The research is clear: the more we embrace fear (exposure, confrontation), the more it will release us from its grip. But how can therapeutic anxiety confrontation be made even more effective? Studies have been able to show that in the treatment of anxiety disorders, it is more effective in the long run not to confront the same situation over and over again, but to master different anxiety-provoking situations. By confronting different challenges, one learns that anxiety is not always justified in every situation and that one can gain control over anxiety. However, one-sided confrontation with a particular situation can lead to stagnation and contribute to the likelihood of a return of fear. The video highlights the exciting research on this topic….

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Studies (small sample only):

Bandarian-Balooch, S., Neumann, D. L., & Boschen, M. J. (2015). Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals. Journal of behavior therapy and experimental psychiatry, 47, 138-144.

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.

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.

de Jong, R., Lommen, M. J., de Jong, P. J., & Nauta, M. H. (2019). Using multiple contexts and retrieval cues in exposure-based therapy to prevent relapse in anxiety disorders. Cognitive and Behavioral Practice, 26(1), 154-165.

Gunther, L. M., Denniston, J. C., & Miller, R. R. (1998). Conducting exposure treatment in multiple contexts can prevent relapse. Behaviour research and therapy, 36(1), 75-91.

Mineka, S., Mystkowski, J. L., Hladek, D., & Rodriguez, B. I. (1999). The effects of changing contexts on return of fear following exposure therapy for spider fear. Journal of consulting and clinical psychology, 67(4), 599.

Shiban, Y., Schelhorn, I., Pauli, P., & Mühlberger, A. (2015). Effect of combined multiple contexts and multiple stimuli exposure in spider phobia: A randomized clinical trial in virtual reality. Behaviour research and therapy, 71, 45-53.

Anyone who successfully confronts his fear (e.g., in the context of cognitive behavioral therapy) builds neuronal “safety networks” in his brain. However, in many situations these safety networks still compete with the old “fear networks”. Depending on which network has the upper hand, our organism reacts with fear or composure. Against this background, many researchers have been looking into the question of how “safety networks” can be further strengthened in our brain. Initial studies were able to show that we can significantly reduce the return of fear through simple mental training (in which we remember successful fear confrontations). Presumably, mental training consolidates the neuronal memory traces of our safety networks.

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Studies and books (only a small selection; all other studies can be found in the book: “Anxiety – what really helps…”):

Burck, E. (2019). Anxiety-What really helps against anxiety and panic attacks?: The most effective strategies against anxiety and panic from a research perspective. BoD Books on Demand.

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behavior research and therapy, 58, 10-23.

Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behavior research and therapy, 46(1), 5-27.

McGlade, A. L., & Craske, M. G. (2021). Optimizing exposure: Between-session mental rehearsal as an augmentation strategy. Behaviour Research and Therapy, 139, 103827.

Mystkowski, J. L., Craske, M. G., Echiverri, A. M., & Labus, J. S. (2006). Mental reinstatement of context and return of fear in spider-fearful participants. Behavior Therapy, 37(1), 49-60.

Vervliet, B., Craske, M. G., & Hermans, D. (2013). Fear extinction and relapse: state of the art. Annual review of clinical psychology, 9, 215-248.