Phobia therapy. What is that? How does it work? Will it work for me?

People ask many questions and have a great deal of preconceptions about how to let go of fears and phobias.

I wanted to share a no-nonsense approach to answering what phobia therapy is and how it works.

As a disclaimer, this blog is of course my own opinions based on my training, my research and my practice working with clients in the context of phobia therapy. There are other people out there with styles and systems that I either haven’t come across, or have yet to research or fully appreciate the merit of.

How does a phobia work?

A phobic response is designed to keep you safe. If the unconscious has a voice it would be saying “I will never let you be harmed by this again.” Unfortunately it acts like a sensitive smoke detector, and sets off a full scale alarm at the faintest whiff of burnt toast.

The panic that results leads to difficult or embarrassing behaviour as well as feelings that are powerful and unpleasant.

It works when the mind associates into a past memory. The person then experiences the feelings related to the memory as if it is happening now, even when they are standing somewhere that is absolutely safe.

Sometimes the location of this memory or traumatic event is obvious. The person may clearly remember the exact moment they developed their fear.

At other times it is much harder to pinpoint as the person may have forgotten or not noticed where they learned their fear from in the first place.

Phobias can also roughly boil down to being simple or complex. This sometimes has an affect on both the time it takes to discover the root cause of the phobia, and the level of time it might take to overcome it.

Phobia Therapy In a nutshell

Phobia therapy allows the person with the phobia to remember or experience their past differently and then to choose a new way to feel and behave in the future.

There are a few key goals the therapist is aiming for when working with a phobia:

Allowing the client to notice they are safe at all times
This lets the unconscious mind explore the subject whilst the parasympathetic nervous system is activated. Previously it has activated the sympathetic nervous system (responsible for the panic responses of fight, flight or freeze) which in turn reinforces the unwanted emotions and behaviours.

Allowing the client to dissociate from their experience
So they no longer experience their fear as really happening each time it is triggered. The goal is to ensure the client will consistently stay dissociated from the experience and that there is no stimulus that will trigger it.

Create new lessons
Now the client is no longer panicking they regain objectivity. The therapist can direct the client to review their past experience and understand it in new ways that they couldn’t previously. The client can then be directed to consider future scenarios and decide how they would prefer to behave.

How is this achieved?

Bearing all of the above in mind the therapist could use any of the following based on what is appropriate for the client:


By using tasks and language that cause confusion the therapist can assist in scrambling up patterns that were once habitual for the client. This makes it hard for the unconscious to recreate those undesired patterns. Furthermore when people are confused it leads to a gap whereby they are more ready to unconsciously accept new suggestions. It is important to note that they will only accept suggestions that they would like to take on board. When a therapist works with compassion and the clients best interest in mind this happens harmoniously.


Play is one of the best ways for humans to learn quickly and effortlessly. Simply put when humans are having fun and being playful they forget to be scared. They can even learn to smile or laugh at things that once terrified them.


Sometimes it is important for the client to learn to be kind to themselves. Often fears begin in childhood, and the client has been carrying emotions with them all this time. Compassion, mourning, forgiveness and self care are often the fundamental needs to attend to in order for the client to let go of a phobia.

Guidance & Direction

The Therapist can direct the client’s attention and keep it where it needs to be better than if the client was alone. In the same way, you might know the plot to your favourite book intimately. But isn’t it much better to remember and imagine it when listening to it via audible? perhaps with your eyes closed? Guidance simply allows the client to follow instructions far more easily and powerfully and with less distractions than if they were to read a ‘how to’ script and close their eyes and try to complete the process.

Ordeal or Compliance

This isn’t something the therapist does, but rather what they represent to the client. By choosing to pay the money and travel to see and sit with the therapist the client has chosen to enter into a contract with themselves that is saying “What I am doing is worthy of my effort and resources”.

Sometimes the therapist may set the client some tasks to overcome. This creates a level of energy or effort that the client must put in. Some people carry the belief “Nothing in life worth having comes easily”.  This is not my own personal belief, and it is one that providing I have permission I will challenge my client to consider because it can create pain and conflict. However if this is something the client believes then the therapist may need to make sure they provide a solution that does not come too easily for the client, or it will not be accepted.

Safe space

Ultimately it is the client who will create the change, and they have all the tools they need to do so already locked away in their mind. At times the client will come in and talk, and as they do so they begin to point the direction for how they will create their own healing.  The therapist works to create a space that is safe and encouraging for the client to unravel their own solution with support when they require it. This is sometimes referred to as a holding space.

Phobia Therapy
The right environment with the right person is essential for releasing a phobia

What does a typical session involve?

It will begin with a conversation to help both the client and therapist to understand each other clearly. Then it will move onto the next step.

Very commonly (but not always) the client will be asked to imagine a cinema. Using the safety of the projection room the client will then be asked to play movies upon the screen.

What happens next depends on what is needed. It involves imagining being in different parts of the cinema, at times the movies will be muddled around, fast forwarded, rewound and all sorts of shenanigans.

At other times it will be played through with the opportunity to provide compassion. Ultimately at the end the client gets to experience a movie of their self behaving in a safe and appropriate way. This will then become their default for when they encounter the stimulus.

They then get to test that they can no longer have their phobic response. Then they can plan how they will be able to practice testing their new way of being in future scenarios.

Does it work?

Yes absolutely. I would say that talking therapy when used with attention and compassion, and in the style I have described here, has the capacity to work for anyone who genuinely wants to let go of their phobia and behave in a different way.

It takes two to tango. The therapist is responsible for the environment and guidance that is suitable for the client. Meanwhile the client must be honest and open about the goal they wish to work towards.

Everybody processes information in a unique way and at different speeds. For some people, in fact many, it might be that they no longer have a phobia in less than an hour. Honestly.

For others it may be that several hours worth of work yields some small progress. This is then often enough for the client to see the light. They can then choose to continue working on releasing their phobia over a period of time with or without the aid of a therapist.

The Proof of the pudding is in the eating

Authentic confidence comes from things going the way we want them to go over time.

Naturally the client will begin to test if the therapy worked for them. First of all they will do this in their mind. Secondly they will plan to test it in real world scenarios.

The Therapist will tend to encourage an element of mindfulness. In doing so the client can then become aware of being the watcher of their thoughts, emotions and behaviours. This is an important step so that the client can consciously become aware that they are no longer holding onto their phobia.

To wrap it up.

And so there it is. As succinctly as I can give it, a run down on how a good phobia therapy might work. I hope that provides some food for thought. If you have any questions, queries or would like to know more then please feel free to contact me.

About the Author

Tom Powell is a Coach and Fear and Phobia Therapist. He works with people to help them to find their calm so that they can take ownership of situations and of their path through life. Tom lives and works in Bristol, providing talking therapy sessions, coaching sessions, and works specifically with the mental performance of Rock Climbers.

Just Calm Down