Anxious is as Anxious Does

Anxious is as Anxious Does

Overcoming Clients' Fears by Provoking Them

By Reid Wilson

November/December 2002

Q: My approach to helping clients deal with panic attacks and phobias focuses initially on teaching them breathing and relaxation exercises, and then encouraging them to gradually face the feared situation without getting so panicky. I often find it a very slow process. Is there any way to speed it up?

A: Yes. My clinical experience indicates that clients who can be persuaded to provoke and endure their symptoms without resorting to relaxation exercises quickly become habituated to their fears. Symptoms sometimes disappear in as little as two or three weeks.

This may sound counterintuitive--I'll stop being anxious if I make myself anxious?!--but treatment centered on provoking anxiety is based on the same theory as the treatment you currently employ. Both approaches assume that the best way for clients to overcome their anxieties is through exposure to the situations that they fear. Your approach aims to overcome clients' natural reluctance to this strategy by teaching them skills that will make the feelings that they experience in these situations more tolerable. Thus equipped, the theory goes, they'll be willing to place themselves in anxiety-provoking situations frequently enough to learn that the catastrophe they fear won't overtake them. At that point, their fear of such situations either dissipates or remains at a manageable level.

I liken this approach to persuading a reluctant swimmer to get wet by wading…

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