Hello, I'm Dan Short and I'm going to talk about fear in the context of psychotherapy. I have been working with the issue of fear for nearly 30 years now and can say that fear is almost always an anger issue. Even anxiety issues related to depression still have their roots in fear. Fear is primary because it is related to survival and is closely related to all other emotions. We experience this today with the pandemic, with life turned upside down including the fear of disease and death. Fear is becoming more and more acute in our society and more so now and we must learn to respond to it.  

In some cases, for some people, the problem develops because they have too few fears or too few emotions, in general. They are smooth people who are not afraid and when the time comes for a decision they think twice before acting. There are also therapeutic situations in which the fear will be increased. But today we are going to start from an excess of intense chronic fear that interferes with a person being able to think clearly and function normally in ordinary daily activities.  

I just met someone before I started this recording who was terrified, a woman who was just diagnosed with type 1 diabetes. She was told she couldn't live the life she wants anymore, her new doctor told her she couldn't go camping or hiking anymore, which is the only thing that gives her joy in life. She was told that the drugs she takes will cause horrible side effects and she is afraid of losing her job because she has already experienced mental confusion. She is currently on leave. I had helped her organize this with her company's human resources so that she would have some free time to adjust but now she has to go back to work. She fears that if she cannot return to work, she will fall back into fear of severe childhood trauma from abuse and neglect by both parents. So she had plenty of reason to be afraid! To work with a person like that, who may be overwhelmed by emotion, fear, anxiety and depression and other feelings, there are three basic things to know:   

The first affects both protagonists, everything must always start with a two-way adjustment. It's not even what you say to a customer that's most important; it's how you feel and how you react to him, and if you ever feel anything that's contrary to how he feels or inconsistent with who he is, then the relationship won't work. Your words won't have any meaning or value, he'll just feel misunderstood and somehow think he can't trust you. If you act out of a sense of trust or out of a sense of gratitude, a strong sense of hope but there is a sense of dread, it's like speaking two different languages. As if you don't understand him and therefore you won't be able to process him and tell him how he should behave. But once you can feel the fear in these people, what is affecting them and tell them “I feel what you feel”, then you can resonate with them and be able to guide them more easily.

My second point is co-creation, the story that people tell each other. So almost all of our emotions don't come from raw facts but from stories like, "This is going to kill me, this is going to hurt me like I've suffered in the past, I've been humiliated at because of that and now I know I'm stupid! There's always a story people tell each other and a story they tell you that you'll be sucked into very quickly like you're in a movie. And when we live in a movie, we quickly lose the awareness that we are part of a story and that story can be told in many different ways. The same story can be told in a thousand ways and provoke different emotional reactions. So you have to be aware that people come to you with stories in their minds but as they interact with that story, that story is going to potentially undergo transformations, expand or contract. There's going to be a co-creation of the story as if you're both screenwriters writing it, and so you have to be aware that you're on the right story and not your own life's or that of other clients you have worked with. The more you acknowledge their story, the more you can involve the person and help them have a positive reaction.

The third thing I want to talk about is what researchers call “emotional counter-regulation” or “emotional counter-regulation.” “Counter-regulation” is the idea that when the nervous system is aroused by certain emotions such as fear, the charge stays in the system until we are either exhausted, completely lacking in energy. , overwhelmed by that emotion, is replaced by another emotion, like when someone starts crying and is just too exhausted to keep it up. And so sometimes fear can turn into anger. I have seen this many times, for example in extreme situations where someone may have been robbed or threatened with a knife or gun pointed at them, he suddenly screams and yells at the attacker or he puts himself in a position of dominance, which makes the attacker confused and frightened and causes him to flee. One emotion can be said to give rise to another, and when the new emotion arrives, it brings with it a new set of behaviors and new ideas. These are specific emotions.  

These are three important points to keep in mind that when you talk to someone who is in a particular emotional state, you have to integrate the effects of fear. We then witness “two-man affect”, “narrative co-creation” and “emotional counter-reaction”. And it's not a step-by-step process like 1, 2, 3, but it's three things that allow you to have maximum and beneficial impact. When you have faced this type of case, influence and help the person in a way that goes beyond consciousness. You then experience some sort of cognitive behavior, trying to think this or trying to tell yourself that, there is nothing wrong with that but these messages go deeper and have more lasting implications.  

