Fear is our body’s natural way of protecting us from a potential threat.
But when fear gets in the driver’s seat, it can keep us from the people and activities we value most.
So how can we help our clients take back control from their fears?
In the video below, Lynn Lyons, LICSW explains a creative technique for helping her client face her fears.
Take a look—it’s about 4 minutes.
Ms. Lyons: I had a woman come to see me and she was in her late 60’s and had a long history of anxiety and depression and it had been on this med and that med and had been to therapy in 1970 and then again in 1983 and sort of managed it okay. Really unexpectedly with no sort of cause ¬– and people like to try and figure out what caused the anxiety, and I find that to be interesting but not really necessarily accurate or helpful – she had developed a fear of driving, particularly on the highway, which she had been able to manage for a few years. She had moved back to New Hampshire, she had actually driven across the country and moved back here, so it wasn’t really a problem a few years ago, but here came this fear and it was just the same church, different pew. Her daughter was going to become pregnant soon, so her daughter was at the time when she was planning to have a family. Her daughter lived about 15 miles away, and the reason she came to see me was, “This fear of driving is going to get in the way of me being able to see my grandchild, and so I need to address it.” So, she came to see me and she had worked previously on it, they had done a lot of breathing and calming stuff, which was sort of helpful, but not all that helpful. The therapist had had her sit in the garage in her car and do her breathing, and had given the instruction of, “When you feel calm, then back out of the driveway and head on your drive.” Well that’s not good – how many times had she gone on a drive? Zero, because how many times had she felt calm and confident sitting in the driver’s seat? So, we did the same thing, we pulled her worry out – she named it Edith or something – and gave a voice to Edith, made Edith into this character. I often ask people, “Is there somebody in your life who, when they talk, you’re like, ‘Errr. . . Not such good advice’? Is there somebody who, when they talk, you sort of nod politely, but you don’t listen to what they say? Let’s fashion your anxiety after that.” I said, “I want you to get in the car, and I want you to invite Edith to go along with you, turn to Edith – literally turn to Edith and say, “Edith I’m glad you’re coming along on this drive, fasten your seatbelt please. I’m not putting you in charge, I want to see my granddaughter, you’re not particularly invested in that, so you can come along as a passenger but I’m taking charge.” And Edith is going to be there, you’re going to feel like this, and then you’re going to put the car in reverse and you’re going to drive. She came back to see me about two weeks later and she said, “I don’t know if I’m doing it right.” I said, “What do you mean?” She said, “I didn’t really feel all that anxious when I got in the car. I know I’m supposed to invite Edith along and feel my worry, but I didn’t really feel that badly.” And she’d gone on, like, five drives in the time that I had seen her.
Dr. Buczynski: As Lynn explained, naming and addressing their fears can help our clients begin to break free from them. Now, we’d like to hear from you. How do you help clients work through their fears? Please leave a comment below, and thanks for watching.
Sometimes it can feel like our fears are in control of us.
But Lynn offered us an example of a creative technique for helping clients take back control from fear.
In the meantime, we’d like to hear from you. How do you help clients face their fears?
Please leave a comment below.
I like this tool and could see it being well applied to a number of clients within the context our their therapy. Differently than the clinician in the video, I do believe that understanding the fear is necessary, not for intellectual gratification but because a fear has roots somewhere in the person’s experience, it formed neuronal connections that keep on being reinforced by thoughts and behaviors. Making sense of these experiences offers integration and supports these top-down strategies. If I only apply the behavioral technique, that particular issue will be extinguished, but the issue that created it will likely find its way in another type of symptom.
I tend to start with bottom-up strategies to relieve excessive dysregulation and offer clients a sense of control over it. Then we try top-down strategies ( this one will be added to my repertoire, thanks!) I like helping them “follow their fear” – “Let’s follow that fear, where does it take you,” and invariably it takes people to a place of threat (threat of something that happened or near happened, a loss – loss of a loved one, loss of safety, loss of separation, of health, of work, of self-esteem, of dignity, etc.) As we extinguish the symptomatic behavior, then I focus on their grieving process ( that which was lost, or nearly lost) to create lasting impact.
This technique makes a lot of since. I am going to try this with one of my mentees who is having fear with being alone in her home. It is almost like seperating yourself from the fear nd then speaking to it as its own person and letting it know that you have no power over me.
Thank you
NAME and CLAIM ….The very act of letting your unconscious know you are listening with Conscious ownership by naming the emotion that caused difficulty prior….means you are our own witness and reclaim the PRESENT Moment – Mindfulness in action.
