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Facing Fears - The Principals of Graded Exposure Therapy

Research and experience have proven the common sense idea that facing our fears helps us to overcome them.  When we become anxious we avoid the thing we fear and the fear gets worse. And so we never get the opportunity to learn that the feeling does not predict bad things actually happening in reality.  When we have a strong fear response that is not related to a real threat we are actually the victim of a stream of extremely negative and mostly distorted thoughts that are taking us away from enjoying the present moment. Graded Exposure is a technique that is used to help someone gradually and gently learn to stay in a feared situation so they can experience nothing bad actually happens and the feeling passes. Recent research suggests when we use this technique we are actually changing how the brain responds to the feared situation and we can train the brain to respond without the intense fear response. Research also shows we can use simulated situations using virtual experiences to succeed in graded exposure.


How to Succeed with Graded Exposure

1. The most critical ingredient for success is having a good relationship with your therapist and this might take a few appointments to establish the trust you will need to allow you to begin this journey.

2. A good foundation for begining exposure work is Mindfulness training which allows us to learn to be present to what is actually happening in the moment and to leave our thoughts in the background.

3. Fears need to be worked on gradually beginning with the least fearful and only approaching the most feared situation once easier ones have been conquered. Sometimes there is only one fear and then we find ways to approach it that are less fear inducing such as talking about it, writing about it or drawing it before actually confronting it directly to provide the graded experience that allows a gentle mastery.

4. It is important to stay in the feared situation for long enough to see nothing bad has happened and that the wave of fear passes.

5. Repetition is critical - you might be tempted to miss an appointment but chances are that is just the old habit of avoiding trying to gain control again.


Using Graded Exposure with Children.

Deborah Skender is an experienced child therapist and uses play, art work and story telling as a gentle and fun way for children to be exposed to their fears. During sessions children frequently enjoy most of the process. However, they will experience some anxiety so they can learn to master their fear.

During the exposure process a child may not want to attend their appointments due to knowing they will be facing some fear. It is important to continue with the process and perhaps offer rewards for attending the sessions. The sessions will get easier for the child as they master their fear and anxiety. Understanding that they can overcome fear is a gift that will remain with your child for their entire life.


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