So let's start with the first concept: "Affect two-man"; there are some things that we have to keep in mind and above all, it is a little easier if the person feels sad and you feel sad with them. Maybe their parents are dead, they're crying and maybe you're crying too or it's just your face showing sadness. Don't worry about the effect that sadness will have on them. Someone is joyful, they are celebrating something and you are enthusiastic and full of energy, joyful energy. We don't care about those two emotions which are a bit tricky to imitate and if you want to bring in emotional energy it's on anger and fear. I've seen people come into my office screaming and literally swearing because they were upset about something in their lives. In fact, the best response is to be angry and show the same energy. On the other hand, you can't be angry with the customer because you might fight and you might even be aggressive. You should never be angry with the person you are trying to help, at them or at anything else. But maybe you are angry at his wife who cheated on him, or you are angry because his best friend abandoned him, you can join them, even if someone is angry at you, because you don't have enough time to receive it today. You may even be unhappy with your schedule because your schedules don't allow you to see it. With fear it's a bit different, we want to be afraid with customers, but we don't want to cause them more fear, so your fear should always be a little lower. My client is afraid of going crazy, maybe that's what will happen, she mentioned the psychiatric hospital, she's terrified of it. I am therefore afraid with her of what she is going to become in a hospital, I am afraid that she will be seriously affected psychologically. I know she is very depressed and so my concern is that she might be so suicidal that it is not safe for her to be home. If she's thinking about killing herself and might actually do it, that's something that concerns me. So I pointed out to him: "You know that if someone tried to put you in the hospital against your will, it would not be me but if someone else were to try to put you in the hospital against your will, you would probably only be kept for a week or so". Here in Arizona, the hospitals hold you for 7 days to stabilize you on medication, and then they release you; so we are talking about seven days.  

After that we get into a bit of “narrative co-creation”, because I help her build a story, the story she started, the story that she could go crazy. Inside this story, I am afraid with her, while being more concerned that she could spend seven days in the hospital with her mind awake. It's as if she were aging and dying in an institution. She therefore feared that she would no longer be able to do her job. I'm also worried that she might go to work on day one and spend her time crying because she's depressed - that's what other clients have done - so I was afraid that 'she's embarrassed to go back to work and cry. I asked her how long she had to work, and pointed out to her that three times a day she had to prepare for this. We needed to have a solution on how she would need to go to the bathroom to freshen up her face. She told me she was working 12 hours, I said she might not be doing three but four trips to the bathroom. So I'm worried and I think of things that must make her anxious. That's my concern and that it doesn't exceed hers since her fear is "it's not going to work out at work and I'm going to be fired". So here I am feeling what she feels but in such a way that she can feel less fear. If someone makes her falsely confident, if the patient gets the idea that you think he can do more than he really can or is more capable than he can do then he can't trust you. So she knows she can trust me.

We are now building the story together and she is telling her emotions. Stories can be about the past, stories can be about the future, but what you're doing is trying to get the person to experience other ways of thinking so they say they're going to work . People ask me "you know what's wrong with you?" and I can't say anything. It would be terribly humiliating. And so I helped her construct another possible story by imagining that someone comes to see her and asks her how she is and how she feels, why she came to work. She must imagine herself saying "Thanks for asking, I appreciate your concern but I'm not ready to talk about it here." And in that moment, we build a new story in which she handles things competently and successfully. So we go through all the different situations she can think of, past and future.

"- In the past, I had problems with crying at work and went to the bathroom".

“Okay, did this cause your manager to question your work, or did your manager threaten to fire you? »  

“- No he complimented me on my work! »  

“Okay, so that's not it; it hasn't been a problem in the past, your superiors are ok with that”. We are currently working on a story that goes back in time and uses the same facts of going to the toilet to cry, but we do it from a different angle. This is therefore very important so that the emotions of the patients enter their story and help them to rearrange or review from a different point of view certain details of the past, certain details of the future, what they expect, how it will play out , how they will behave. And for “co-regulation”, ask them what they would like to feel instead! That's what I just asked my client: "Instead of being afraid, how would you like to feel?" She says she would like to feel some confidence. So we start talking about how she could get there and one of the important things is that I tell her that she's going to get there, that the best way to get there is to set the goal consciously: "I want to have more self-confidence", but she must not try to achieve this consciously because the conscious does not control the emotions; she must set a goal and then trust the unconscious which will find a way to give her a little more confidence or to bring in a little more emotion. And each time she does, she will get better and better. Fear will be crushed by trust and if you want, you can put this into practice in therapy with a role play during which they will discover what story they are telling themselves, while having them identify the emotions. They want to feel peace, gratitude, compassion or whatever. You then help them to tell a new story and to do a role play in a different way so that they feel another emotion, so that they regain some confidence, because after doing it in your office they will be able to then do it in the outside world.

So if you remember these three simple concepts, I think you'll have more than enough to work with and help your clients.