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psychotherapist with whom you should consult about any self-help
efforts. If any of these conditions apply to you, see a professional (or
continue with the one you are seeing).
Attacking the behavioral-environmental parts of the problem
Confront the stressful situation
There are researchers who contend that the most effective way
(maybe the only way) to reduce a fear or phobia is to repeatedly face
and handle the scary situation (Marks, 1978; Jeffers, 1987; Greist,
Jefferson & Marks, 1986), if you can. You need to find out that the
imagined awful consequences don't actually occur (Epstein, 1983;
Rachman, 1990). So, if you are afraid of swimming, go swimming
every day and do it safely. If you are uncomfortable meeting people,
go to parties and socialize more, go out of your way to meet new
people. If you are afraid of speaking up in class, try to ask a question
or make a comment, when appropriate, every day in some class. Take
a speech class.
This idea of getting back on a horse that has thrown you as soon
as possible is not a new idea. Almost 100 years ago, Freud said that
talking to a therapist would not overcome specific fears; instead you
have to confront the frightening situation. Most therapists today agree
that it is essential to practice approaching and handling stress, rather
than avoiding it. First, it may help to learn a good approach by
watching others (a model), seeking advice (read chapter 12!), or
correcting some false ideas you have about the situation (see
imagination) rehearse or to role-play with a friend an improved
approach to the situation (see chapter 13). Certainly some planning
and practice may be helpful, but don't get bogged down over-
preparing. Go do something! Take a friend along if there is any danger
or if you need support. You may also prefer to expose yourself to more
threatening situations gradually, developing skills and confidence as
you go. Marks (1978) suggests it doesn't matter much if you are
scared, what matters is that you have the courage to do it and stay in
the scary situation long enough to master it. The details for
confronting a fear are given in chapter 12.
Keep in mind that we are speaking only of physically harmless
situations. On the other hand, if you are afraid of water, a very real
fear if you can't swim, it would be both physically dangerous and
emotionally traumatic--just plain stupid--to go into deep water. Always
protect yourself from real dangers!
Exposure doesn't always work well, however. Hoffart (1993) found
that about 50% of agoraphobics (afraid of having a panic attack in
public places) drop out or do not respond to exposure therapy. Almost
half of agoraphobics who stay in therapy and get some benefit
continue to have some symptoms. This has encouraged the
development of other methods, especially cognitive techniques. Also,
