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Welcome to TheFearMonsterSlayer

Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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TOE TO TOE WITH THEFEARMONSTER

8/24/2014

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"Exposure yourself to your deepest fear; after that, fear has no power and the fear shrinks and vanishes. You are free"--Jim Morrison, The Doors


In previous posts I've talked about some simple, fun and effective tools for managing fear and anxiety: Thought Shifting, Distraction, Threat Assessment, The Useful Thought Question, "Cats, Bats and Rats", and told some stories, among others. And while these can be very helpful in managing anxiety and getting through some difficult situations, they don't really teach us how to face down and overcome our fears. In fact, they can reinforce anxiety.


What? Wait just a minute! I've spent all this time talking about ways to manage anxiety and now I'm saying they can actually reinforce it. So what's the deal? Well, here's what happens. These tools work in the short term on a situation by situation basis and that's great, but wouldn't it be better to eliminate the anxiety entirely or at least get it down to a level that's just a brief blip on our emotional radar screen?


Negative reinforcement  strategies provide temporary relief but may actually make the anxiety stronger. It's paying the bully. Examples are avoiding anxiety situations, escape, distraction, safety nets like taking a Xanax or flask of vodka along "Just in case" (Remember the Black Box Study in my last post?), safety-seeking behaviors such as reassurance-seeking, checking and rechecking, or having immediate access to medications, to name just a few. So now what?


I know that therapy is simple but hard work, frustrating, slow, and sometimes downright scary. But now it's time to bite the bullet and bring it on with THEFEARMONSTER. The way we do this is called Exposure Response Prevention or ERP. Simply put, we expose ourselves to an anxiety-producing situation-- such as ordering a Grande Caramel Macchiato at Starbucks--and learn how to not respond to it with anxiety or fear.


It's confronting fear and discontinuing escape responses while building anxiety tolerance through repeated exposure to the situation. Anxiety will go up for awhile so some calming and self-soothing techniques such as controlled breathing and repeating self-affirmations such as "This is uncomfortable but I can get through this" are helpful. And getting help from a trained professional therapist who teaches this technique.


I had a client whose wife was pregnant and of course he wanted to be with her in the delivery room when their baby was born. But he was absolutely terrified of being there during the delivery and experienced a near panic attack even thinking about it.But it was very important to both of them and he didn't want to let his wife down and miss out on one of life's greatest experiences. So together we came up with a plan (actually this was his idea).


He made a list of his anxieties about childbirth from least distressing to absolute worst, an anxiety hierarchy. He decided that seeing pictures of pregnant women was least distressing and being in the delivery room was the absolute worst. Then he set about looking at pictures pf pregnant women in parenting magazines, on the internet, photos of pregnant celebrities in checkout stand magazines. And he did this until he was able to see pregnant women without becoming overwhelmingly anxious.


Then he moved on to tackle the next fear on the hierarchy until he could manage it. He kept practicing this, moving up the fear hierarchy (fortunately, he had several months to work on it), doing things like driving by the hospital, parking in its lot by the labor and delivery entrance, getting out of his car and walking up to the door, going inside and riding the elevator to the maternity floor. In his last task he went to the maternity floor reception desk and explained to the staff that his wife would be giving birth there and went on a tour of the ward, including the nursery and actual delivery room. So little by little, through Exposure Response Prevention, he was able to overcome his anxiety about being at their baby's delivery.


So, you're probably wondering, how did he do when the baby came? I don't know, I never saw him again. But I did get a photo a few weeks later of him in surgical gown and mask with his wife and new baby girl in the delivery room.


Next Time: DEFEATING THEFEARMONSTER


 
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FACING DOWN THEFEARMONSTER

8/14/2014

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"I must not fear. Fear is the mind-killer.
Fear is the little-death that brings total obliteration.
I will face my fear. I will permit it to pass over me and through me.
And when it has gone past I will turn the inner eye to see its path.
Where the fear has gone there will be nothing. Only I will remain."
                                                                                                            --Litany Against Fear
                                                                                                              Dune by Frank Herbert


So far I've talked about some great, simple and fun ideas for managing fear and anxiety and told some entertaining and useful stories. But now it's time to face the Monster head on. It's where the rubber meets the road.

Fear is a bully; it's the kid in the schoolyard who says, "Give me your lunch money and I'll leave you alone otherwise I'll kick your butt." So we give him our lunch money and guess what? The next day he's back.We have to stand up to the bully. Avoidance gives us temporary relief but actually reinforces the fear or anxiety and it keeps coming back. Now there are some things that may be best to avoid. I can go through my entire life and never pick up a snake and it doesn't make a bit of difference (unless my dog has one in his mouth). But there are other things we have to confront; otherwise our lives become very terrifying and limited.

A really interesting study was done at the University of Texas in 2010 in which a group of student volunteers being treated for claustrophobia (fear of being closed in or having no escape) agreed to be enclosed in a wooden box that was painted black and lined with foam. They were divided into three groups.

