How to face your fears

WWhen Barbara Rothbaum crashed her bike down a hill and broke both elbows a few years ago, she “needed to be her own therapist,” she says. Fortunately, she’s a clinical psychologist. Rothbaum was hesitant to jump back in the saddle after her injury, but she knew she had to face those feelings head-on and get through them.

Our evolutionary instincts can cultivate lingering fears after frightening experiences like a crash, but this built-in risk-avoidance system is essential to our survival. Our ancient ancestors faced countless threats—from hungry crocodiles to deadly infections—so humans developed complex physiological responses that keep us on our toes.

“We’re wired for fear,” says Rothbaum, a professor of psychiatry at Emory University School of Medicine in Atlanta. “We are animals, we live in a dangerous world, and this robust system will help us survive.”

Similar defensive impulses Found In most mammalian species, dissecting rodent brains has allowed scientists to derive detailed insights into the neural underpinnings of fear. Studies have also mapped people’s brain activity as they experience and overcome fears in laboratory settings.

You have to get rid of your fear in order to overcome it.

After sensing a threat, the human brain quickly initiates a domino effect of responses throughout the body. The amygdala immediately dictates how we react, whether to confront the enemy, flee, or freeze, depending on our proximity to the threat, says Michael Fanselow, a psychologist at the University of California, Los Angeles. Our brain also activates the nervous system and prompts us to produce beneficial stress hormones such as adrenaline and cortisol. Our heart and breathing rates change, and blood flows toward our extremities in preparation for quick battle or flight.

But these responses can fail, leading to persistent, irrational fears — referred to as phobias — and conditions such as post-traumatic stress disorder. PTSD may be associated with decreased connectivity between the amygdala and prefrontal cortex, Fanselow says, and increased gray matter volume in the amygdala. Such changes can inhibit an individual’s ability to process fear in a healthy way.

Read more: “How Evolution Designed Your Fears”

Exposure therapies, the gold standard methods used by specialists to treat phobias and other conditions related to fear processing, can help people recover. In fact, you can do exposure therapy yourself, Rothbaum says, as long as the fear is mild and doesn’t interfere with your daily life. The key is to immerse yourself in the stimuli that triggered a specific fear, whether it’s dogs, driving, heights, a bike crash, or any other specific experience that makes you anxious. “When we avoid [these situations]“We can’t see that fear is unnecessary, that the threat is not at the level we feel in our bodies,” Rothbaum says.

“You have to get rid of your fears in order to overcome them,” she explains. She did this, quite literally, while riding a bike, continuing to cycle around as her panic rose and she eventually stabilized. If you are afraid of dogs, for example, you can spend some time with a small, calm, well-behaved dog and wait until your distress disappears.

Rothbaum and Fanciello also recommend escalating exposure with increasing doses, which may look like hanging out with larger dogs over time, riding up steep hills, or driving farther from home, depending on the stimulus given. The presence of loved ones can make exposure therapy more effective, Fanselow says past Results Linking social support and fear inhibition.

“Fear in a really dangerous situation is a good thing.”

It’s important to get professional help if “your life is in danger,” Fanselow says. “If you can’t do the things you want or need to do, you should seek treatment.”

Fanselow says therapy is effective for addressing concerns. But in the long run, it did male It is common for people’s long-standing or severe fears to return. He says exposure therapy helps develop a “safe” association with a particular stimulus, but it tends to be limited to the specific context in which people learn it, such as a therapist’s office. People still retain the “dangerous” connection, which the mind may reclaim in other, unsupervised environments. To treat fear of flying, for example, Rothbaum says she used to take patients on actual flights, but that was often impractical.

Virtual reality exposure therapy is one way to help overcome this limitation. Rothbaum pioneered this practice and did just that I searched For decades, including as a treatment for Veterans With PTSD. Because virtual reality is highly customizable, Rothbaum says it can be used to mimic settings that might be difficult to visit. It can also serve as a particularly useful stimulus for PTSD patients by enabling therapists to match the memories they describe. Scientists are also exploring whether exposure therapy can be enhanced Certain medicationsincluded Hallucinogensalong with Brain stimulation.

But it’s important not to be intimidated by fear itself, Fanselow points out, and to keep the benefits in mind when it works as intended. “People need to realize that fear in really dangerous situations is a good thing,” he says. “These are biological systems that have evolved to do something good for us.” Whether you encounter a grizzly in the woods, or perhaps a misbehaving Chihuahua, you have millions of years of evolution supporting your next move.

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Main image: Wikimedia Commons

• Molly Glick

  Posted on November 5, 2025

  Molly Glick is the newsletter editor for Nautilus.