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Fear and physiological arousal
Fears, Phobias & Procedural Anxiety
Specific fears can produce powerful physical responses even when a person understands intellectually that the situation is safe.
The clinical perspective
Individualised rather than confrontational
Treatment aims to understand how the fear is organised, what maintains it and how new learning can occur safely and at an appropriate pace.
The work may involve preparation, attention training, imagery, graded behavioural experiments, clinical hypnosis and other CBT-informed strategies. Exposure is collaborative and carefully paced rather than imposed.
Procedural anxiety may relate to needles, dentistry, anaesthesia, medical settings, enclosed spaces or previous difficult experiences. Treatment does not require assuming that every fear has a hidden cause or recovering uncertain memories.
How the work is approached
Assessment, formulation and practical change
Clarify the pattern
Identify triggers, predictions, safety behaviours and the physical fear response.
Build control
Develop practical skills for regulating attention, arousal and anticipatory anxiety.
Create new learning
Approach feared situations in manageable steps chosen collaboratively.
Prepare for procedures
Coordinate with the treating team when a specific medical or dental procedure is planned.
Important context
Part of appropriate clinical care
Suitability is assessed individually. No particular outcome can be guaranteed, and another form of medical, psychological or allied-health care may sometimes be more appropriate.
Where other clinicians are involved, coordinated care is encouraged.
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