Therapy for a specific fear

introduction

The therapy of a phobia, here the specific phobia, can be in addition to the psychotherapy also one medication (Anti-anxiety drugs). If a drug is used, a "Antidepressants"Or in rare cases a"Anxiolytic“(Anxiety Reliever) prescribed.
In addition to drug treatment, there are other methods that the affected people can use to counter their strong fears. These standard psychotherapeutic methods should be the focus of anxiety therapy.

Model learning

Model learning is not only responsible for the development of a phobia, but with this process, the phobia can also be forgotten again. People learn and take over by observing other people and their behaviors. The person concerned can also take advantage of this aspect within the therapy.
The person has the opportunity to observe other people, such as the therapist. This shows the person concerned which behavior should be shown in the specific, fearful situation. By verbally explaining the behavior to be learned, the person can learn to include this in their own behavioral repertoire and then to carry it out independently later. Through this method, the person concerned sees that the fearful situation does not trigger a disaster, as is actually expected of the fearful person.

desensitization

Since fear and relaxation do not go together, learning and applying relaxation should replace fear in the specific situation. Desensitization means systematically approaching the stimulus that triggers fear. This method is commonly known as "Systematic Desensitization".
Overall, desensitization includes three successive different phases:

1. Relaxation training: Here the person concerned learns a relaxation technique, e.g. Progressive muscle relaxation according to Jacobson

Other relaxation methods are:

  • autogenic training
  • Breathing exercises

2. Create a fear hierarchy:

In this phase, the person indicates the situation in which they feel the least fear up to the situation in which they feel the most fear. This hierarchy now also represents the treatment plan. Starting with the situation / stimulus with the lowest specified fear , up to the highest fear trigger.

3. Actual desensitization: The person should now first be confronted with the slightest fear trigger. As soon as the first signs of fear appear, she should relax with the help of the learned procedure. If the person concerned gives their consent, they will first be confronted with the fear-inducing stimulus in the form of pictures, toys, etc. In the last step, the person is confronted in reality with the actual stimulus, the situation that previously triggered the fear. The aim is for the person to stay in the situation without fleeing.With the help of the relaxation process she has learned, she should try to get the fear in the situation under control. Each of these steps is only taken with the consent of the data subject.

Even if a relaxed feeling is very useful in a fearful situation, forms of therapy such as direct confrontation are much more effective.

Exposure therapies (exposure)

As the name suggests, this procedure represents the encounter with the fearful stimulus, the fearful situation. This happens under certain rules and always with the guidance of the therapist. There are different approaches. The confrontation can occur in thought or in reality. You either go step by step, or there is a sudden direct confrontation with one of the very fearful stimuli.
The aim is for the person to learn to remain in the fearful situation and to endure the physical symptoms with the help of learned exercises until the fear is reduced and the person concerned has got used to the situation.

A method of stimulus confrontation is briefly explained below:

Overstimulation (massaged confrontation, flooding)

The assumption for this procedure is that the person concerned only loses their fears by repeatedly being confronted with the fearful situation and thus realizing that the situation does not have any serious consequences.
The affected person is confronted directly with the strong fear trigger without a slow introduction.
Before it comes to this step, the person is thoroughly informed about the procedure and prepared for it by the treating therapist. During the direct confrontation with the fearful stimulus, the therapist is always within reach so that he can intervene if necessary. Thus the person concerned learns that even the worst fear diminishes if one remains in the situation and does not seek to escape. If this method was carried out with the consent of the person concerned, the previous fear trigger is almost ineffective.
The aim of this method is that the fear is admitted, but the person still remains in the fear-inducing situation and can determine that nothing is happening that could harm them.

forecast

Specific phobias have one of the best chances of treatment because they do not limit the lives of those affected as much as Agoraphobias or social phobias. However, many of those affected see no need for treatment or do not accept any help.
The specific phobias occur more frequently in early adulthood. In childhood, fears can be viewed as “phases” that are short-lived. Therefore, one cannot yet assume that children have a phobia. The later a phobia occurs, the more difficult it becomes to treat. In adulthood, the specific phobias often have a tendency to take on a chronic course. For the good prognosis in the treatment of a specific phobia, several factors must be considered:

  • timely treatment
  • the connection of the phobia with a current life conflict
  • family support in treating the phobia

These are just a few factors that can lead to positive treatment opportunities.

Prevention / relapse prevention

As a precaution, the person concerned should be aware that too biological processes can lead to relapse again. The longer a person who has been healed of the phobia no longer comes into contact with the former fear object, the more the reaction threshold in the brain drops again. In the event of a sudden confrontation with the former fear object, a relapse can occur very quickly.

Therefore, everyone affected can take precautions by regularly continuing what they have learned in therapy in everyday life. Through the relaxation methods learned, the person concerned can regulate their fear in the specific situations so that normal behavior occurs. In therapy, the person concerned should also learn new points of view. It is particularly important that the person concerned does not feel that he is “at the mercy of fear”, but can actively counter the fear. Admitting your fear is a big step in the right direction. The encounter with the former object of fear shows the people affected that there will be no catastrophe and that the fear is unfounded. All of these steps to take action against fear will also boost the person's self-esteem.
For all prevention methods that have been learned within the therapy, it is important not to expose yourself to time pressure. With the relaxation methods learned, it should be possible for those affected to seek out even the most intense, fearful situations and experience them without fleeing.