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CBT for Phobias

fall-leaves-autumn-graphy-views_356851Phobias are specific fears that interfere with an effective lifestyle. Common examples are:

  • Claustrophobia – the fear of being trapped, unable to leave
  • Social Anxiety – meeting new people, conversations, deepening relationships  
  • Public Speaking & Performance Anxiety
  • Health Anxiety – fear of becoming sick and needing medical care

At times the phobic fear may intensify to panic. It almost always involves some level of rumination and worry when anticipating the feared event. CBT is effective, clinically-proven treatment for phobias.  

Emotion Education

Phobias occur when a “reflexive” emotional process, the fight-flight response, arises during situations that, while safe, may hold the potential  for risk. It’s hard to pinpoint why these fears occur for some people and not others. What is certain is that once the fear develops, the natural response is avoidance and escape. This may help in the short-run by providing immediate relief. However, avoidance and escape tend to cause considerable damage in the long run by preventing you from living a full, effective life.  

Cognitive Skills

When you are frightened, it’s natural to believe you are in true danger. The very belief (cognition) that you are in danger, even when safe, can have a strong influence over your emotions: the fight-flight response will intensify, reinforcing catastrophic predictions, leading to more fear,  dysfunctional avoidance and escape.

CBT helps replace catastrophic cognitions with reasonable beliefs. When fear begins, It’s important to remind yourself to review the evidence that this is a false alarm, you are not in danger. The goal is to develop a nurturing, coaching inner voice to help stay grounded and effectively accept and cope with panicky feelings as they run their course (see “Exposure” below).

Exposure

The natural response to fear is avoidance and escape. Yet the more you attempt to avoid and escape fear (the fight-flight response), the stronger it becomes and the more ground you lose. This is because avoidance blocks your brain’s ability to learn: 1) that the feared situations are not dangerous, 2) effective skills to engage in these situations, to become an effective part of your life, 

Exposure is done gradually, starting with low to moderately stressful experiences and situations, and building “emotional muscle,” gaining confidence with each successive step, until you can effectively take on the toughest challenges. Cognitive skills and mindfulness are practiced during exposure, to minimize discomfort and maximize success.

 

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