cases, however, especially when the other steps have been accomplished
in sequence, when the insights are attained, the working through becomes
little more than a walk in the park.
Desensitization is at the heart of all treatments for fear. With panic
disorder, the places and situations in which attacks might occur are
approached first, and finally the panic itself.
Throughout this narrative, we have been moving in circles around
the details of Jane’s treatment. Her biggest breakthrough came when she
was able to enter a panic attack knowing that she would come out alive.
That actually happened fairly early in her disorder, but the learning was
obscured by her frantic attempts to escape.
Cognitive Therapy
The basic idea of this approach is: What you feel is determined by what
you say to yourself inside your head. To feel better, you have to talk your-
self out of overly negative interpretations of your experience by substitut-
ing internal phrases that more accurately describe reality.
When Jane finally recognized that panic wouldn’t kill her, she
still had to convince her body. Her therapist had her repeat the
phrase “I’m going to be fine” hundreds of times. Eventually it
worked. The physical components of fear began to decrease.Cognitive therapy is simple, though not quite so simple as I have
portrayed it. We will explore its intricacies in later chapters. For now, realize
that almost every sentence in this book is meant to be used as an internal
phrase that more accurately describes reality.
Step 4: Creating a New Balance
Whatever else they are, psychological symptoms are like lights on the
dashboard warning that something is wrong under the hood. Therapists
must first be mind mechanics, able to fix the symptoms. Consider the
chapter thus far as the shop manual for the repair of fear disorders.
We aren’t just mechanics, though; we’re creatures of art and intuition.
When therapists look at an explosive person, they don’t see a col-
lection of symptoms, but rather a whole personality, often clearly out of
The Psychology of Fear ❧ 121