In the last 20 years the behavioral approach to therapy has revolutionized the treatment of persistent phobias and obsessive-compulsive rituals. This approach is based on old principles, but these are applied with a new thoroughness that can bring reliable relief of suffering that previously might have continued unchanged for decades. Behavior therapy does not assume that phobias and rituals are symbolic transformations of hidden difficulties. Instead, it regards the phobia or ritual itself as the main handicap and tries to eliminate this handicap directly—not by uncovering unconscious meanings, but by teaching the sufferer how to face those situations that trigger discomfort and how to eventually come to tolerate them. For some people, problems that have been present for 30 years or more have been overcome in a few hours of exposure over a couple of days.
Effective treatment usually taxes somewhat longer though— perhaps several weeks to months.
Not all behavioral methods are equally effective. Relaxation for anxiety is often called a behavior therapy, but it does not reduce phobias or rituals. The many variants of behavioral approaches that are effective have in common the principle of exposure to that which frightens you until you get used to it. Once you confront your fear with determination, it will diminish. We don’t know quite how or why this method works. But it does work, provided that exposure continues long enough.
In fact you can observe the process at work even with very simple animals. If you touch the antennae of a snail, they will quickly retract; after a minute or two the snail will put out its antennae once more. Touch them again and they will be drawn back a second time, but on this occasion a bit less quickly, and after a shorter interval they will creep out again. Touch them a third time, and a fourth time, and a fifth, and progressively the snail will get used to your touch and its antennae will eventually stop retreating from your finger. Through repeated exposure to this provoking activity, the snail’s “anxiety” has been extinguished. This simple process, called habituation, is similar to the way that phobics and ritualizers react during exposure therapy. Habituation has been shown to last for weeks in snails and for many years in humans. In other words, improvement in phobic and ritualizing behaviors can endure, provided that the habituation by exposure has been sufficiently thorough.
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