Even as there are effective treatments for phobias, some treatments fail, slow recovery, or even hold sufferers back.
Not committing to CBT or exposure therapy consistently is counterproductive, making it difficult to capitalize on the gains made during each session. Practicing exposure therapy once a month simply won't be efficient to desensitize most people from their phobia. Two or three or more times a week is recommended. The more often CBT is practiced, the more results we can expect.
Negative environments (not having supportive family and friends, or having critical or abusive family and friends) are extremely detrimental to the recovery process. Some people are very strong and can plow through the negativity and recover despite it, but most people will find that this negativity slows them down, stops their progress completely, or is actually making their anxiety worse—or is its cause.
Though finding new friends or leaving home can be very difficult, for those who have this option it's important for more than their emotional well-being to do so. We are the company we keep, and if we choose to keep good company instead of bad company, we clear many obstacles that once blocked our life goals. Positive people wear off on us, help us grow, and make life much more bearable. Likewise, we pick up the habits of negative people and become negative.
The next two deal with the treatment of phobias, and is a warning to those who may not want to take a whole approach to healing. Each of these is beneficial when paired with CBT, but as separate tools, rarely stand up by themselves.
For years I was involved in talk therapy, the most common therapy for depression and anxiety. It never helped me, and often confused me more as it brought up a lot of difficult emotions that my short sessions or switching doctors never resolved.
Looking back I see how futile this method was. Discussing why I had anxiety, or why I was depressed didn't help me because it was focused on what had already happened, whereas the depression and anxiety were happening right now. Talk therapy was great for knowing why I was the way I was, which was useful later on when I started CBT, but I missed out on the most effective coping strategies during my talk sessions.
There is no way of measuring talk therapy's effectiveness—if it is effective at all. With CBT, especially when exposure therapy is used, because I was actually doing something, learning and practicing coping mechanisms, I could write down and observe my progress in relation to the activities I performed. I could then set goals for myself, and observe what was working and what wasn't. But using only talk therapy I had no way of setting individual and short-term goals, and no way of tracking my daily or weekly progress.
If it doesn't work, why is talk therapy still so popular? Because it is convenient. It allows patients, if they wish, to talk about their feelings openly without fear of criticism. Many talk therapists do not challenge their patients, and so there relationship becomes non-confrontational. For those who just want to be heard, this is perfect.
I was medicated for most of my teens. I took Paxil and Zoloft for years, yet neither medication helped me overcome my phobias—some of my phobias grew significantly worse.
Medication does one thing: it relaxes us enough so that we may feel comfortable. Stronger medications like Xanax and Valium are more effective, but are also highly addictive and potentially dangerous. What medications do not do is give us the motivation we need to take advantage of these relaxed states.
Relying on medication alone failed to cure my phobias because it could not give me the motivation or confidence a good therapist using an effective CBT program could. Yet coupled with CBT, medication can get sufferers through difficult situations, helping to build confidence and motivation. But eventually for the sufferer to test his or her progress, it will be necessary to taper off meds and go through exposure therapy without this aid.
I chose to stop medication and live pill free because I wasn't comfortable with their side effects, and I knew that to be fully healed I would have to do the things I wanted to do without their help. For people who are comfortable taking pills, medication can make a profound difference in their recovery, but even then medications should not be relied on completely, or be treated as a cure-all.
Just like with talk therapy, taking medications is convenient. Drug companies tout their medications, but it's rarely ever mentioned that pills work best when coupled with CBT. And in our world of instant gratification, people hoping for a quick recovery can easily be swayed by the belief that meds alone can cure us, though this is rarely true.
In the end phobias are complicated events, but getting over them can be as simple or as complicated as a sufferer wants to make it. With a little motivation one can begin taking slow and planned steps to recovery, building confidence with each small achievement. Though talk therapy and medication are not cures in and of themselves, they can, when part of a CBT and exposure therapy program, help bring understanding and relaxation to the process, further bolstering confidence.
Recovery does not need to be overnight. All that is necessary is moving by inches, until finally the sufferer looks back and sees miles have gone between.
Tao of Anxiety: Series
Tao of Anxiety: Series