This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
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Treatment option 37: Practicing your fears
In When Things Fall Apart: Heart Advice for Difficult Times, Pema Chödrön tells the story of a young warrior who asked Fear how to defeat him. Fear replied, “My weapons are that I talk fast, and I get very close to your face. Then you get completely unnerved, and you do whatever I say. If you don’t do what I tell you, I have no power. You can listen to me, and you can have respect for me. You can even be convinced by me. But if you don’t do what I say, I have no power.”
Exposure therapy is the behavioral method of choice for overcoming acute and specific anxieties. It prescribes a two-step approach: first, doing what you’re afraid to do; and second, allowing yourself to feel the discomfort without running away.
Carefully and gradually, a person is exposed to the activities or situations that bring feelings of panic so that their minds and bodies can acclimate. Social anxiety, fear of failure, fear of saying the wrong thing–even fear of not checking the door lock five times before bed–all of these respond well to simply doing them anyway … then noticing the uncomfortable feelings slowly fade.
Though exposure therapy is primarily a behavioral strategy, it is a cognitive one, too. If you’re afraid to ride on a plane and you practice doing so over and over while also practicing your distressing narrative, you might never overcome your fear. Use helpful self-talk.
When in doubt, ask a therapist to guide you through this challenging process. They will help you identify which fears to tackle first and how to coach yourself through uncomfortable moments. In addition, they might suggest a systematic approach that allows you to break down your feared experience into small steps that you can practice one at a time.
Here is a script that can be used during exposure therapy: “I feel uncomfortable right now, and that’s okay. I am allowed to feel this way. This feeling isn’t fun, but it is temporary. I am strong enough to handle it.” Edit as desired. The key here is that you don’t fight the anxiety you experience; instead, you welcome it, knowing it’s an important part of the corrective process. Each time you feel anxious while practicing your fear, then practice it anyway, you have taken another step toward defeating it.
When I was in college, I came across this quote by Ralph Waldo Emerson: “Always do what you are afraid to do.” At the time, I didn’t have many guiding principles; this became one of my first. I’ve been following it for over twenty years.
To learn more about exposure therapy, including some novel (and in some cases, hilarious) cognitive and behavioral strategies, read When Panic Attacks: A New Drug-Free Therapy to Beat Chronic Shyness, Anxiety and Phobias by David Burns.
If desired, add “practicing your fears” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
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