Build a fear ladder
Face something you avoid in small, safe steps, from easiest to hardest.
Key takeaways
- Avoiding a fear brings relief now and keeps the fear alive. Facing it in steps you can manage is how it shrinks.
- List the situations you avoid, rate each from 0 to 100, and start with one that is hard but doable.
- Stay in each step long enough to learn what actually happens, repeat it, and drop any safety behaviors along the way.
For fears of things that are actually safe. Not for memories of trauma, or anything genuinely dangerous.
One rung at a time
In the 1950s, a South African psychiatrist named Joseph Wolpe tried something his colleagues thought was risky: instead of helping people avoid what frightened them, he helped them face it. Slowly, in steps.
Each patient made a list of feared situations, from mildly uncomfortable to terrifying, and rated each one. Then they worked up the list, one rung at a time. Wolpe called it an anxiety hierarchy. Today it's usually called a fear ladder, and exposure built on it is one of the best-tested treatments for anxiety there is.
Why avoiding keeps fear alive
Avoiding something you fear brings instant relief. The trouble is what your brain learns from that relief: "Phew, that was close." The fear never gets the chance to be proved wrong, so next time it's just as strong, or stronger.
Facing it, in a step you can manage, teaches something different: the feared thing didn't happen, or it did and you coped. Researchers now think this new learning, more than simply getting used to it, is what makes exposure work. That's why the goal of a step isn't to feel calm. It's to find out.
Question 1 of 3
Sam has avoided freeways for two years, since a panic attack while driving. Which of these would make a good step on Sam's ladder?
- Sitting in the car on an on-ramp, engine running, for five minutes
- Rush hour on the freeway on day one, to get it over with
- Driving one exit early on a quiet Sunday morning
- Driving one exit, but only with a friend ready to take the wheel
- Doing one exit, then avoiding freeways for a month
0 of 5 sorted
On the step
How to climb
- Pick the first rung
Something around 30 to 50 out of 100: hard, but doable.
- Predict
Before you start, write down what you fear will happen.
- Stay
Stay long enough to see whether the prediction comes true. The anxiety may not drop much, and that's fine.
- Repeat
Do the same rung several times, close together, before moving up.
- Check
Afterward: what happened, compared with what you predicted?
Question 2 of 3
Sam is on a step, and anxiety climbs to 60 out of 100. What's most helpful?
What it can look like in Maya
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Build your own ladder
If you like, try it on something of your own. Pick something you avoid that is safe, but feels frightening. Keep it everyday while you're learning.
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Ines and the elevator
Three years ago, Ines was stuck in an elevator for forty minutes. Since then she has taken the stairs everywhere. Her new office is on the twelfth floor, and she arrives every morning out of breath and late. She has decided to work on it, and her plan is to ride all twelve floors at 9am on Monday, when the elevator is packed, "and get it over with".
Question 3 of 3
Sources and further reading
- Wolpe, J. (1958). Psychotherapy by Reciprocal Inhibition. Stanford University Press.
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
Finish the lesson
0 of 3 questions done. Answer the rest to finish.