How Can Cognitive-Behavioral Therapy Help?

Your fear and anxiety will begin to fade when you learn, from experience, that your phobia is unfounded. Cognitive-behavioral therapy for specific phobia is about helping you face what you fear rather than avoiding it. In order to overcome your fear, your therapist will have you make a list of the objects or situations that you fear, describe how intense your fear is, and indicate what your beliefs are about each object or situation (for example, do you think that you will be contaminated, die, be attacked, or go insane?).

You will be taught how to relax when you are feeling tense. Your therapist may ask you to form images in your mind about a feared situation and hold these images in mind until you feel less anxious. You may observe your therapist doing the things that you fear, and later you may imitate him or her. Your exposure to the things that you fear will be gradual. Your therapist will explain everything before you do it; you are free to refuse to do anything; there will be no surprises sprung on you; and you will determine the pace at which you make progress. Most patients using these techniques find that they feel much less tense, become able to do things that they feared, and feel more effective in their lives. Many patients are able to improve rapidly with a few prolonged sessions (for example, 2- to 3-hour sessions) that allow intense exposure to the feared objects or situations. Depending on the fear, between 74% and 94% of patients improve when they use these techniques. Although some patients may use antidepressants or anti-anxiety medications for these fears, the treatments that we have described do not require these medications.