Cognitive Behavioral Therapy and Facing Fears

Cognitive behavioral therapy, or CBT, focuses on how our thoughts (cognitions), actions (behaviors), and feelings (emotions) interact with each other. It teaches that by changing one of these, the other two will also be impacted. 

For example, if you change something about the way you think, you will feel differently and your behavior will be impacted. Or, if you do something different, you will think differently and how you feel will change as well. The same is true for your emotions-what you do and think are impacted by how you feel. 

CBT is used to treat a myriad of disorders and concerns and it is the treatment of choice for anxiety. Avoiding anxiety is negatively reinforcing, meaning that when someone avoids the anxiety provoking stimulus or situation and experiences temporary relief from the anxiety, he or she will be more likely to avoid the anxiety provoking stimulus or situation again.This can be problematic over time.

For example, let us imagine that John is afraid of dogs and therefore avoids dogs at all costs. Because of the negatively reinforcing nature of anxiety, his fear of dogs will remain elevated over time if he never gives himself the opportunity to have a positive interaction with a friendly dog or prove to himself that he can tolerate his anxiety. With avoidance, there is never the chance for new evidence to be presented to decrease or invalidate his original fear. 

Unfortunately, John’s fears may become generalized where his original fear of large, loud, German Shepherd dogs could spread to all big dogs and then to all dogs. As time goes on, his fear may further generalize to locations where dogs may be present or even to loud noises. Before long, John could become emotionally paralyzed by his anxiety and become quite limited in the places he feels comfortable going.

Because of the nature of anxiety, one of the most effective ways to reduce fear is to face it head on. This process can be done very gently and gradually (systematic desensitization) or all at once (flooding). A cognitive behavioral therapist helps clients identify specific fears and the related cognitions, behaviors, and emotions. From there, strategic steps are taken to help clients expose themselves to the feared stimuli or situations while being coached-and ultimately coaching themselves-through modified cognitions and from a more confident and relaxed place until they have met their personalized goals of being able to tolerate and even enjoy the once feared stimuli.  

Are there fears holding you back from enjoying your life?  Make an appointment with a cognitive behavioral therapist and get the tools you need to reduce your anxiety with CBT!

By: Shelly Reed, PsyD, S-PSB