One way to do this, and my preferred way, is through systematic desensitisation. This involves gradual exposure to that which causes fear and discomfort. To start off, I work with my clients to develop a hierarchy, starting with what causes the least amount of fear, or anxiety, and building up to that which causes the most fear. It’s important that clients follow these steps in an environment that is safe and predictable. Let’s use fear of dogs as an example. Depending on the severity, step one may be just talking about dogs. Believe it or not, this alone can be enough to cause uneasy feelings for some. I ask my client to rate their anxiety level for step one (1-10). The idea is that the more the client is exposed to this step, they will become desensitised, leading to their self-rating to drop over time. Once the client is comfortable and essentially bored with this step, we then move onto step two. Step two may involve looking at pictures of dogs. For example, I would advise against going to a dog park to observe dogs there, as this is an unpredictable environment, as we cannot control or stop a dog from running up to the client, which could lead to more distress. Moving on, step three may involve looking at videos of dogs. Once again, the client would continue to rate their level of discomfort, and eventually, once this drops to an extremely comfortable level, we move on to the next step. Eventually, the aim and goal would be to have the client comfortably sitting in a room with the dog, and even interact with a dog.
In addition to a hierarchy, it is beneficial to work on breathing strategies in sessions as well. These help ease some of the discomfort within each step. Learning to challenge unhelpful and unrealistic thoughts via CBT (Cognitive Behavioural Therapy) is also very helpful, as often, we overestimate the level of threat, and are more fearful of certain things than necessary.