Confrontation therapy
Within behavioral therapy, confrontation with anxiety-inducing situations has proven to be a successful method for losing the fear of situations or objects. The affected person consciously seeks out the situations (often accompanied by the therapist) that he or she has avoided in the past or only sought out with great fear. The aim is, as with other anxiety disorders (social phobia, specific phobia), that the person learns to stay in these situations.
In this way, despite their fear reactions, they notice that nothing bad will happen. This step is also called “decatastrophising”, because the feared catastrophe will not happen. In order that the affected person is not helpless in the fear-stricken situations, they learn to reduce the fear reactions in the respective situations with the help of relaxation techniques.
The person recognizes that if he or she actively acts against the fear in the situation, he or she can act independently and does not have to flee the situation. Possible relaxation methods are progressive muscle relaxation or autogenic training. There are two types of procedures within confrontation therapy, which are used depending on the type and severity of the existing fear.
Before the person is “confronted” with the actual situations, the therapist discusses each step with the person concerned. An anxiety hierarchy is created, i.e. the person should name the anxious situations in a hierarchical order. Starting with situations that are hardly feared by him or her and ending with situations that are very strongly connected with fear.With the help of this hierarchy, the situations mentioned are then gradually visited by the person concerned.
As soon as the first signs of anxiety reactions appear in the situation, the person should independently reduce their anxiety in the situation with the help of the learned relaxation method (e.g. Progressive Muscle Relaxation). Flooding (stimulus satiation) is another method. Here the person is confronted directly, after the preliminary discussion with the therapist, with the strongest fear stimulus (situation).
The person must not flee the situation, but should wait and learn that the fear will be reduced independently. The person learns after the first session that no bad event has occurred and that the fear of the situation is unfounded. This procedure is most effective, but also very stressful for the person concerned.
Since this procedure is very successful, it is very often used for anxiety disorders, for example, also for the specific phobia. An average of 10 to 20 sessions are needed to allow the person to return to the previously anxiety-ridden situations almost without fear.
- Systematic desensitization
- Flooding
