explain this point.

In the beginning, looking at pictures of spiders might produce the maximum amount of fear that you can handle. However, by repeatedly exposing yourself to pictures of spiders, you’ll naturally become more comfortable with those images. This process is called habituation.

Once you become comfortable looking at pictures of spiders, you identify the next largest stimulant you can tolerate and repeat the process. You continue these steps until you can perform your desired behavior.

Here’s how you can use graded exposure to overcome your fears.

If you want to ask someone for a date but fear rejection, progress by asking people you find attractive for the time, directions, and their opinion.

To develop the courage to say no to your friends, progress by saying no to your waiter, co-workers, and family.

And, if you want to start a YouTube channel but fear criticism, progress by sharing your videos with your family, friends, and co-workers.

4. Take Positive Action Despite How You Feel

Fear becomes problematic when it prevents you from doing the things that improve your life. Knowing this, here is one of the most important things you can learn when dealing with fear. You can take positive action even when you feel afraid.

You can ask for a date despite the fear of rejection. You can say no to your friends despite being afraid that you’ll upset them. And you can post a video to YouTube despite the fear of criticism.

Ultimately, overcoming fear begins with courage.

“Courage is not the absence of fear, but the mastery of it.” —Mark Twain

5. Take Note Of What Actually Happened

After you take your first step, write down what actually happened. Then, compare that to what you thought would happen. More often than not, what you thought would happen will be worse than what actually happened.

So, if you ask someone for a date, and their answer is no, it’s unlikely they will laugh in your face. Instead, it’s more likely that they will politely decline the offer.

If you say no to your friends, it’s unlikely that they won’t speak to you again. Rather, it’s more likely that they’ll still love you.

And, if you post a video on YouTube, it’s unlikely that you’ll get flooded with criticism. Instead, it’s more likely that you’ll receive some criticism but more praise.

Ultimately, this step provides the proof your brain needs to rewire a new association.

6. Ditch Your Security Blanket

Many people with irrational fears comfort themselves with objects or rituals.

For example, someone who fears social interaction might bury their face in their cell phone to avoid communicating with others. Or, someone who feels nervous before a big event might develop a ritual of obsessively checking and rechecking that they are ready.

Once you’ve started exposure therapy, try to reduce any use of objects or rituals.

7. Add Variability

Once you’ve overcome your fear in one context, try to overcome it in another context.

So, if you found the courage to ask someone out using a dating app, try asking someone out in person. If you said no to your friend’s movie choice, try saying no to their weekend plans. And, if you posted a video on YouTube, try posting the same video on FaceBook or Instagram.

How To Overcome Problems When Following This Advice

Here are two common problems you might face when practicing exposure therapy.

1. You have a bad experience. Technically, you could be the 1 in 1,000,000 who gets trapped in an elevator. Hopefully, that doesn’t happen, but don’t give up if you have a bad experience. Instead, try the new behavior several times to find an average outcome.

If you continue having bad experiences, that’s a sign that your current stimulant is too strong. In that case, find a smaller stimulant and try again.

2. You expect to get better right away. Most valuable improvements don’t happen overnight. Instead, they demand consistent effort. Exposure therapy is no exception to this rule.

So, if your first attempt doesn’t produce the desired result, that’s ok. With enough persistence, there’s a good chance you’ll experience a noticeable improvement in time.

How To Know When You Taken These Ideas Too Far

The following two examples explain what can happen if you take the ideas in this article too far.

1. You expect to feel no fear. It’s completely unrealistic if you expect to feel no fear. The best athletes, entertainers, and business professionals feel fear for many reasons.

Remember, the goal of exposure therapy is not to eliminate fear. Instead, exposure therapy helps you develop the courage to face your fears.

2. You try to eliminate rational fears. It’s important to remember that rational fear is helpful. For example, if someone breaks into your home, the fear you feel is sending you an important message. Using exposure therapy to manage this type of fear would be a bad idea.

So, before you attempt to manage your fear, ask if the fear is rational. If it is, figure out what the fear is telling you and take action.

In A Nutshell

Here are the key takeaways from this article.

• Rational fear is an appropriate level of fear linked to a specific object or event.
• Irrational fear is an unrealistic level of fear linked to a specific object or event.
• Fear can affect the quality of your life by (1) making you avoid positive behaviors and (2) reducing your ability to make logical decisions.
• Exposure therapy is a highly effective strategy for managing your fear.
• Exposure therapy helps you (1) think clearly, (2) behave in beneficial ways, (3) reduce irrational fear, and (4) develop more control.
• To practice exposure therapy, (1) identify what you’re avoiding, (2) write down what you expect to happen, (3) start small, (4) take positive action despite how you feel, (5) take note of what actually happened, (6) ditch your security blanket, and (7) add variability.
• Avoid common problems when practicing exposure therapy by (1) not giving up if you have a bad experience and (2) staying consistent.
• You’ve taken the ideas in this article too far if (1) you expect to feel no fear and (2) you try to eliminate rational fears.

Books That Influenced This Article

The following book links are Amazon affiliate links. If you purchase a book after clicking one of the links, I will receive a commission.

ACT Made Simple
Book | Kindle

The Upside Of Stress
Book | Audiobook | Kindle

Footnotes

1. Howard Hughes. Wikipedia.
2. Howard Hughes. Entrepreneur.com. (October 10, 2008).
3. Raj Persaud. The aviator on the couch. INDEPENDENT.co.uk. (December 13, 2004).
4. Johanna S. Kaplan, Ph.D., David F. Tolin, Ph.D. Exposure Therapy for Anxiety Disorders. Psychiatric Times. (September 6, 2011).
5. How Reliable Are Elevators And Escalators. ElevatingStudio.com. (May 21, 2018).
6. Joseph E. LeDoux. Wikipedia.
7. Note: A big thanks to author Kelly McGonigal and her book “The Upside Of Stress” for influencing this list. KellyMcGonigal.com
8. Barbara Olasov Rothbaum, Page Anderson, Elana Zimand, Larry Hodges, Delia Lang, & Jeff Wilson. Virtual reality exposure therapy and standard (in vivo) exposure therapy in the treatment of fear of flying. National Library Of Medicine. (February 24, 2006).
9. Sarah Schumacher, Robert Miller, Lydia Fehm, Clemens Kirschbaum, Thomas Fydrich, & Andreas Ströhle. Therapists’ and patients’ stress responses during graduated versus flooding in vivo exposure in the treatment of specific phobia: A preliminary observational study. National Library Of Medicine. (November 10, 2015).