Areas › Worry and anxiety › Facing it a step at a time
No step happens without the person agreeing to it. Not ordered, not dragged, not talked round in a bright voice. Agreement is a condition of the thing working, not a courtesy.
Coerced exposure teaches two lessons at once: that the situation is dangerous, and that you are not safe with the people who arranged it. After that you have the original fear plus an adult who has to be managed. Ask, wait, accept a no, and offer something smaller instead. The slower route is the only one that ends with someone saying they did it themselves.
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
Do not be afraid, I am with you both (Quran 20:46). What Moses and Aaron were given before walking into what they dreaded was company, not a command.
قَالَ لَا تَخَافَآۖ إِنَّنِي مَعَكُمَآ أَسۡمَعُ وَأَرَىٰ
He said, ‘Do not be afraid, I am with you both, hearing and seeing everything
Qur’an 20:46read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A meta-analysis of dropout from virtual reality exposure found it was about the same as dropout from real world exposure, so making the format feel gentler does not by itself keep people in treatment. Whatever holds people in is something other than how easy the situation looks from outside, and willing agreement is the obvious candidate. That candidate is not what the meta-analysis tested.
Benbow AA, Anderson PL. (2019). A meta-analytic examination of attrition in virtual reality exposure therapy for anxiety disorders.. Journal of anxiety disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Going towards something because you chose to is what leaves you with proof about yourself.
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
Being shown a breathing technique is not the same as being able to use one. Practise it while nothing is wrong, often enough that it runs without you having to remember the order.
Ask which step they are willing to try, and then go with their answer. A smaller step they chose themselves tends to get attempted, and a bigger one you chose for them often does not.
Put a number on each step, nought to ten, and let it be your number. Two people facing the same school will not agree about which part is worst, and the ladder has to belong to the person climbing it.