Neuroscience
Putting the spotlight on exposure therapy

It's long been known that exposing people to what they fear can sometimes help them overcome their anxieties. It's called exposure therapy. But there's an aspect of this approach for which the evidence remains inconsistent - that is, should the person being exposed to their fear, focus on it, or try to ignore it?
Imagine a spider phobic being exposed to
spidey pics. The rationale for focusing on the pictures is that in relative safety, the person would gradually learn that their fear response is disproportionate, thus uncoupling spiders and "yikes!" in their mind. By contrast, the rationale for teaching the person to distract themselves from the pictures is more of a coping strategy, in that the person would gradually learn how to master being confronted with spiders without being overwhelmed by anxiety.
The evidence in favour of these approaches is mixed, but tends to suggest that distraction is better in terms of subjective feelings, whereas focusing is more effective in terms of physiological measures.
Now
Gudrun Sartory and colleagues have tested both approaches with 63 people with a dentist phobia. The participants were shown four images of dental instruments and were either told to focus on them, or they were encouraged to learn how to distract themselves, helped by the researcher who played a puzzle game with them while the pictures were shown.
An assessment before the exposure treatment, and then a week after it, showed both exposure approaches were equally
beneficial as judged by changes to the participants' heart rate when shown dentist-related pictures. However, in terms of dentist-related fearful thoughts and anxieties, the focusing approach to exposure was more effective, although all participants showed benefits.
So it seems this study supports a focusing approach to exposure therapy, but such a conclusion is undermined by the
study's weaknesses: there was no control group, and no way of checking during exposure just how much the participants did or did not focus on the dental instrument pictures.
_________________________________
Schmid-
Leuz, B.,
Elsesser, K.,
Lohrmann, T.,
Johren, P. &
Sartory, G. (2007). Attention focusing versus distraction during exposure in dental phobia. Behaviour Research and Therapy, 45, 2691-2703.
Post written by Christian Jarrett
(@psych_writer
) for the BPS Research Digest
.
-
Can A Fear Of Blushing Be Cured In A Weekend?
You may have heard of weekend workshops in creative writing or first aid but what about a weekend course to reduce your fear of blushing? Could such a brief, intensive intervention help people for whom a dread of turning red ruins their social lives and...
-
Acceptance, Not Distraction, Is The Way To Deal With Pain
You've got a painful visit to the dentist lined up and what do people advise you to do once you're there? Try to think of something nice, they always say. Imagine yourself lying on a lovely sandy beach. Not only can such advice be annoying, new...
-
Why Eye Movement Therapy Works
It involves recalling your horrific experience and then following your therapist’s moving finger with your eyes, which may sound a bit wacky, but as a treatment for post-traumatic stress, eye movement desensitisation and reprocessing therapy (EMDR)...
-
Scared Of Flying?
"From the Archives", first published in the Digest 29.09.03. If so, join the gang - apparently 10-15 per cent of us are significantly scared while flying. Flight courses run by the major airlines are a successful remedy, but expensive. What about using...
-
Social Phobia
People with social phobia dread social situations and live in fear of public embarrassment. Their anxiety often permeates all public activities, including eating out, or visiting a public lavatory. Research shows they catastrophise about social situations,...
Neuroscience