Learn the skills to manage your anxiety


The Need to Face your Fears

"You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, 'I have lived through this horror. I can take the next thing that comes along.' You must do the thing you think you cannot do." 
-Eleanor Roosevelt It often makes sense to avoid what seems scary and potentially dangerous. We look both ways before crossing the street to avoid being struck by a speeding car, we instinctively stand back from the edge of a cliff to be sure we don’t fall and we avoid eating foods that we think have gone bad. Yet what are we to do if we are avoiding things that are not really dangerous, but for whatever reason we believe they are and feel afraid? For example, if we are afraid of bridges should we avoid them or not? Once in a great while bridges do collapse, but very rarely so the degree of danger is very low. Most people cross bridges without giving it a second thought. If you live in a city with few bridges you may be able to get by for years and never have to worry about crossing a bridge, but if you live in a city like Portland, Oregon where a river divides the city and there are numerous bridges it becomes a real problem if you can’t cross bridges. To overcome your fear of bridges, you must ignore your fears and do what your fears are telling you not to do.

This is the basis of exposure therapy for the treatment of anxiety disorders. As Eleanor Roosevelt said: “You must do the thing you think you cannot do." Many people approach their fear by waiting until they feel safe before they face their fears. Rarely does this method work and usually the more you avoid the worse the fear becomes. If you regularly avoid crossing bridges, the fear will most likely get worse and not better. The best way to overcome a fear of bridges is to cross bridges. Yet if you take this advice you will likely feel, at times, very anxious. What do you do about this anxiety? The answer to that question is not always simple, but the basic idea is to accept it, to let it come and ride it out. If you start crossing bridges and keep doing so regularly, despite your fears, the anxiety will almost certainly come down. I often use the metaphor of getting into a pool full of cold water. At first the water will feel cold, but if you stay in the water soon it won’t feel quite so cold. Your body will gradually get used to the water’s temperature. In the same way if you stay with the anxiety you will gradually adjust and you will “learn” that bridges aren’t so dangerous after all and your anxiety will reduce.

The source of the fear will vary between anxiety disorders, from a fear of social situations in Social Anxiety to a fear of Panic Attacks in Panic Disorder to fears of contamination (and other types of fears as well) in Obsessive Compulsive Disorder. Exposure treatment is tailored to each different disorder, but the general principle of facing what you fear remains the same. Your ability to learn to manage and potentially overcome your anxiety disorder will depend in large part on your willingness to tolerate the discomfort of your anxiety during exposure. If you aren’t willing to experience your anxiety how can you cross that first bridge? Medication may seem like a logical way to reduce your anxiety as you do the exposure…but that is a topic for a future post.

(Photo credit: Franklin D. Roosevelt Presidential Library and Museum)
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