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An example of the fear-avoidance model, anxiety sensitivity stems from the fear that the symptoms of anxiety will lead to harmful social and physical effects. As a result, the individual delays the situation by avoiding any stimuli related to pain-inducing situations and activities, becoming restricted in normal daily function.
The principles of systematic desensitization can be used by children to help reduce their test anxiety. Children can practice the muscle relaxation techniques by tensing and relaxing different muscle groups. With older children and college students, an explanation of desensitization can help to increase the effectiveness of the process.
When designing an exposure hierarchy, therapists first conduct a thorough assessment of their client's fear with particular attention to the (a) feared object or situation, (b) feared consequences of confronting the object, (c) fear-related avoidance or safety behaviors, and (d) triggers and contexts of the fear. [3]
Exposure therapy is based on the principle of respondent conditioning often termed Pavlovian extinction. [10] The exposure therapist identifies the cognitions, emotions and physiological arousal that accompany a fear-inducing stimulus and then tries to break the pattern of escape that maintains the fear.
These behaviors are aimed to reduce fear or anxiety in a currently threatening situation. [12] Examples include: Escaping the situation [4] Using safety signals such as looking at cell phones to reduce social anxiety [4] Subtle avoidance behaviors such as breathing techniques [4] Compulsive behaviors such as repeatedly washing hands [4]
A phobic reaction is twofold—the first part being the "intense irrational fear" and the second part being "avoidance." [4] Children during their developmental stages experience fears. Fear is a natural part of self-preservation. Fears allow children to act with the necessary cautions to stay safe. [5]
Distress is an inextricable part of life; therefore, avoidance is often only a temporary solution. Avoidance reinforces the notion that discomfort, distress and anxiety are bad, or dangerous. Sustaining avoidance often requires effort and energy. Avoidance limits one's focus at the expense of fully experiencing what is going on in the present.
The neural circuit responsible for expressing signaled avoidance behavior is the same that controls extinction of fear responses. The presentation of the aversive stimulus activates neurons in the central amygdala which project to the periaqueductal gray region to elicit a fear-motivated motor response.