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Treating Fear in the 21st Century: Lessons from David Blaine

06/07/2013 10:54 am ET | Updated Aug 07, 2013

Click here to read an original op-ed from the TED speaker who inspired this post and watch the TEDTalk below.

What would you expect to see upon entering a psychologist's office? Perhaps you imagine a couch supporting a distressed-looking client and a serious-looking therapist nodding and analyzing every word?

Well, if you were to peek into my office during a therapy session, you just might discover something a bit unusual -- my client and I breathing through narrow straws.

This is therapy in the modern era.

One of the great aspects of David Blaine's recent TEDTalk presentation was his concrete discussion and recall of how he trains his body and mind for various shows. In particular, the overview of various strategies he uses to train for the breath-holding spectacle offers us the opportunity to learn about how we can stretch and manipulate the thresholds of our body and mind. In fact, such lessons can be instructive in terms of demonstrating an important part of therapy for fear.

Decades of research on factors that play a causal role in fear and anxiety have allowed psychologists to design treatments that target these underlying causes.

For example, there is plenty of research that shows how something called anxiety sensitivity predisposes people to develop fears and anxiety disorders. Anxiety sensitivity is the degree to which a person reacts negatively to the physiological symptoms of anxiety. For example, if you are very sensitive to anxiety, you are likely to become frightened when you notice a change in heart rate (you might think "hey, this could mean I am having a heart attack").

People who are very sensitive to anxiety tend to avoid physical sensations, such as changes in heart rate, dizziness and shortness of breath. Unfortunately, repeatedly avoiding physical sensations worsens the fear because it increases the sensitivity to anxiety, makes the person believe that anxiety is harmful and must be avoided, and can actually create an addiction-like response to avoidance.

For example, when anxious patients come to see me for therapy, they are often very sensitive to changes in their body. In fact, whereas many patients experience some shortness of breath and dizziness while breathing through a straw for a minute, a significant portion of my anxious patients cannot last one minute because these symptoms are too disturbing.

Blaine was able to do what many people who have anxiety are afraid to do -- expose themselves to all kinds of physical sensations that cause extreme discomfort. --Roger Covin, Ph.D.

Anxiety sensitivity affects many fears. David Blaine disclosed that he was a hypochondriac -- someone who fears illness. Often, hypochondriacs don't like physical sensations because they could mean that there is something wrong with the body (ex: chest pain could mean heart disease). Blaine was able to do what many people who have anxiety are afraid to do -- expose themselves to all kinds of physical sensations that cause extreme discomfort.

Blaine's various training strategies were often associated with changes in the body that mimic fear and even panic. His description of breath-holding attempts, especially the one on Oprah, was filled with examples of uncomfortable physical symptoms. His whole training process demonstrated some important things that psychologists use as a basis for therapy:

  1. Expose the Body: We can use all types of exercises to artificially stimulate physical symptoms of anxiety. This is called interoceptive exposure.
  2. Change the Body: We can then use interoceptive exposure to decrease patient's sensitivity to anxiety. Just as Blaine was able to gradually increase his body's ability to adjust to not breathing, we can all adjust our sensitivity to physical sensations in order to become less fearful.
  3. Change the Mind: Not only can we adjust our bodies, but we can also adjust our minds, which was also a key point of the Blaine talk and is a core aspect of therapy. If you can reinterpret what a physical sensation means, you can essentially defeat fear. For example, if a person who fears panic attacks learns that shortness of breath and even panic is not dangerous, they can conquer Panic Disorder.

Therapy in the 21st century looks very different from what Freud was doing a century ago. Therapy for anxiety and fear tends to involve more than just interoceptive exposure therapy, but this is certainly a key component of treatments. When we retrain the body and mind to make uncomfortable physical sensations more acceptable, the outcomes can be remarkable.

David Blaine not only shows how far we can shape our physical and psychological boundaries, but is an inspiration to those looking to overcome the more common fears in everyday life.

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