As the old saying goes: “if a horse throws you, get back on the horse right away!”  In a nutshell, these words of wisdom highlight the essential step in overcoming fears–you have to get back on the horse!  The technical term for confronting fears as opposed to avoiding them is called “Exposure”.  Recently scientists have discovered that exposure actually changes the brain in a very positive way (for more information see “The Anxious Brain and Its Parts” ).  There are several types of Exposure that are effective for specific fears. There is even a type of Exposure for out of the blue panic attacks called Interoceptive Exposure.

Habituation is the process of facing a fear enough to lower the activation in the Mid-brain and Amygdala described above. Go to “Exposure and Habituation” which describes in more depth the process of recovery from anxiety disorders.

How Exposure Works
When you initially face a feared situation anxiety often rises quickly (your body is preparing you to Fight or Flee). When anxiety rises it becomes uncomfortable and there is a strong urge to leave or avoid the situation or do something to dampen down or subtly avoid the anxiety. But what happens if you resist the urge to leave and instead fully enter into the situation and you do so many times or for long durations? The answer is that you learn over time if the situation is really threatening, or not. If it really is not threatening, your fear response goes away! In this case you have Habituated to your fear, meaning the situation does not activate your Amygdala to trigger a fear response anymore because there is no danger. You have re-conditioned your Amygdala!

However, most people with Anxiety Disorders have a long history of succumbing to fear and avoiding the situation. Avoidance can happen even if you know there is nothing to be afraid of because your Amygdala has been conditioned to activate your fear response! Remember though, the more you avoid the more you give your Amygdala the message that there really is something to be afraid of. You are conditioning it to remind you to be afraid, to trigger a fear response. The relief you feel for avoiding the discomfort of anxiety, comes at a steep price: You have actually rewarded your Amygdala for making a false assessment!

Another way of looking at this process is by describing it as a “Fear and Avoidance Cycle”. Not only does Avoidance keep your anxiety going, but it also makes all those anxious thoughts and beliefs about the situation more active (you will see later that there is a special way of dealing with anxious thinking called Cognitive Restructuring). Before describing the Fear and Avoidance Cycle, a little more information on Habituation and Avoidance will be helpful.