A small mountain of scientific evidence supports the idea that facing your fears is the way to get over them. However, that evidence doesn’t make it any easier to confront, say, the group of people staring directly at you on the podium as you start to speak. Regardless, a dogma of the treatment of anxiety disorders is that we must undergo this highly aversive experience of confronting our fears—what psychologists call exposure—in order to reduce them.
A new research program suggests that there is a considerably less aversive way to reduce fear, at least initially.
Source: Paul Siegel
Joel Weinberger and I have conducted a series of experiments showing that exposure is effective when delivered unconsciously—when images depicting common fears flicker too quickly on a computer screen to be consciously recognized. For example, when spider-phobic individuals are unconsciously exposed to a series of creepy spiders, it subsequently reduces their avoidance when approaching a live tarantula (housed in an aquarium). After unconscious exposure, the phobic participants both get closer to the tarantula and report that they are less afraid of it.
This new form of exposure, what we term very brief exposure (VBE), is based on a classic method for presenting stimuli unconsciously. An image is very briefly presented (for no longer than .033 seconds), and followed immediately by a second, masking stimulus. The image is still carried from the eye to the brain, but the mask blocks conscious recognition of the image. Your unconscious brain “sees” the image, but you don’t. In VBE, masked pictures of common fears (spiders, judgmental faces) are continuously presented in order to desensitize the brain’s fear circuitry at an unconscious level.
VBE is based in part on the phenomenon of counter-phobia, which Freud first documented in his clinical encounters with World War I combat veterans. Although these young men avoided talking about traumatic memories of combat, they seemed destined to repeat them—albeit unwittingly—in clearly symbolic ways in their daily lives. A modern-day example is the survivor of childhood sexual abuse who has similar difficulty recalling memories of the abuse, but is drawn to romantic partners who are abusive.
Freud explained counter-phobia by proposing that “Inside of every phobic, there is a counter-phobic”—an unconscious wish to master what we fear. As much as Freud believed in the power of unconscious processes, he also believed that we are beings of agency. Behind our conscious fears, we want to approach and come to terms with them. However, we usually aren’t aware of our counter-phobic desires.
If Freud is correct—if phobic people unconsciously wish to confront what they fear—then when stimuli depicting their fears are unconsciously presented, it should be gratifying rather than scary.
That is what Joel Weinberger and I have repeatedly and independently found in our psychology labs (at Adelphi University and Purchase College/SUNY, respectively). These links show two such studies. In each of nine separate experiments, VBE to masked images of spiders caused phobic individuals to get closer to a live tarantula. VBE does not, however, cause them to experience fear because they are unable to make out the masked stimuli.
Clearly visible exposure (CVE) to the same spider images has exactly the opposite effects. Unsurprisingly, CVE causes phobic persons to experience distress because they repeatedly view the pictures of creepy spiders. CVE does not, however, affect their avoidance of the tarantula—they don’t get any closer to it. Thus, spider phobic persons only get closer to the tarantula after they are presented with spider stimuli that they are not aware of.
Figure 1 shows these differing effects of VBE and CVE on avoidance of the tarantula relative to control exposure, masked flowers. Flowers are ideal control stimuli for spiders; they are living things of the same visual configuration (central body and multiple radiations), but aren’t fear-inducing.
Figure 1. Effects of VBE and CVE to spiders, and control exposure, on approaching the tarantula (# of completed approach tasks).
Source: Paul Siegel
Figure 1 also shows that the immediate, fear-reducing effect of VBE was maintained when our phobic participants returned to approach the tarantula again one year later. That is, phobic persons who receive VBE maintain their gains. They get just as close to the tarantula one year after exposure.
Figure 2 consistently shows that VBE does not induce autonomic arousal in phobic persons—as measured by a very sensitive indicator, electrical changes in skin conductance. CVE, however, induces arousal in phobics, which is not surprising because it causes them to experience distress.
Figure 2. Mean skin conductance during VBE and CVE to spiders, and control exposure to masked flowers.
Source: Paul Siegel
The human subjects in these studies weren’t seeking treatment, but undergraduates who were paid to participate. However, they resembled a treatment-seeking population because they were very afraid and avoidant of the tarantula. My collaborators and I are now applying VBE to other, more impairing fear-related disorders, such as Post-Traumatic Stress Disorder and Social Anxiety Disorder, the fear circuitry of which is quite similar to that of spider phobia.
These results have clinical implications. The majority of people suffering with phobias do not seek treatment because they are unwilling to confront their fears. If they could initially bypass this aversive experience with an unconscious method of exposure, it would significantly diminish their emotional distress, if not eliminate it entirely. That would render them more likely to pursue treatment.