Persistent Negative Attitude Can Undo Benefits of Exposure Therapy

by Justin Bashore

New research shows that exposure therapy alone for phobias has many flaws.

Ohio State University psychology researchers found that people who held negative attitudes about public speaking after exposure therapy was completed were more likely to experience a return of their fear a month later than were people with less negative attitudes.  The fear returned among those with the same negative attitudes even if they showed improvement in the exposure portions of the treatment.
 
This suggests that even those who confront their fears and start to make progress against phobias do not make permanent progress unless their brain's "memory-driven negative attitudes" about the feared objects or events are altered.  Without doing this, their recovery won't last since negative attitudes can thwart all of their progress and push them back to square one on the road to recovery.
 
The Ohio State scientists say this could be because the treatment tends to focus on building skills to fight the fear, without addressing the automatic negative attitudes that the average person with a phobia has.
 
Russell Fazio, professor of psychology at Ohio State, explains, "In exposure therapy, people can learn some skills to control the negativity and fear that got automatically activated and be able to perform well despite that activation.  But if that's all that happens, then the person may still very likely have a problem because there will be situations where their confidence will end up being eroded, they won't be able to manage their fear and they will have a failure experience."
 
This study illustrates how important the cognitive part of cognitive-behavioral therapy is in helping people overcome anxiety disorders, phobias, and depression.  Without changing our deeply held beliefs about ourselves, we cannot change the way our brains automatically respond to events we have feared in the past.  These fears are so deeply entrenched that exposure therapy alone cannot help us make permanent progress, only a real change in the brain can, which is what cogntitive-behavioral therapy provides for us.
 
Published 03/07/2013

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