Many people struggle with a phobia, a powerful but irrational fear of a situation, object, or person. For some people, these fears are so mild that they don’t cause much distress, such as someone who feels a little upset at the sight of blood, but manages to shake off that feeling and move on.
However, some people grapple with phobias so strong that they impact their lives. If phobias prevent you from doing things you want to do, or the anxiety they create is causing you intense distress, you may want to consider treatment. We have found that Cognitive Behaviour Therapy (CBT) is a powerful way to help patients find relief from phobias. Here’s what you should know about this approach and how it works.
Facts About Phobias
According to the Canadian Psychological Association, phobias affect roughly one in 10 Canadians. These powerful fears may be the result of a traumatic situation, such as a dog attack, that results in persistent fear of all dogs, no matter how gentle most may be. Sometimes, however, people have no memory of any event that could have triggered their phobias.
Phobias can significantly alter someone’s life, preventing them from engaging in normal activities and causing them stress and anxiety. If a phobia is causing you distress, the good news is that there is effective treatment available.
Given how much anxiety is associated with phobias, you might expect antianxiety medication would help. However, medications have been shown to be mostly ineffective when dealing with phobias. Patients are sometimes prescribed short-acting medications to help them get through very difficult situations, but this approach may only be a temporary solution. These medications can even make people feel as though they have less control over their reactions.
On the other hand, therapy has been found to be quite effective. Specifically, CBT is considered the treatment of choice when dealing with phobias, and there is solid research to back that up.
A Brief Look at the Evidence
The body of research supporting the use of CBT when treating phobias is impressive. A review of 41 of these studies was published in the journal Neuropsychiatric Disease and Treatment. It concluded that the evidence showed that CBT was more effective than other psychological techniques. The meta-analysis also showed that CBT Therapy provided longer-lasting relief than medications, such as SSRI antidepressants.
The relief patients experience from CBT goes deeper than you may expect. The journal Psychiatry and Clinical Neurosciences published a meta-study that dug into the research on how CBT affects the brain’s response to phobias. After patients went through CBT, scientists were able to use functional brain imaging to show how their brains reacted to exposure to their phobias.
The imaging showed that their brains had less stimulation in the areas that are associated with fear and heightened emotions. Simply put, CBT helped them adjust to how the brain responds to the phobia, reducing their fear and discomfort.
Here’s how that works.
Focusing on Cognition
One of the pillars of CBT is examining your thoughts and how they affect your feelings and behaviours. When addressing phobias, one of the frustrating obstacles is that logic doesn’t have much impact on the fear. For example, knowing that air travel is safer than driving doesn’t take away someone’s fear of getting on a plane.
But CBT approaches thoughts differently. Rather than labelling certain thoughts or reactions as “wrong,” patients learn to observe their thoughts without judgment.
Through this practice, patients start to recognize cognitive distortions, or thought patterns that are inaccurate or unhelpful. Being aware of these distortions helps you to replace these thoughts with other ones. In the case of a phobia, that process might include:
- Becoming aware that you’re experiencing a phobia.
- Reminding yourself that the feelings will pass.
- Paying attention to any thoughts you may have that are adding to the fear.
- Replacing the inaccurate thoughts with accurate ones.
Mindfulness is an important part of CBT, and it can help people with phobias stay grounded in the moment. Being able to use skills such as meditation and tuning into how your body is feeling can be powerful when you are facing a phobia. These tools can help you interrupt the self-feeding spiral of fear and cognitive distortions.
Another important tool used in CBT is exposure therapy. The goal is to help patients to systematically encounter the object of their phobia. Over time, these repeated exposures help them to feel less afraid and more in charge of their responses. To make this a positive experience, the process is done in a carefully controlled way.
First, patients are taught relaxation techniques they can use when they feel anxious. Once they have the skills to calm themselves, they are gradually exposed to their phobia, starting with the least anxiety-producing encounter possible. For example, someone who is afraid of snakes may look at a picture of one. If a photograph is too upsetting, they may instead start with a cartoon drawing.
At each stage, the patient encounters their fears and practices their relaxation techniques, becoming desensitized to the stimulus over time. When they are ready to move on, they move to the next encounter, such as viewing a photograph or video of a snake.
This process trains the brain to deal with the item or situation that causes fear, dialing down the heightened response. Eventually, the patient becomes ready to face the specific situation that causes their fear. This time, they are prepared to deal with the feelings that come up. This approach has been shown to be very effective in treating phobias.
If you are struggling with a phobia, you don’t have to fight this battle alone. The compassionate, skilled therapists at Trillium Counselling are here to help you find freedom from your fears. If you would like to get more information or schedule an appointment, we urge you to contact us today.