“I think maybe you’re not getting scared enough.” These actual words from this actual psychologist to an actual patient, explaining why they weren’t yet seeing any improvements from CBT. What I wanted to know was what was stopping them from amping up the fear levels. I assume what you want to know is why on earth I was terrorising my patient.
The technique The task I’d set wasn’t complicated: face the thing they fear, stay there, repeat. I have used this strategy with a lot of people and I have seen it work brilliantly. Many people get on board with the simple analogy that if you were to watch a scary movie over and over, eventually it would cease to be scary. But one of my early lessons as a therapist was that being on board is not the same thing as being able to put it into practice, for one very good reason: most people don’t like feeling scared.
I can explain the logic behind it, I can explain the physiology behind it. What I can’t explain is what it’s going to take to do it. The trouble is, I don’t understand what it is I’m actually asking of people. I can’t relate to my own scary movie analogy for one very good reason: I really, really don’t like feeling scared. I have no idea if fear reduces on repeated viewings, primarily because I hate scary movies and I avoid them at all costs.
The explanation The following situation will be familiar to anyone who grew up in Australia. I’m in a car looking through the windscreen when I feel a surge of fear coursing through my body. It’s beyond my control, it's instantaneous, and I feel it even before my brain has pieced together the information telling me the cause: through the glass is a hairy spider, right at eye level.
I’d be grateful for this physical response if, say, that spider was a man with an axe, and that car was nothing but empty space. Among its many benefits, that surge sends oxygen to the muscles I need to fight or to run away, generally the latter in the case of axes. I’m a little less grateful when the physical response means I am about to crap my pants over an almost harmless creature utterly incapable of reaching me.
I now have my body telling me I’m in danger and my brain saying the opposite. I have two imperfect choices to recover from the fear. If I stop the car and remove the spider somehow, I’ll feel almost instant relief but I might be late. If I keep driving, I’ll get there sooner but I won’t feel good doing it.
If this were a one-off situation, the choice of action would be a simple question of which is more important to me right now: to be on time or to take away this horrible feeling? But I grew up in Australia, where seeing a spider on the windshield is hardly an exception to the rule. My response now will also shape how I react next time.
If I remove the spider, my body never learns that it was not a danger to me. Untested, the fear response grows and generalises to anything resembling an arachnid. My kind protective body might even try to warn me to prepare for potential spider viewings, by making me feel on edge every time I get in the car. This doesn’t feel very nice so I might start limiting the length of my journeys or even avoiding the car altogether.
The alternative is to keep driving. To accept that my body is just trying to do its job but has got it wrong this time, and to keep doing what I want to do in spite of the uncomfortable feeling that’s taken over. As a result, my body gets a bit of evidence that seeing a spider is not the same as imminent biting by said spider, and the more evidence I accumulate, the sooner my body will stop reacting as if it is. What my body also learns is that, in the absence of actual danger, the fear response eventually fades.
This is a straightforward example of what can be a crippling problem. Imagine if that spider was something you faced every day, or something you couldn’t see – let alone brush off with a broom – like a terrifying memory or a panic attack. Now imagine that whatever coping strategies you had weren’t quite working, but the only alternative being offered to you was to dive headfirst into the very thing you’d been working so hard to avoid. Welcome to CBT.
The experiment What is it like to deliberately induce fear? How does it feel to do something that makes you afraid and then do it again? And again? What might get in the way of sticking with it? Does your body really adjust to it?
This week I am going to try out my own over-used analogy to find some answers to these questions. I have asked my friends and family which films scared them the most, and then based on those responses and my knowledge of the films I have rated them in order of how inclined I am to watch them.
Wearing a heart rate monitor to record my body's fear response, I will start by watching The Thing. If I don’t get scared enough to answer my experiment questions, I will reluctantly work my way down that list until I see some results.
Are there any scary movies you've seen so many times they no longer terrify you? Which films scare the bejeezus out of you no matter how often you watch them? Please leave a comment below.
© Cognitive Behave Yourself, 2013. Excerpts and links may be used, provided that full credit is given to Jane Gregory with a link to the original material. For CBT in North-West London please visit www.hampsteadcbt.com.