90
The latter is considered by some to be "deeper" or real cognitive
therapy.
First, let's compare two different treatment approaches based on
different theories. There is a squabble between conditioning and
cognitive explanations of fears. You may need to understand these
different theories in order to select the self-help method that best fits
your condition. Each theory recommends somewhat different
treatment methods, e.g. exposure to the scary situation vs. changing
erroneous ideas (next 3 methods) or guided mastery. If phobias are
largely conditioned physiological reactions, then you should be able to
reduce the phobia response by exposing yourself for a long time to the
harmless but frightening object or situation (although this alone would
surely change your appraisal of the situation). But, if phobias are
largely caused by your own erroneous beliefs or thinking, you would
need to correct your appraisal of the situation, learn some skills useful
in that situation, correct your false conclusions about the situation,
and re-evaluate your ability to cope with that situation. A therapist,
self-help guide, or ordinary person acting as a model would probably
be helpful when using many cognitive techniques with strong fears or
panic.
Despite being very different theories, the treatment of fear based
on conditioning and cognition have a lot in common. Both eventually
require the frightened person to confront the frightening but harmless
situation. This exposure will usually gradually extinguish the intense
fear response and cause the person to think more realistically about
the situation. Which is the critical change? The scientist needs to
know. It doesn't matter much to the phobic, if his/her treatment
method works. If the method you try doesn't work, just select another
method.
Is it possible that some fears are based more on conditioning and
others are caused more by fantasies and faulty perceptions or
thinking? Yes, very likely, although psychologists can't, at this time,
tell one kind of fear from another. Joseph Wolpe used desensitization
with a patient fearful of cockroaches. It didn't work. Then he learned
that her husband was nicknamed "Cockroach" and that they had
serious marital problems. After Wolpe did marital therapy, the
relationship improved and the cockroach phobia went away without
special treatment. Wolpe now believes about 1/3 of phobias are
cognitive and don't benefit from desensitization, which he "invented."
So, when we are distressed, we will just have to try different
treatments and see what works best for us. Knowing the different
theories, however, helps you find or devise different approaches to
changing.
Fortunately, the research to date indicates that both exposure to
the frightening situation and correcting our faulty perceptions and
conclusions are generally effective in reducing fears. As you consider
the next three cognitive methods try to decide which would work best
for you.
