Psychology In The News | Unconscious Exposure Therapy

As part of your study of Psychology, you may have learned

about phobias. Defined by the NHS as an ‘overwhelming and debilitating fear of an object, place, situation, feeling or animal’ around 10 million people in the UK have a phobia, making them the most common anxiety disorder.

Phobias fall under two broad categories: specific and complex. Specific phobias focus on objects, animals, or situations like spiders, heights, or dental visits, often developing in childhood. Complex phobias, including agoraphobia and social phobia, are more severe and typically emerge in adulthood. Both types can significantly disrupt daily life, causing anxiety and avoidance of triggering situations.

Traditional exposure therapy, which involves deliberately confronting feared objects (either in a staged manner, such as systematic desensitisation or at a very high level of exposure immediately, such as flooding), is effective but often traumatic. Many patients find the process so stressful that they avoid treatment or drop out midway.

A groundbreaking meta-analysis suggests that unconscious exposure therapy could be a promising new approach to treating phobias. Researchers Paul Siegel and Bradley Peterson analysed 39 studies exploring interventions that help reduce fear responses without causing conscious distress.

The study examined 10 different unconscious exposure approaches. One method called ‘very brief exposure’, involved showing images of feared objects for a very brief duration, immediately followed by neutral images, which prevents conscious recognition. Another technique, ‘spiderless arachnophobia therapy’, uses images resembling spiders (like a camera tripod) that are processed unconsciously.

Remarkably, 38 of the 39 studies showed positive results. These unconscious interventions successfully reduced fear responses without triggering conscious anxiety. While the behavioural effects were slightly less pronounced than traditional exposure therapy, they were still considered significant.

The researchers propose that human brains process scary stimuli through separate unconscious and conscious pathways. During unconscious exposure, the amygdala detects threats without generating physical fear responses like increased heart rate or sweating. Repeated exposure potentially ‘rewrites’ the brain's threat memory, teaching it that certain stimuli are not inherently dangerous.

Most studies involved only a single treatment session, suggesting the potential for even greater effectiveness with multiple interventions. The researchers hypothesise that this approach could be particularly valuable for specific phobias and potentially applicable to other anxiety disorders like PTSD (Post-traumatic stress disorder).

This research challenges long-standing psychological beliefs that confrontation is necessary to reduce fear. Instead, it suggests a new generation of exposure therapies could leverage unconscious processing to mitigate anxiety and revolutionise mental health treatment.

ANSWER THE FOLLOWING QUESTIONS!

1. What is the difference between a simple phobia and a complex phobia?
2. Use your knowledge of traditional exposure therapy (Systematic desensitisation or Flooding) to explain how someone with a phobia of spiders may usually receive treatment
3. How could research into this area have positive economic implications?
4. How does unconscious exposure therapy demonstrate neuroplasticity?
5. The reference for this article is below, what is missing? Siegel, P., & Peterson, B. S. (2024). “All we have to fear is fear itself”: Paradigms for reducing fear by preventing awareness of it. Psychological Bulletin, 150(9), 1118–1154.

References

NHS UK Overview - Phobias https://www.nhs.uk/mental-heal... (accessed 3.12.24)

British Psychological Society Research Digest: Could exposure therapy, without conscious exposure, actually work? https://www.bps.org.uk/researc... (accessed 3.12.24)