With Halloween right around the corner, it feels like the perfect time to talk about fear. Fear is built into us—it’s part of how we survive. After all, it makes sense to feel a healthy dose of fear about skydiving without a parachute or reaching out to pet a wild bear on a hike.
But sometimes, fear doesn’t stay in its lane. It can start creeping into everyday life, keeping people from doing things they want—or need—to do. When fear gets that big, it can feel like it’s running the show.
So how do you break free when fear takes the wheel? The answer: Exposure Therapy. It’s one of the most well-researched, effective ways we have to treat anxiety and phobias. Let’s break it down in simple terms so it’s a little less scary.
The Cycle of Fear and Avoidance
Here’s what usually happens when fear shows up:
- You bump into something that triggers fear.
- Anxiety spikes, and it feels awful.
- You avoid the thing making you anxious.
- The anxiety drops, and you feel relief.
- Your brain remembers that avoidance worked.
So, the next time the same scary thing pops up, you avoid it again—and feel better again. This becomes a habit. But here’s the kicker: the more you avoid, the bigger and more powerful the fear gets over time.
Avoidance feels good in the moment. Long term? It makes the fear grow roots.
How Exposure Therapy Breaks the Cycle
Exposure therapy flips the script. Instead of running from the fear, you turn around and face it—on purpose, in small, manageable steps.
It sounds backward, right? But the idea is to help your brain learn that you can handle it. When you stick with the feared situation instead of bailing, the anxiety slowly burns itself out.
The first few times might feel intense, but over time, your nervous system gets the message: “Oh… maybe this isn’t so dangerous after all.” With repetition, the fear shrinks instead of grows.
The Fear Hierarchy: Baby Steps Toward Big Change
Now, don’t worry—exposure therapy isn’t about throwing someone into the deep end on day one. That would be a nightmare.
Instead, therapists use something called a fear hierarchy. Think of it as a ladder of fear, starting with the easiest steps and slowly climbing toward the hardest.
For example, if someone has a fear of driving, the steps might look like this:
- Watching someone else drive
- Sitting in the car with the engine off
- Sitting in the car with the engine on
- Driving in an empty parking lot
- Driving around the block
- Driving on a quiet street
- Driving on the freeway
You’d start at the bottom, only moving up when the anxiety about the current step drops to about half its starting level. By the time you reach the top, the fear has usually lost its grip.
Types of Exposure Therapy
Exposure therapy isn’t one-size-fits-all. Therapists have different tools depending on the person and the fear they’re facing. Here are the main ones:
In Vivo Exposure
This is the real-life version—literally facing the fear in person. If you’re afraid of dogs, you might start by looking at pictures, then watching videos, and eventually meeting a calm, friendly dog.
Imaginal Exposure
Sometimes the real-life situation isn’t possible—or it’s too overwhelming at first. In imaginal exposure, you picture the feared situation in your mind in vivid detail. It’s a stepping stone toward facing it for real.
Virtual Reality Exposure
Tech has made it possible to use VR headsets for things like fear of flying or public speaking. It feels real enough to trigger anxiety, but it’s safe and controlled.
Systematic Desensitization
This combines relaxation techniques—like deep breathing or muscle relaxation—with gradual exposure. It helps people stay calmer as they climb the fear ladder.
Applied Muscle Tension
For fears that involve fainting, like blood or needle phobias, this method teaches people to tense their muscles to keep blood pressure up and prevent passing out during exposure.
Conditions Exposure Therapy Can Help
Exposure therapy can be used for a wide range of fears and anxiety-related conditions, including:
- Animal phobias (spiders, snakes, dogs, etc.)
- Flying phobia
- Claustrophobia (fear of small spaces)
- Social anxiety
- Panic disorder
- PTSD
- Health-related fears (like fear of medical procedures)
Basically, if fear or anxiety is keeping you from living the life you want, exposure therapy might be part of the solution.
Extra Tools That Sometimes Help
While exposure therapy is powerful on its own, sometimes it’s combined with other treatments for extra support.
Cognitive Behavioral Therapy (CBT)
Exposure therapy often happens as part of CBT (Cognitive Behavioral Therapy), which helps people notice unhelpful thought patterns and swap them for healthier ones. The two work hand in hand—CBT helps you change how you think, while exposure therapy helps you change how you react.
Medication Options
Medication isn’t usually our first choice for phobias, but it can help in certain cases, especially when anxiety symptoms are severe.
- Antidepressants like SSRIs or SNRIs for anxiety disorders
- Beta blockers for physical symptoms like a racing heart
- Benzodiazepines (tranquilizers) for short-term relief in very intense situations
Medication can take the edge off so people can fully engage in therapy, but it’s usually not a standalone solution.
Other Therapy Approaches You Might Hear About
While exposure therapy is a powerful tool, it’s not the only option out there. If you’re curious about other therapy approaches, here are a few worth exploring:
- Dialectical Behavior Therapy (DBT): Focuses on mindfulness, emotion regulation, and building healthy coping skills.
- Eye Movement Desensitization and Reprocessing (EMDR): Usually used for trauma and PTSD, EMDR helps the brain reprocess distressing memories in a healthier way.
- Prolonged Exposure Therapy (PE): A structured approach often used for PTSD that helps people safely revisit and process traumatic memories instead of avoiding them.
Although these are all valuable options for certain situations, CBT remains the gold standard for treating phobias and anxiety because it’s backed by decades of scientific research and proven techniques.
Why Researchers Back Exposure Therapy
Exposure therapy isn’t just popular because therapists like it—it’s backed by decades of research. Studies consistently show it works for many types of phobias and anxiety disorders, and organizations like the American Psychological Association list it as a top evidence-based treatment.
That means when you choose exposure therapy, you’re not just guessing—you’re choosing a method proven to help people get their lives back.
How to Access Exposure Therapy
All of this information can be scary, but there are ways to get you started on your own or with help.
- Self-guided approaches: Some people start with books, online programs, or videos, especially for mild fears.
- Professional help: A trained therapist like Lindsey Phillips, LPC or Ben Smith, LPC can make the process smoother, safer, and more effective.
- Finding the right specialist: Look for therapists with experience in CBT and exposure techniques. They’ll know how to guide you at a pace that works for you. Therapists at Evolve Counseling in Fort Collins are well-trained in CBT and have had much success in using this.
Having someone in your corner—especially someone who knows the science and the process—can make a huge difference.
Getting Help at Evolve Counseling Services
If fear or anxiety has been running your life, you don’t have to face it alone. At Evolve Counseling Services in Fort Collins, our team specializes in CBT and exposure therapy to help people take back control from their fears. Whether it’s a specific phobia or general anxiety, we can help guide you step by step with proven techniques and a supportive, down-to-earth approach.
When you’re ready to break free from the cycle of fear, reach out to Evolve Counseling Services. Together, we can help you feel confident, capable, and back in charge of your life.