Image: Courage the Cowardly Dog

Phobias are irrational or excessive fears. If a phobia interferes with someone’s everyday life, it may be anywhere from annoying to debilitating. Other phobias will only come up once every so often, so they are less intrusive.

If a phobia interferes with an everyday or essential activity–such as dental work, flying, or animals–a person might choose to get treatment in order to overcome it. Phobias can be treated by exposure treatment, an intervention in which the person is exposed to tolerable aspects of the phobia in a safe environment until their anxiety diminishes.

First, the treatment focuses on exposure to the least anxiety provoking aspects of the phobia, as determined by the patient in a “hierarchy of fear.” The accompanying anxiety is addressed until it diminishes to tolerable levels, however long that takes.

Then, and only then, does the exposure move to increasingly more anxiety provoking aspects of the phobia. This may take days, weeks, or even months, depending on the nature of the phobia and the person’s level of anxiety.

An example of a phobia hierarchy based on items generated by clients working in exposure treatment:

Hierarchy Example

Just thinking about exposure treatment may be anxiety provoking enough to count as exposure!

As a certain little pink dog has taught us, it takes courage to face your fears. Being courageous doesn’t mean not being afraid, it means taking action, even if it feels scary to begin.

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