John R. Cook, Ph.D.
Registered Psychologist

In the The Work Horse of Anxiety Treatments article we learned that anxiety is a kind of "false alarm" resulting in our responding to ordinary situations as if they were dangerous. We subsequently learned how to treat the problem of anxiety by dividing it into three parts. The first of these was about physical sensations that we learned could be managed with relaxation exercises. The second was about anxiety-producing thinking errors that we found could be handled by recognizing and challenging them.

The third part of anxiety is Behaviour – responding to the false alarm as if it were real, by performing some sort of corrective action. In the case of people who suffer from generalized anxiety or worry, this corrective action involves endless worrying and procrastination. In the case of people suffering from panic attacks, the tendency is to want to escape, and if possible, to seek sanctuary. People with obsessive-compulsive disorder (OCD) engage in rituals that are magically designed to protect them from the unseen danger. People with post-traumatic stress disorder (PTSD) respond to present-day situations as if they were back in the situation that damaged them. In all cases of anxiety, the Behaviour response is generally some form of escape or avoidance.

The treatment of choice for our behavioral response to anxiety is desensitization. Desensitization is arguably one of the most powerful forms of psychotherapy known. It usually involves doing exactly what we least want to do – facing our fear by engaging the situation or circumstance that triggers it. If we don't face our fear and instead run away from it, we risk making our anxiety worse in two ways. First, we make the "running away" more likely to occur in the future because it usually makes us feel better, at least in the short term. Second, by avoiding or escaping, we deprive ourselves of the opportunity to learn that nothing dangerous is going to happen.

Desensitization works by forcing us to trust that the false alarm is indeed a false alarm. Although we may understand the false alarm on an intellectual level, and know that we should not be responding as we are, we have to confront our fear by literally living through the situation. The rule of thumb guideline in performing desensitizations is to stay in a situation long enough – anywhere from 10 minutes to several hours – for our anxiety to decrease 50% or more, naturally on its own.

Think of anxiety as a bully that forces you to take actions you wouldn't otherwise take, such as giving up your lunch money or running away. The task of desensitization then becomes one of standing your ground and facing the bully. It helps if you actively provoke the bully by inviting him to do his worst. Although you may pay the price in the short run by getting thumped, you benefit in the long run by taking the bully's power away from him and causing him to lose interest. Bullies such as anxiety look for targets of convenience – people who will give in.

The next article in this series will teach you specific types of desensitization and how they can be applied to different forms of anxiety such as worry, panic, OCD and PTSD. If your problem can't wait, give me a call at 881-1206 for a free 20-minute consultation, or check out some of our program offerings at PsycServ.com