Countless studies show: If you want to overcome your fear, you would do well to face it. Whether it’s a fear of spiders, dogs, lectures, heights, thunderstorms, small rooms, dental treatment, etc., as soon as we manage to shed our avoidance behavior, we can make the important experience that the feared situations are nowhere near as dangerous as we originally feared (or sometimes even fun).
But what mindset allows us to get the maximum therapeutic benefit from a confrontation? A classic study by Southworth and Kirsch (1988) with subjects suffering from agoraphobia provides exciting answers…

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Studies (small sample only):

Southworth, S., & Kirsch, I. (1988). The role of expectancy in exposure-generated fear reduction in agoraphobia. Behavior Research and Therapy, 26(2), 113-120.

Burck, E. (2019). Angst-Was hilft wirklich gegen Angst und Panikattacken?: The most effective strategies against anxiety and panic from a research perspective. BoD Books on Demand.

Is it possible to rewrite old traumatic fear memories and thus significantly reduce the suffering of many patients? The discovery of memory reconsolidation suggests that this could be much easier than many researchers have long assumed.  This is because new research has shown that our memory hovers in a changeable, protein synthesis-dependent state after each recall. During this time window, it is possible to “update” the memory through interventions (e.g. preventing protein synthesis with anisomycin). (Nader & Hardt, 2009; Nader, Schafe, & Le Doux, 2000). Our memory is therefore much more modifiable than we realize. This opens up many new possibilities for the psychotherapy of anxiety disorders (panic disorder, post-traumatic stress disorder, social anxiety, phobias, agoraphobia, etc.).

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Studies (just a small selection):  Elsey, J. W., & Kindt, M. (2017). Tackling maladaptive memories through reconsolidation: From neural to clinical science. Neurobiology of Learning and Memory, 142, 108-117.

Mallet, C., Chick, C. F., Maatoug, R., Fossati, P., Brunet, A., & Millet, B. (2022). Memory reconsolidation impairment using the β-adrenergic receptor blocker propranolol reduces nightmare severity in patients with posttraumatic stress disorder: a preliminary study. Journal of Clinical Sleep Medicine, 18(7), 1847-1855.

Pigeon, S., Lonergan, M., Rotondo, O., Pitman, R. K., & Brunet, A. (2022). Impairing memory reconsolidation with propranolol in healthy and clinical samples: a meta-analysis. Journal of Psychiatry and Neuroscience, 47(2), E109-E122.

Soeter, M., & Kindt, M. (2011). Disrupting reconsolidation: pharmacological and behavioral manipulations. Learning & Memory, 18(6), 357-366.

Approximately 5% of all people in Europe suffer from agoraphobia at least once in their lives (the 12-month prevalence is about 2%; Wittchen and Hoyer, 2011). Due to fear (of panic attacks or other symptoms), sufferers avoid e.g. department stores, cinemas, public transport, crowds, confined or enclosed spaces, and car journeys. Many almost never leave their own home because of the fear. Fortunately, from numerous studies we can derive clear tips on how to cope with the anxiety in the long term…

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Studies and books (only a small selection; all further studies can be found in the book: “Angst – was hilft wirklich?”):

Burck, E. (2019). Angst-Was hilft wirklich gegen Angst und Panikattacken?: Die effektivsten Strategien gegen Angst und Panik aus Sicht der Forschung. BoD–Books on Demand.

Broocks, A., Bandelow, B., Pekrun, G., George, A., Meyer, T., Bartmann, U., … & Rüther, E. (1998). Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder. American Journal of Psychiatry, 155(5), 603-609.

Gaudlitz, K., Plag, J., Dimeo, F., & Ströhle, A. (2015). Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder. Depression and anxiety, 32(3), 221-228.

Ito, L. M., De Araujo, L. A., Tess, V. L. C., de Barros-Neto, T. P., Asbahr, F. R., & Marks, I. (2001). Self-exposure therapy for panic disorder with agoraphobia: randomised controlled study of external v. interoceptive self-exposure. The British Journal of Psychiatry, 178(4), 331-336.

Meuret, A. E., Wolitzky-Taylor, K. B., Twohig, M. P., & Craske, M. G. (2012). Coping skills and exposure therapy in panic disorder and agoraphobia: latest advances and future directions. Behavior therapy, 43(2), 271-284.

Southworth, S., & Kirsch, I. (1988). The role of expectancy in exposure-generated fear reduction in agoraphobia. Behaviour Research and Therapy, 26(2), 113-120.

Ströhle, A., Feller, C., Onken, M., Godemann, F., Heinz, A., & Dimeo, F. (2005). The acute antipanic activity of aerobic exercise. American Journal of Psychiatry, 162(12), 2376-2378.

Ströhle, A., Stoy, M., Graetz, B., Scheel, M., Wittmann, A., Gallinat, J., … & Hellweg, R. (2010). Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology, 35(3), 364-368.

Ströhle, A., Graetz, B., Scheel, M., Wittmann, A., Feller, C., Heinz, A., & Dimeo, F. (2009). The acute antipanic and anxiolytic activity of aerobic exercise in patients with panic disorder and healthy control subjects. Journal of psychiatric research, 43(12), 1013-1017.

Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling: a meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological bulletin, 138(4), 775.