Dawn Huebner on Rethinking Anxiety: Learning to Face Fear (Transcript)

We decided to start with bees and went on a campaign to get Eli to go outside. He’s maybe 11 at this point, and it isn’t much of a stretch to say that his life revolved around Legos: big sets, complicated castles, and forts, and islands, and ships. He would do just about anything for money for Legos.

You can probably guess where this is going: I bribed him. “Just go outside,” I said, “You’re not going to get stung. And if you do, I’ll give you ten dollars.”

I’m going to pause the story for a moment.

I made two major mistakes with that intervention: the first was telling him, in a definitive way, he wasn’t going to get stung. How crazy is that? How could I possibly know whether or not he gets stung? What I should have told him was that a sting was unlikely which would have been more accurate and also more useful because an important part of overcoming anxiety is learning to take a chance, to take action even though you feel unsure, to be nervous and do something anyway.

My other mistake was offering a reward for the bad thing happening. What I should have been rewarding was the part of the CBT triangle I wanted him to be paying attention to: the action. I should have rewarded his going outside. I could have bought the Lego set he wanted and given him a single piece every time he went out. That would have been rewarding his bravery, his willingness to face his fear, step into the uncertainty not the bee sting.

But I didn’t know then what I know now, so I did the wrong thing. Although it accomplished something important: got him to go outside.

My husband was on the same page, dangling the same carrot, a bigger carrot. “If you go outside,” he said, “and get stung, I’ll give you 20 dollars.”

So, Eli went outside with great trepidation but fueled by the possibility of a pay-off, and he did get stung, something like five minutes after we told him he wouldn’t. He handled the sting itself pretty well, which is typically how it goes. The possibility of a bad thing is often worse than the actual bad thing, and he was delighted that we now had to fork over 30 dollars; that was half a Lego ship back then. Money well spent as far as we were concerned, because he saw that he could survive the sting.

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He went outside more willingly after that, nervous but liking the financial gain, and gradually, his fears abated. It wasn’t the perfect cure although he did get over his fear of long, sharp objects that poked enough to take up fencing which was enough to propel me further into CBT as a theoretical orientation.

I learned more about how to use cognitive behavioral strategies without the bribes, and it transformed the way I worked with children, anxious children, who got better, so much better that I decided to write a self-help book to bring these skills to a wider audience.

My first book was for anxious kids on What to Do When You Worry Too Much, and it took off. Sales were higher than my publisher and I ever anticipated, and then I wrote another book, and another, all teaching cognitive behavioral strategies directly to children empowering them to help themselves.

I started being contacted by the national media, and by parenting groups, and professional groups wanting me to come speak, but oddly enough, I was never available. The timing of a conference wasn’t quite right, I had other plans, couldn’t take time off from my practice. These were the excuses I gave one after another as I turned down invitation after invitation, “I’m sorry. I just can’t make it.”

I turned down public speaking invitations for two years. I was aware at some level of what I was doing. I knew I was afraid I would fall flat, get tongue-tied, not be interesting enough or funny enough. I told myself that public speaking just wasn’t my thing, and that that was OK.

But eventually, the irony of this particular fear jumped up and slapped me in the face.

Here I was: a psychologist with a best-selling book about anxiety, a national expert on the treatment of anxiety; anxiety — the very thing that was keeping me from standing up and talking about it. I’d like to be able to tell you my first thought was, “Great, this will be an opportunity to practice all those skills I’ve been teaching,” but I’d be lying.

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My first thought was, “If I want to be able to face myself in the mirror, I need to do something about this.”

One of the primary cognitive behavioral interventions for dealing with anxiety is exposure with the aim of desensitizing to whatever we’re afraid of. Let’s imagine we’re putting together a tool box; exposure’s our first tool. How does it work? Well, think about jumping into a swimming pool; it’s cold, but if you stay in the water, start swimming, or playing, or whatever, pretty soon it feels fine; you’ve desensitized. The water’s just as cold as it was when you first jumped in, but you don’t notice the cold anymore, you’ve gotten used to it.

One version of this exposure technique is called flooding. It’s like exposure on steroids, the literal equivalent of jumping into a cold pool, all at once, “Just deal with it.” Afraid of spiders? Plunge your hand into a jar of them. Afraid of germs? Go to a pediatrician’s office, touch all the toys in the waiting room, rub your hands on your face.

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