This technique sounds like it is adapted from the Internal Family Systems (IFS) Model. Thanks for sharing this practical application with your client Lynn. It’s brilliant to know that clients can be great resources for themselves in this way of what sounds like a mix of IFS and assertiveness training.
By use of analogies, talking through possible triggers and exploring past and current management strategies with the young people I have worked with. I have found this decreases their fears and empowers them to take charge and develop their self determination.
Terrible advice to call innovate especially!! Life coaches have been doing this forever and much better, and honestly with a little more humility! Traditionally Psychology is really stuck in the head! Even with it comes to emotions, we are still looking for a formula. Thank god Coaching separates itself from its old grandpa to start its own venture. In general, it’s much more effective to see a coach than swing therapists with all kinds of colourful degrees—if one is after results.
Its nice to know that clients have choices – what suits one client may not suit another – Psychology – hence psychologists and their techniques have a place in therapy – just as Coaches and your techniques do: one size does not fit all.
What a wonderful response to an unfriendly post. As a therapist, I find my self molding constantly to best meet my clients needs, desires, personalities, etc. take care!
The creative technique used by Lynn is called ‘concretizing’ and is a part of a methodology called Psychodrama. Psychodrama is an experiential form of group psychotherapy founded by J.L.Moreno. In this type of psychotherapy, techniques such as doubling, role reversal, mirroring and concretizing allow clients to give shape and voice to thoughts, fears, expectations and more. It also allows clients to practice new behaviors and have productive conversations with an auxiliary in a safe environment.
I use an NLP strategy. First practise breathing and relaxation, then imagine going into the back of a cinema and watching the situation on a screen in colour. Rewind the film fast in black and white. Run forward in colour again then rewind in black and white. Repeat until the energy has diminished enough for them not to feel any anxiety. Can use a scale of 0 – 10. Gradually imagine moving closer to the screen. Finally associate the person into the film and repeat as above until they feel totally fine about it. Get them to leave the cinema and do it for real using the breathing and relaxation exercises again beforehand.
Great idea to externalise the fear/worry enabling the client to create some distance between the anxiety and herself. A similar technique can be used with clients who present with OCD or anger asking them what it looks like, feels like, sounds like. The client may draw/paint the emotion so that it takes on it’s own identity separate from the person and it’s presence starts to diminish. This can be worked through by the client developing a best/compassionate/wise version of themselves, which over time extinguishes the “out of control” emotion.
It’s so good to be reminded that distance from anxiety helps greatly in achieving a more objective perspective of a person’s fears. This fits in with some practical advice I offer via my trauma research entitled: “Lives Unseen: Unacknowledged Trauma of Non-Disordered, Competent Adult Children of Parents with a Severe Mental Illness” freely available at The University of Melbourne, Australia. This research will also come up if you just google my name, along with some trauma-informed articles I’ve posted on medium.com. You should also be able to access my resource website same way. (Hope this is helpful). Thanks heaps for your terrific work!
Thanks. Your sharing echoes acceptance commitment therapy. It works similarly to the passengers on the bus metophor. Thanks for your sharing.
I am always telling my students to take ownership of their actions because when one recognizes faults is when one can start to learn from the faults. I liked her technique with naming the anxiety as it removed the anxiety from her.
No One
I am not sure if anyone can help me move out of fear.
Fear has controlled me since I was a traumatized kid,
and later an abused wife.
When fear tells me what to do or NOT to do or things I must be afraid of –
I have such a visceral reaction;
if I try to move toward it: the fearful thing,
it feels like someone is grabbing or choking me.
Sometimes I feel things crawling all over me.
Sometimes I believe I am about to die.
Sometimes I think I am so near to death I should finish it
Mostly I freeze.
I stop.
And often when it becomes overwhelming,
my dissociative mind will blank out
and I won’t even remember anything that happened
like the trigger or that I blanked out and missed periods of time.
I am so afraid of doing something wrong
Or disappointing someone
Or screwing up or saying something unkind
I am so afraid of doing something wrong
Or disappointing someone
Or screwing up or saying something unkind
I read that sentence and relate entirely though I am not as abused as you obviously have been. But I do recognize that “doing something wrong”, “disappointing someone” and “screwing up” are all value judgements. There are no correct things to do to avoid making mistakes – it is just the way we learn (in a nurturing and caring environment).
Your first priority needs to be safety from the abuse. If you are still in the situation then all the negatives are being reinforced endlessly. You need help to establish boundaries to protect you. I have found great solace at Al-Anon meetings where anonymity is paramount and you will be given the tools to recover.
