What follows is a guest post by a frequent contributor to the comments and Discussion Forum of this blog, Dr. Nate Eliason. Nate, who has an M.D. in Pathology, has written on the Discussion Forum about his own success in applying hormesis to vision improvement. As someone who sees the medical system “from the inside”, Nate has observed that medical interventions such as antidepressants often deliver short-term benefits while paradoxically causing long-term impairments. This is the mirror image of hormesis, which promotes long-term health by deliberate application of short-term “stress”.
In this post, Nate focuses on an interesting case where “controlled stress” is particularly useful: the treatment of phobias by exposure therapy.
Exposure therapy has interested me since my days in medical school. It is a very effective, but often underused therapy for phobias, Obsessive-Compulsive Disorder (OCD), and anxiety. In writing this post, I have relied on David Tolin’s excellent book, “Face Your Fears“. I highly recommend it.
When fear becomes a problem. Fear is a natural emotion, necessary for our survival. A good analogy for how fear works is a car alarm system. A well-functioning car alarm system protects our car by alerting us when someone is attempting to break in. A car alarm which constantly goes off, however, is more harmful than helpful. In the same way, some people have a “broken” fear system, in which fear becomes hyperactive, turning into anxiety. Common anxiety disorders include panic disorder, agoraphobia, phobias, social phobia, OCD, generalized anxiety, post-traumatic stress disorder, and separation anxiety disorder. All of these are categorized as specific disorders, they have many features in common, and all respond to exposure therapy. While exposure therapy is primarily used for dealing with pathologic fears, it can also help us deal with routine fears which aren’t severe enough to be pathologic. For instance, most people have some fear of public speaking–but not to the degree that it is pathologic. The same principles apply in overcoming non-pathologic fears. Towards the end of this post, I’ll give some examples on how I’ve used exposure therapy to deal with my own fears.
Fear is necessarily unpleasant because its “purpose” is to help us stay safe by avoiding dangerous situations. However, when it becomes overactive, our entire life can be unpleasant. Exposure therapy deliberately ‘exposes’ us to fear in order to help us learn how to bring it under control and experience it in a normal way. I need to emphasize that one of the primary objectives in exposure therapy is to feel the fear. That’s right–our goal is to feel fear, and then to learn to deal with that fear. Read More