AreasWorry and anxietyFacing it a step at a time

Five minutesAfter a rowCBTWorry and anxiety

Being pushed into something before you are ready does more than frighten you. It teaches you that the pacing you were promised cannot be trusted, and that is the harder thing to repair.

After a step that overwhelmed them, most people go straight back to avoiding, and they also start negotiating every later step defensively, which is a reasonable response to having been misled once. If you are the one guiding, an apology and a visibly smaller next step is the repair. If you are the one who got pushed, saying plainly that it was too much is not a loss of nerve.

Before you use this

Facing a fear in steps works, and it works best with someone guiding the ladder. Read this as an explanation of how it works, and take the steps themselves to a therapist.

Qur’an and Sunnah

Draw near! Do not be afraid, for you are one of those who are safe (Quran 28:31). Moses had already fled, and what came next was a call back rather than a reproach.

وَأَنۡ أَلۡقِ عَصَاكَۚ فَلَمَّا رَءَاهَا تَهۡتَزُّ كَأَنَّهَا جَآنࣱّ وَلَّىٰ مُدۡبِرࣰ ا وَلَمۡ يُعَقِّبۡۚ يَٰمُوسَىٰٓ أَقۡبِلۡ وَلَا تَخَفۡۖ إِنَّكَ مِنَ ٱلۡأٓمِنِينَ

Throw down your staff.’ When he saw his staff moving like a snake, he fled in fear and would not return. Again [he was called]: ‘Moses! Draw near! Do not be afraid, for you are one of those who are safe

Qur’an 28:31read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

One caution against overstating this. A theoretical review notes that neither how much fear drops during a session nor how anxious a person is at the end predicts the outcome, so a distressing session is not automatically a wasted one. What makes a step go wrong is escaping before anything was learned, rather than the distress itself. The evidence that a badly judged step actively sets people back is thinner than clinical confidence about it suggests.

Craske MG, Kircanski K, Zelikowsky M, Mystkowski J, Chowdhury N, Baker A. (2008). Optimizing inhibitory learning during exposure therapy.. Behaviour research and therapy doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

Trust in the plan is what carries someone into the next step, so it is worth more than any single rung.

This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.

Near this one

More on worry and anxiety

Being pushed into something before you are ready does more than frighten you. It teaches you that the pacing you were promised cannot be trusted, and that is the harder thing to repair · Inshirah