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The information provided in this section is intended for clients as an adjunct to their treatment at Psychological Services of Pendleton, LLC. It may also provide useful information to the general public, but it should not be considered a substitute for psychotherapy with a psychologist or other qualified mental health professional.

Steps for Facing Fear

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Terrel L. Templeman, Ph.D.

The following is one of the methods used by Dr. Templeman in treating anxiety.

Franklin Delano Roosevelt once said, “We have nothing to fear but fear itself,” but most people have something in mind when feeling afraid. Here are three simple steps to facing fear.

Step One: Pin down what you are afraid of.

When contemplating risky situations, such as health problems, a loved one traveling abroad, or even a party invitation, it’s easy to feel a general kind of anxiousness about them, thinking, “Something could happen.” Of course “something” could mean “anything,” at which point your mind may begin collecting more worrisome thoughts of cancer, car wrecks, muggings, or doing “something embarrassing.” Such images are usually followed by attempts to put them out of mind – “Don’t even go there!” But paradoxically trying not to think about something actually focuses your attention on it. For example, take a moment and try not to think about the color purple and you will see the paradox. Trying to put your mind on something else also keeps you from really defining what it is you’re afraid of, which in turn makes it scarier. For example, take a moment and imagine something in your basement, it’s making a growling noise and it sounds huge. Now picture a large German shepherd dog in your basement, its teeth bared and growling. Even though both images are frightening, which is more so?

Another way people make themselves more afraid is by means of the “What if...” Game. Many of us learned this game as children. I learned it at summer camp, lying in a dark bunk house after lights out with about eight other campers. In the pitch black darkness someone would say, “Hey, did you know there’s an insane asylum not too far from this camp? No, it’s true, and they have murderers there. What if one of them killed a guard and escaped, like in that movie? And what if he took off for the mountains so no one would find him? What if he ended up finding our camp? What if he started looking for people to kill? Man, it’s too quiet outside – what if he’s already found the other cabins and killed off the staff? What if he has gone completely crazy and is looking for more kids to kill? What if he’s right outside our door?” At which point someone would bang on the wall and everyone would scream. Notice that each “What if” ratchets up the fear a notch, until you can’t stand it and have to break away from the thought. Adults play this game too, without an audience but with the same unfinished ending. Here’s an example for the party invitation: “What if I go to the party and I don’t know anyone? What if everyone stares at me? What if someone asks me something I can’t answer? What if I say something stupid, or worse, I can’t think of anything to say at all? What if everyone decides I’m stupid? What if people start talking about me behind my back? What if I’m the geek of the party?” Notice that each “What if...” leads to a scarier thought that makes you want to think about something else.

Instead of “Don’t go there!” or “What if...” Step One asks you to picture clearly in your mind what you predict will actually happen in that situation. Be precise. What is it about the scenario that really frightens you? Be objective. Go to the worst case, don’t water it down. Imagine variations of the situation until you hit on the one that really scares you, then picture it clearly. For example, if you’re anxious about going to a party, explore your fear about it. Imagine having nothing to say. Picture yourself stumbling with your words. Imagine yourself sitting alone in a corner, no one talking to you. Picture the looks on people’s faces.

Step Two: Estimate the likelihood that your fear will come true.

Human beings tend to overestimate risks, especially when they’re afraid, so it’s important to be objective when estimating risk. To help you stay objective, think of risk on a continuum, as shown below:

risk continuum

A risk of 100% is a sure thing, which means the feared event will inevitably happen. At the other end 0% risk means there is no way it will ever happen. Of course few risks occur or don’t occur with such certainty. Most occur somewhere along the continuum, and many of our worst fears fall at the low end of the scale. Take for example the airplane crash. On any given day in the United States the odds that a commercial airline will crash with you on it are 1 in 1.6 million, or 0.00006%. This is called a base rate. In contrast, the base rate for being struck by lightning in the United States is 1 in 250 million or .0000004%. Notice that on the scale above both base rates are much closer to zero than to the 1% mark. Although the risk of a plane crash is more likely than being struck by lightning, both numbers are vanishingly small. In the case of a plane crash, you would on average have to book 1,600,000 flights before one crashed. Even if you flew every day, it would take you over 4,000 years to get to your crash date! Of course airline crashes do occur more frequently than once every 4000 years. When we see it on the news, our fears are heightened by the sight of it and our empathy for the people aboard – “Hey, that could be me!” -- distracting us from all the thousands of other flights that occurred the same year that didn’t crash. By overlooking the rate of non-occurrence we overestimate the risk of such a catastrophe occurring.

So how do we estimate the base rate of more common worries and fears? Let’s take that party invitation mentioned above. Our fear is that we will be sidelined, shunned, or even ridiculed. First estimate how many social gatherings you have gone to in the past. Put a number on it. Maybe you’ve only been to five parties in your life, but maybe you’ve been to 15 other types of gatherings where you didn’t know many people. Of those 20 experiences, how many resulted in your being neglected or shunned? Let’s say you can recall two very bad occasions out of 20 that left you sitting in the corner by yourself. Your base rate then is 2/20 or 10%. Circle that on the scale above. Two out of twenty is not very high. That means 18 out of 20 occasions were not catastrophes. A couple of those situations might even have been mildly enjoyable, a base rate also about 10%. Thus the odds of being sidelined are much lower than you thought, based on your own experience!

