How Can a Therapist Help Me Overcome a Phobia?

By: Danielle Bertini, LCPC

There aren’t many people I know who love spiders, let’s be honest. But what happens when that fear is so strong that it causes symptoms like hyperventilating, nausea, an overwhelming sense of doom, and dizziness? These are some common symptoms of a phobia. Phobias affect 9.1% of Americans, from fear of public spaces, confined spaces, spiders, and more. A phobia can feel like a prison sentence, where a person is restricted to the spaces where they feel safe, maybe meaning they may never leave their home or room. For those who suffer from phobias, know that there is hope. Bates (2021) outlines eight steps you can take to work through your phobia of phobias.

Recognition

The first step to overcoming a phobia is recognizing that the phobia is irrational. Sometimes when there is a traumatic event, an object can be mistakenly associated with the traumatic experience. For example, a drunk driver blows through a stop sign causing a crash. After that event, the person who was hit had a phobia of stop signs. Certainly, the stop sign didn’t cause the person trauma. It was the drunk driver.

There are also many cases where a person develops a phobia outside of any sort of traumatic event. This can be due to a variety of factors, such as genes, behavior patterns, brain chemistry, and environmental conditions. 

Triggers

Triggers can be anything from thoughts or even feelings that lead to phobic responses. For example, someone who has a phobia of spiders might have a panic attack by simply thinking about spiders. A therapist can help the client identify what their most common triggers are.

Biofeedback

A therapist’s first step in working with a client who suffers from a phobia is often helping them understand their physiological reaction when triggered. This might start with them asking their client what they sense is taking place in their body. Maybe they note increased blood pressure, sweating, tightness in their chest, and nausea, among other symptoms. This is useful to note because they can now better identify when they are triggered.

Understanding the Sequence

Once the client becomes better aware of how their body reacts to triggers, they can then better understand their emotional response. Here is what this sequence looks like:

1. Trigger
2. Physiological response
3. Emotional response
4. Unhealthy response
5. Negative outcome

Understanding this sequence can help the client engage in the process of change. Interventions can be applied at each stage of the sequence to achieve a better outcome, such as:

1. Trigger
2. Physiological response
3. Emotional response
4. Healthy outcome 
5. Positive outcome

Cognitive Shift

During the first part of the sequence, a therapist can help the client recognize the irrationality of their phobia. There isn’t anything inherently dangerous about a stop sign, the color orange, or small spaces. Challenging these thoughts helps to create space for new, more rational beliefs. 

Self-Soothing

During the second leg of the sequence, the client can help apply self-soothing skills. This can include mindfulness, which is a practice that allows you to center and ground yourself so that emotions don’t spiral out of control. This idea helps you understand that you don’t need to think your way out of distressing situations, but rather soothe the intense physiological reaction.

Emotional Regulation

In the third leg, you can then apply skills that help you process what you are feeling and regulate those feelings and find a resolution.

Exposure

Once a client is able to recognize the sequence and learns the different skills to intervene at each stage, the client can then be ready to be challenged. This involves the therapist systematically exposing the client to triggering situations, starting with the least anxiety-inducing situation, and then progressing to the highest anxiety-inducing situation.

An example might be starting off with the client imagining spiders, and then coaching them to use their skills to regulate their panic response. Once they’ve learned to manage at the lowest level, they then might transition to exposing the client to looking at photos of spiders. As they move up levels, they will be able to confront their fear in any setting. 

If you find yourself struggling with a phobia, you may find it helpful to talk with one of our therapists at Symmetry Counseling. Explore our counseling services online, and contact Symmetry today by calling (312) 578-9990 to get matched with one of our licensed counselors in Chicago, Phoenix, Washington D.C., or Texas.

References

Bates, D. (2021, January 15). 8 Steps to Overcome a Phobia. Psychology Today. Retrieved May 19, 2022, from https://www.psychologytoday.com/us/blog/mental-health-nerd/202101/8-steps-overcome-phobia