One of the motivating factors that often pushes people to enter therapy in the hopes of achieving better mental health is fear. Fear can occur in many forms, some of which are reasonable and healthy, while others are maladaptive and self-defeating. The latter type of fear, which can manifest in forms such as anxiety, can pose significant obstacles to a patient's happiness and success.
Fortunately, once a patient takes the necessary step to seek therapy to deal with the fear, a therapist can make use of any number of techniques and approaches to guide him through it and teach him how to deal with it. However, the particular technique and/or approach to use depends on the type of fear that a patient is experiencing. Therefore, successful treatment depends on the therapist's ability to identify the type of fear that the patient is experiencing.
Types of Fear
There are essentially two types of fear. Rational fears motivate a patient to avoid situations, people, and objects that are potentially dangerous or harmful. Irrational fears manifest in the face of an object, person, or situation that is actually harmless, though perceived as the opposite in the patient's mind. Such fears are maladaptive because they result in paralysis and avoidance that is self-defeating. An irrational fear may be seen as a prison holding the patient captive and preventing her from living life but merely surviving it.
It is important to note that irrational fears do not always start out that way. Irrational fears often stem from an experience the patient had in childhood. At the time, the fear may have been entirely rational, and the patient's response to it adaptive. However, the situation may have changed over time to the point where the fear is no longer rational and the patient's response is self-defeating, though it may have been adaptive originally.
Examples of Irrational Fears
Irrational fear can take many forms, some of which may not be recognizable as such to the layperson but all of which can have a destabilizing effect. Irrationality is one of the distinguishing characteristics of a phobia. One such example is agoraphobia, in which the fear can be said to literally imprison the patient. Another example is anorexia nervosa, a common eating disorder in which the patient has so much anxiety about food, specifically consuming too much, that he will avoid eating, compulsively denying himself that which sustains life.
What these two examples have in common is self-defeating potential of each. Anorexia nervosa can result in literal self-starvation. A patient with agoraphobia can barely function in society without going outside. The overwhelming fear inhibits rational, healthy behavior.
Approaches for Treatment
Finding real-life topics for therapeutic discussion with a patient in the office should not be too difficult because fear is a daily occurrence. Identification of the patient's fears is the first step to determining a treatment approach. An example of an approach that may be effective is a visualization technique in which the therapist encourages the patient to visualize the fear as something concrete. The previous example of a cage imprisoning the patient is one possibility. Another example is to encourage the patient to imagine walking through a fog bank to illustrate that going through the pain directly is the most effective way to leave it behind and get free of it.
Remember that it would not be adaptive to be rid of fear entirely. Fear can be a valuable defense mechanism that helps to ensure continued survival.