When individuals seek professional help due to anxiety, exposure therapists typically assess for more than just the severity and impact that said fear has had on their lives. Exposure therapists also evaluate whether the content of fears is realistic or magical in thinking, and often help patients increase insight into the probability vs. possibility of perceived outcomes. Exposure therapists know that insight and logic simply isn’t enough to overcome fears. In fact, most people know that their fears are unlikely to occur, though it’s usually the 1% chance that something can go wrong that individuals focus on and attempt to control the most. And it’s that 1% chance that causes senseless attempts of obtaining relief while simultaneously decreasing their sense of freedom. Therefore, our work is to help individuals learn to tolerate life’s uncertainties as a solution to living in fear of irrational, unlikely, sometimes magical, catastrophic outcomes.
But what happens when the likelihood of a catastrophic outcome increases? How can therapists help patients navigate today’s real-life horrors? Halloween goblins, phobias, germs, and social rejection seem trivial in comparison to modern-day threats to our survival, such as school shootings. The way that therapists support their patients through these real-life horrors matters, especially as our awareness of these tragedies increases with constant political and media attention, which only intensifies fear.
It’s important for mental health professionals to acknowledge and normalize these fears. And because exposure therapists focus on changing behaviors and negative thinking traps, it is especially important for them to make room for honest dialogue around these issues and validate emotions.
Just as we do in any other exposure work, may it be to trauma, phobias, or OCD, the goal is to help our patients face their fears and learn to live with acceptance of reality and freedom from being controlled by unpredictable events.
When it comes to real-life horrors, those fears may not subside, and that is important for our survival.
After all, if these situations didn’t scare us, we would probably be less likely to survive them. And as therapists, our job is to help buffer the effects of these realities for our patients by encouraging their ongoing engagement in activities. Our role remains as facilitators of tolerance to these uncertainties rather than fearlessness.