Avoidance versus Exposure: The Importance of Facing Your Fears
By Caroline Christian What are you afraid of? We are all afraid of something. Fear is not only normal, it is healthy! The tinge of fear you get when a large blur crosses your periphery when you are walking in the woods is the same fear that has kept humans alive for hundreds of thousands of years. Fear helps us to recognize and escape when we are in dangerous situations. The problem with fear is that we can become afraid of things that can’t really hurt us, such as taking a test, giving a presentation, or eating certain foods. These fears may stop us from doing things we like to do or from having meaningful relationships, potentially spiraling into more stress, anxiety, and even isolation. The good news is that there are things we can do to reduce these fears. There are basically two options: you can avoid the thing you fear or you can face the fear head on. To see these two strategies in action, let’s look at an example. Say you are afraid of talking to new people: 1) You can avoid putting yourself in a situation where you may have to talk to new people. This would likely mean avoiding grocery stores, job interviews, dating, holiday parties, traveling, doctors’ appointments, etc. The benefit of this is that never facing your fear can provide a brief sense of relief, and may lessen your anxiety in the short term because the fear is not imminent. However, the problem with this method is that avoidance can intensify the fear in the long term, because by never experiencing this irrational fear, you never see that it isn’t as bad as you thought it would be. 2) Or you can actively put yourself in situations where you will have to talk to new people. This could be something like: initiating small talk with a new coworker, asking someone on a date, complimenting a stranger at the store, hosting a party, etc. The downside of exposing yourself to your fear is that it can be difficult at first and may cause some (or a lot of!) anxiety. However, the benefit is that by facing the thing you are afraid of, you get to see that you are strong enough to handle it. Over time if you continue to expose yourself to that fear, the anxiety will lessen and the fear will have less control over your life. Thus, when it comes to handling fear it may be easier initially just to avoid it, but avoidance in the long-term only serves to worsen the fear. Exposure has the opposite effect: while it may be difficult initially, repeated exposures can lessen the anxiety and make it more bearable. This idea is the basis of exposure therapy, which is a cognitive-behavioral approach that has been shown to be effective in treating anxiety disorders, including specific phobias, PTSD, and OCD. Exposure allows people to confront their fears in a safe and controlled environment, so that when the fears come up in the real world, they have less anxiety and are equipped with the tools to handle it. In contrast to the many clinicians that utilize exposure to treat anxiety and eating disorders, there are a small number of psychologists that advocate for avoidance methods in therapy. This approach has been spurred by the increased awareness of using politically correct language and avoiding triggering words in our society. Topics that are controversial, or that could be potentially painful for individuals based on their past experiences, typically are avoided in academic or professional settings. Although it may be helpful in some places in our society, this type of avoidance does not have a place in therapy or rehabilitation programs. The problem with avoidance in therapy is the same as avoidance in the real world. By never experiencing the fear, you never see that it isn’t as scary as you imagined. This will cause the anxiety to build up, and then if something happens to trigger these emotions outside of therapy, the anxiety will be even worse. That is why exposure is so important in therapy- talking about things that are scary and anxiety provoking in a safe environment allows for less anxiety when faced in the real world. Additionally, there are things you can do outside of therapy to implement these strategies to better your own life. Beyond therapy, exposure also can be used to tackle everyday anxieties, like testing anxiety or public speaking. Taking sample tests, practicing with friends and coworkers, and visualization exercises are all exposure-based techniques that can help reduce tension and anxiety, so it doesn’t build up on the big day. So in conclusion, when it comes to battling your fears (whether they are big or small) choose exposure! Although it is difficult at first, in the long term it will give you more control over your fears. In the EAT lab, we are exploring the use of exposure therapy for eating disorders by exposing people to fears such as gaining weight, losing control, making mistakes, or eating certain foods. If you struggle with an eating disorder and you are interested in participating in these studies, click here! Additional reading: This article discusses ways in which we use avoidance in every day life, and may not even realize it! Check out this article on how to implement exposure strategies into your everyday routine.
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