Overview of Fear: When fear is temporary, it can be an ally. When it takes over, it can destroy peace and happiness. Fear is a normal and natural part of life, without which our chances of survival would be greatly diminished. However, when fears are irrational, persistent, or intense, our level of happiness and our ability to function can be compromised.
• Body: Trembling, racing heart, burning stomach, tension in muscles and belly, headaches, crying, rapid shallow breathing, restlessness, temporary paralysis, and/or sweaty palms.
• Mind: Repeating thoughts, terrifying images, and/or distracting thoughts.
• Emotions: Terror, anger, despair, and/or numbness.
Fear is a signal that our well-being is threatened; if this is the case, fear tells us we need to act. But sometimes, we are afraid when there is really no threat. Such irrational fears may be covering over deeper fears and needs that we can discover and examine in therapy. Persistent phobias, which can be terrifying and debilitating, can be overcome through the work of therapy. Sometimes, we may feel afraid and not be certain why, or not be clear whether our fears are realistic. Talking about your fear in therapy can help clarify these issues.
Feeling fear may be quite unpleasant, but attempting to suppress fearful emotions will probably not help. Instead, allowing yourself to feel your fear, taking a few deep breaths, and beginning to rationally examine your fears can help you manage. Most people are at least a little afraid of death. Examining your attitude towards death can be helpful in managing fears.
A few good questions to ask yourself about fear are:
• What am I afraid of? Is this fear realistic?
• What, really, is the worst that can happen? And what can I do protect myself from that outcome?
• Where in my body do I feel fear? How do I feel when I take a few deep breaths?
The Medical Model and Fear: In the DSM, anxiety disorders often involve some kind of fear. Phobias involve specific fears, such as fears of snakes or social situations. Schizophrenia, which can include paranoid thoughts, may cause people to feel afraid of others. Schizophrenia can also include delusions, which may involve frightening themes, and hallucinations, which can be frightening. Sometimes, fear is a part of depression, for example a fear of death, being alone, or being a failure.
Case Examples of Fear:
Kurt, 37, reports feeling afraid of “almost everything.” He has taken time off from work because he is scared to go out in public. Loud noises cause his heart to race. He barely sleeps. The therapist teaches Kurt some simple meditation techniques to help him calm down enough for conversation in therapy. Then Kurt and the therapist discuss Kurt’s fears rationally. All of Kurt’s fears eventually lead to a fear of death. Kurt is relieved to know that most people fear dying, and begins to work on making peace with this inevitable reality.
Daisy, 21, is afraid of men. She identifies a past experience as the root cause of this; when she was 11, she was assaulted by an older cousin and has never gotten over it. Daisy is referred to a support group for survivors of abuse, which she finds comforting. She also begins to explore how her fears fail to keep her safe, and prevent her from developing positive relationships. She identifies several men she respects and does not fear. She is able to talk openly about her fears, and this in itself provides some relief. Daisy also discovers her latent anger at her attacker, and feels more empowered to take care of herself.
Therapy for Fear : There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of fear. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for fear or any other issue, it is helpful to familiarize oneself with these elements.
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