Group one was given a cell phone and  told that they weren't expected to stay in the box for very long and when they wanted out, to use the cell phone and they'd be let out.
Group two was given a phone and told to stay in as long as they could and when they couldn't stand it any longer to use the phone and they'd be let out.
But Group three was given no phone and told they'd have to stay in the box until the researchers let them out. No escape, just tough it out. Then the researchers timed how long each group stayed in the box.

Then after an interval they repeated the exercise to see how long each group did staying in the box the second time. Now here's the interesting part. Which group do you think did the best staying in the box for as long as possible? Most people I ask this question to answer Group two as they knew they could get out at any time. But it's actually Group three.

The study found that there was no change in the length of time that groups one and two stayed in the box compared to the first time. In other words, they didn't improve. Group three actually stayed in the box longer the second time they were closed in.

What happens is that when we know we have a way out or a safety net we aren't forced to face our fear. While sometimes medications are necessary and helpful for fighting off anxiety or panic attacks, simply relying on them alone doesn't allow us to develop the tools necessary to manage our fears.Some people become afraid to leave home without them. They keep paying the bully.

I once had a client who was very anxious at work and kept a small flask of vodka in her car in case she needed it to calm herself. She made sure to park far away so it was inconvenient to get to and no one was likely to see her if she went to her car for a drink. She actually never did use it but she knew it was there just in case so she really wasn't facing her anxiety. And then one day she was running late for work and in her hurry dropped and broke the flask getting into her car in her garage. She had no choice but to go to work without it, worried about how she'd get through the day. The day was a little bit bumpy but she actually got through it okay and realized that she could manage her anxiety on her own. And she never went back to carrying the vodka again.

So facing down fear really means dropping the safety net and stepping out into the void. I know it can be pretty scary stuff but it gets a little better each time. Remember how to get to Carnegie Hall? ( Thought Shifting, Post 5/15/14)



"When you come to the edge of all that is known and step out into the void, know that one of two things will happen: There will be something under you or you will learn to fly."--Author unknown

Next Time: TOE TO TOE WITH THEFEARMONSTER
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THEFEARMONSTER OF LONDON

8/5/2014

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Londoners during the Blitz
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"The only thing we have to fear is fear itself."--Franklin D. Roosevelt

Malcolm Gladwell, in his recent book, David and Goliath, describes a very interesting observation about how the British citizenry dealt with fear during the German Blitzkrieg bombing of London during World War Two. I really like Gladwell's books as they challenge conventional wisdom about why and how things happen. They're all on my recommended books list (They're also on THEFEARMONSTER'S banned books list).

In the years leading up to the war, the British government knew that the German Air Force would bomb London and that there was nothing they could do to stop it. The British military command predicted that a sustained bombing would kill an estimated 600,000 people, wound another 1.2 million and create mass panic.

Plans to build a massive network of underground bomb shelters were abandoned because it was feared that people would never come out of them. And several psychiatric hospitals were set up outside the city limits to treat what was expected to be a flood of psychological casualties.

In 1940 the attack began. For eight months, beginning with 57 consecutive nights of devastating bombardment, German bombers dropped tens of thousands of bombs and more than a million incendiary devices, fire bombs. Forty thousand people were killed, another forty-six thousand were injured, and a million buildings were damaged or destroyed.

But then an interesting thing happened. Every prediction about how Londoners would react was wrong. The panic never came! The psychiatric hospitals were switched to military use because no one showed up. Many women and children were evacuated to the countryside but people who needed to stay in the city mostly stayed. As the German assaults increased, authorities began to observe, to their astonishment, not just courage during the bombing but something closer to indifference.

People went on about their business, kids played in the streets and went to school and life went on pretty much as usual. It became astonishingly clear that the bombing didn't have the effect everyone thought it would. So why was that?

At the end of the war a study was done to solve the puzzle. It was found that the morale of the community depends on the reaction of the survivors. The so-called "near misses", people who feel the blast, are horrified by the destruction and carnage, may be wounded but survive, and are left with a powerful reaction associated with the bombing. They may continue to experience what's called post traumatic stress disorder or PTSD.

Then there are the "remote misses" who make up a far greater percentage of the population. People who hear the sirens, see the bombers overhead and hear the explosions. But the bomb hits some distance away. They survived the second or third time that happens, they experience a feeling of excitement tinged with a feeling of invulnerability. Their reaction is exactly the opposite of that of the "near misses" who are traumatized. A remote miss creates a feeling of invincibility.

In recollections of Londoners who lived through The Blitz, countless people described feeling happy and triumphant, exhilarated and invulnerable. One Londoner, who had been bombed out of his house two times, refused to be evacuated to the countryside. He said, "What and miss all this? Not for all the gold in China!"

The study concluded that  we are not only liable to fear but also afraid of being afraid. Conquering that fear produces exhilaration and a self-confidence that is "the very father and mother of courage." Soldiers going into combat of course fear dying or being maimed but right behind that is the fear of not showing courage and letting their buddies down.

Courage is not the absence of fear but doing something courageous in the face of fear. It's what we earn when we get through the tough times and realize they aren't so tough at all.

Next Time: FACING DOWN THEFEARMONSTER
 


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    Jeff Aronson

    Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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