Eventually you will re-learn, as I am doing, that making mistakes is fine and that your own value-judgements are the perfect vehicle for you learn the lessons of your life. I wish you all the best help, love and support in your journey through recovery. You are not alone.
My clients fear is of someone trying to kill her its severe not sure this would work for her.
Thank you very much. I will try it tomorrow 😀
I have used this technique to great effect, with 2 clients. In both cases, it allowed the clients to distance themselves from the anxiety and hear their fears verbalized in a ridiculous cartoonish voice. The result is a more objective perspective of their fears, making the anxiety seem silly to themselves. It works and works quickly.
I’ve watched my fear of driving grow and blossom from a sensible 15yr old’s fear (which I managed to get over and drive for going on two decades).
Now, I feel the fear of killing someone (my dad was killed by a car when I was 15 and just like that a handful of lives were changed forever).
I’m using this fear to mask my fear of life in general.
I can drive locally but have put this fear in the way of engaging with my family (except for their occasional visits).
I don’t know where to go next?
Please help me with some ideas.
thanx.
I’ve used several practical suggestions from within Buddhist psychology (that don’t require a belief in Buddhism per se), for example:
– “I see you Mara” – externalising and giving a personality to the inner critic or inner worry-monger. Invite “Mara” in for a cup of tea and see clearly what it’s trying to do before gently inviting it to go on its way.
– “Don’t make fear your enemy, but don’t let it be the boss of you.” Yongey Mingyur Rinpoche, who suffered extreme panic attacks from the age of 6 until about 13. Youtube has videos of his talks on working through panic.
– “Working with Fear” talk by Joseph Goldstein. This one was a real breakthrough for recurrent panic attacks. One phrase particularly resonated regarding how crippling fear can become: “I was afraid to go from sitting to standing.” And the solution of acceptance: “If this fear is here for the rest of my life, it’s OK.”
– Naming the panic aloud: “I am afraid!” Which led to a sudden outburst of laughter, and the attacks soon disappeared. The feeling in the body still arises in specific circumstances, but it’s possible to stay with it until it passes.
The writings of Peter Levine, Stephen Porges, Jaak Panksepp and Bessel van der Kolk have been influential in this process. I believe it to be a question of sympathetic and parasympathetic arousal in the body, which we can learn to work with.
I love techniques that are based on acceptance and don’t challenge resistance. I use Energy phychology like EFT. I have worked successfully with fear of driving. And time I’m in heavy traffic I do it myself. I tap on the meridian points s and focus on my feelings of being tense and anxious and when I feel more relaxed I tap on my intention to be obsevant and focused and on arriving safely. Has helped a lot driving in the Bay area or in my homtown Stockholm Sweden .
When working with a 7 year old on his fear of flying we did a combination of EFT and naming his fear, also acknowleding the fear and questioning if it had anything new exept tge boring standard phrase: this is dangerous.
Thanks.
Inviting them to voice what they believe will happen if they act or do something that causes their feat
excellent, I work with little kids- naming fears also anger and other emotions works really well- reminds me of the movie Inside Out- all the different emotions are in character form —
Hi Sam!
You’re talking about Internal Family Systems (IFS)! The developer uses Inside Out to try and explain what’s it’s like inside ourselves. 😉
Different frameworks in psychology handle a variety of concepts or strategies similarly, even though the nomenclature and the details change. The longer I work in the field, I realize that one particular intervention is not always a trademark of a theory. Nancy McWilliams does a fantastic job, for example, integrating and pulling apart several different psychodynamic frameworks, and what one thing would be called in this theory, and how it’d be called in another. Anyway, just to say that working on the “child” self symbolically is very intuitive and not limited to IFS. 🙂
This is a drama therapy technique. Check it out. There even a drama therapy association NADT. 🙂
Simple, straightforward, and brilliant guidance, a lovely embodiment in direction and outcome of the principles of responsible self-leadership. Thanks for this gem of reminding I, for one, need often, often, often…
Excellent technique! Thank you.
Thank you for sharing this playful way to deal with a driving fear. It seems to have an interesting mix of ’60’s Jay Haley/Ericson/Bateson, second cybernetics with some multi and equifinality thrown together with a narrative twist. I think Bill might be able to weigh in on these areas quite well.
Nice reframe interacting with the fear identity and accepting , then distancing from it. Thank you.
You invite your fear to come along and then you get stood up by your fear! Imagine that!!
That was very helpful. What a great way to externalize the fear and do it afraid!
Thanks so much!
Helpful, reminded me of Elizabeth Gilbert’s comments about fear being with her on the road trip of her creativity, she invites fear along but they are not allowed in drivers seat!