There may also be ways of improving the odds. For example, planning something to say before you go to the party and practicing it in the mirror may improve your chances at conversation. Learning something about the people who are likely to attend may also help. Notice that in many situations we are not passive recipients of life events in the way that an airline passenger is.

Step Three: Estimate the impact of the feared event. How bad would it be?

Suppose your worst nightmare happens. You go to the party, nobody talks to you, you sit in the corner for an hour nursing your drink, and go home. Here again a scale is useful:

impact scale

It helps to anchor this scale with other scary events. For example, let’s put plane crash at 100, since you would probably be dead if that happened. How about being held up at gun point, maybe 80? Perhaps being audited by the IRS at 50? Being called into your boss’s office for your annual performance evaluation, 30? So where does the bad party experience fall? In the larger scope of things, is it quite the catastrophe you imagined, or merely an uncomfortable evening?

Everyone can think of life events that would be catastrophic but are unlikely to happen. Step Two helps estimate the likelihood of such events happening to you. Since you may have had no experience with these actual catastrophes, it is often helpful to look up the base rates on the internet, especially for diseases and accidents. There are many more common life events that are uncomfortable but not life threatening. Step Three helps put those in perspective. Social gaffes, physical pain, loss, even ostracism are all unwanted but not at the same end of the continuum as true catastrophes.

Step 4: Create an approach hierarchy.

Approach hierarchies work best when you are avoiding going someplace or doing something. Avoidance is usually associated with phobias, such as heights, school, social gatherings, crowds, going outside, but it can also apply to certain people or situations that make you anxious. Let’s take social phobia as an example. Pick the most frightening social situation you can imagine (perhaps going to a party where you don’t know anyone) and give it a rank of 100. Think of something social you can do now with little or no anxiety (say, going to a movie matinee with few people in attendance) and rank it 0. Next think of a social situation that would be intermediate in difficulty between these two extremes, perhaps going to a crowded mall, and assign it a rank of 50. Once you have these anchors, fill in the remaining gaps with other situations of greater or lesser difficulty. Make sure you choose situations that you actually have the opportunity to do or have to do at some point in the future. The hierarchy helps you rank how difficult it would be for you to face each situation. In the case of the social phobic, the hierarchy might look something like this:

100
Going to a party where you don’t know anyone
75
Going to a party where you know everyone
50
Going to a crowded mall
25
Going to a drive-in restaurant
0
Going to a movie matinee

Once you have your hierarchy, begin at the bottom and work your way up by approaching each situation until you can do so calmly. There are several techniques for staying calm as you practice each situation. Use Steps 1 – 3 to assess and reconsider your fears about each situation. Practice breathing, relaxation, or mindfulness exercises to stay physically calm. It is helpful to have a way to gauge your anxiety during this step. The 10 point scale below is a good guide.

anxiety scale

Remember that anxiety is anticipatory, that is, it is likely to be mild (3 or 4 on the scale) just thinking about the situation, and it will rise further (5 or 6) as you approach it. You will experience an urge to flee the situation just after you enter it (7-8), but if you leave then you will actually make it harder to go back to the situation later! This is because your mind associates the situation with the last feeling you had while in it! Thus if you leave while feeling afraid you will experience that fear next time you think of the situation and won’t want to try it again. The key to success is to practice your self-calming exercise once you are in the situation so that no matter how anxious you felt going in you can leave feeling better. Try to get yourself back down to a 5 or less before you leave, and you will be more likely to try it again. Or, as William Shakespeare once said, “All’s well that ends well.” Once you can remain calm in a situation at one level, you are ready to move up a level to the next situation. In this way you literally work your way up to your worst fear.

The Benefits and Costs of Fear

Fear certainly has a place in a healthy life. Our ability to detect life threatening danger and take measures to eliminate it or at least avoid it helps us survive. Fear is the emotion that motivates us to take action against threat. Humans are very good at detecting potentially dangerous situations. In fact we are so good we are easily tricked by our senses into feeling fearful even when there is no immediate threat to us personally. Consider the news stories you hear every day, either through media or other people. Images of war, crime, famine, natural disasters, illness, social ostracism, and so forth keep us vigilant even when we are not in danger ourselves. It’s no wonder so many people live in a state of continual fearfulness. Such fear is very inhibiting. It keeps us not only out of harm’s way but out of the way of opportunities for relationships, advancement, or enjoyment. Fear is also hard on the nervous system and the cardiovascular system. To exhaust oneself with it when there is no threat is a waste of energy. Hence the goal of these steps is not to eliminate fear but to assist in the rational appraisal of threat so that we can conserve our energy for more useful or pleasurable endeavors. If nothing else, these steps may just help get you out of the house!