A specific phobia is defined as an intense fear of an object or situation that results in avoidance and/or distress (American Psychiatric Association, 2013). The fear or anxiety is culturally deemed to be disproportionate to the actual danger posed, last over six months, and cause impairment in either social, occupational, or other important areas of life (American Psychiatric Association, 2013). Specific phobias can be debilitating and, at the very least, limiting. The most common and effective way to overcome specific phobias is through exposure treatment. Although this sounds incredibly intense, when done correctly, it essentially means slow and graded exposure to the phobic object or situation (Peris, Storch & McGuire, 2020). This is best done with the help of a mental health professional. What they will work with you to create is something which is often called an exposure hierarchy. Based on principles of Cognitive Behavioural Therapy (CBT), an exposure hierarchy is a ranking, from lowest to highest, of what scenarios cause fear or anxiety (Peris, Storch & McGuire, 2020).
For example, let's take a common phobia of spiders, also called arachnophobia. Let's say this ladder has ten rungs on it. At the bottom of this ladder, causing the least distress, could be a picture of a cartoon spider, causing 10% anxiety. Next could be a plastic cartoon spider toy, causing 20% anxiety. Third could be a picture of a real spider at 30%, a video of a real spider at 40%, and being in the same room as a spider while the spider is in a covered box at 50%. 60% distress could be being in the same room as a spider in a glass box, 70% could be being in the same room as the spider while the spider is someone's hand across the room, 80% could be the spider in someone's hand while they are seated closer to you in the room, and 90% could be you touching the spider. At the top of the ladder at 100% could be holding the real spider. Essentially, what this hierarchy does is provide us with steps to increase tolerance and reduce distress for the individual's specific phobia over repeated, gradual exposure. When you've looked at a picture of a spider repeatedly so as to reach the point of habituation (a point where you are no longer experiencing the emotional response of high anxiety) you are ready to move on to the next step. This involves a step which exposes you to a progressively, but only slightly, higher level of anxiety. In this case it might be watching a video of a spider. These "baby steps" of exposure allow for gradual exposure to anxiety over prolonged periods of time with the goal of habituation. This results in the progression through all the steps from the lowest rung on the ladder or hierarchy up to the highest with a significant reduction in the intensity of the phobia.
This is essentially how exposure therapy works. However, it is safest to do this with a mental health professional to guide you through this process. We can help -
contact us for a free 15 minute phone consultation!
Written By: Maya (Mostaghim-Vaezi) Dousti, M.Psy., B.A. (Hons)
Edited/Reviewed by: Dr. Stacy Lekkos, C. Psych
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596
Peris, T. S., Storch, E. A., & McGuire, J. F. (2020). Exposure therapy for children with anxiety and OCD: clinicians guide to integrated treatment. London: Academic Press.
Our administrative assistants at Toronto Psychologists are available to assist you in booking your first appointment and answer any questions you may have. They are available from Monday to Friday, between the hours of 8:30am to 5:00pm.
If you are visiting us outside of our business hours,
click here to book an appointment now, complete the form on our
contact page to receive a call back, or leave us a message.
Location:
Yonge Eglinton Centre
2300 Yonge St., Suite 1600
Toronto, Ontario M4P 1E4
© All Rights Reserved. 2022. Dr. Stacy Lekkos.
Smart Site Design & SEO Services by Green Lotus Agency