Emotional Resilience Blog from The Fear Course

The latest research, realisations and thinking in the world of emotional resilience, anxiety and fear reduction from around the world.

  • Home
    Home This is where you can find all the blog posts throughout the site.
  • Categories
    Categories Displays a list of categories from this blog.
  • Tags
    Tags Displays a list of tags that have been used in the blog.
  • Bloggers
    Bloggers Search for your favorite blogger from this site.
  • Team Blogs
    Team Blogs Find your favorite team blogs here.
  • Archives
    Archives Contains a list of blog posts that were created previously.
  • Login
    Login Login form
Recent blog posts
The Top 10 Fears / Anxieties And How Long It Takes To Treat Them

Every year I do an audit of the anxieties and fears we treat and how long it took to treat them. There are five numbers to look at.

  1. Frequency - the number of people presenting with a particular fear or anxiety.
  2. Control average - The average time (in days) it took to get the fear or anxiety to level 3 (0 = no feelings of anxiety or fear. 10 = Maximum anxiety and fear feelings). Level 3 is a definition of the disorder being under control by the individual. Most people present to us at levels 8-10.
  3. Control range - How long in days (quickest to longest) it took to get the disorder to get to level 3 (see notes above).
  4. Discharge average - the average time (in days) it took individuals to feel they had the fear or anxiety under control enough to discharge themselves from the programme. Usually at level 0.
  5. Discharge range - How long in days (quickest to longest) it took to get the disorder under complete control (to get to level 0 or 1) and to discharge themselves or leave the programme having been successfully treated.
Anxiety / Fear   Frequency 

 Control Av 

 Control Rng   Discharge Av   Discharge Rng 
1. General Anxiety Disorder 403 12 4 - 21 16 11 - 33
2. Social Anxiety Disorders * 368 9 3 - 16 16 13 - 21
3. Fear of Rejection 360 10 7 - 14 16 12 - 22
4. Fear of Failure 337 11 7 - 20 17 14 - 31
5. Fear of Meetings 324 9 5 - 17 15 7 - 20
6. Panic or Anxiety Attacks 211 7 2 - 9 10 6 - 19
7. Public Speaking Anxieties 209 8 5 - 16 15 7 - 19
8. Agoraphobia 194 7 3 - 22 19 8 - 34
9. Sexual Performance Anxieties  162 14 7 - 30 23 11 - 38
10. Fear of Flying 131 9 7 - 18 16 12 - 19


*Social anxiety disorders (SAD) include fears and anxieties around being in social situations, meeting people, dating, having to talk to people unexpectedly, going to gatherings etc.


  1. The top three fears and anxieties tend (but not always) to be versions of a fear of rejection.
  2. When I started conducting therapeutic interventions the presence I was surprised about the predominance of a fear of meetings. At first I assumed a fear of meetings was a subset of public speaking anxieties, however over the years I have come to recognise both the prevalence of this disorder and its grounding in a fear of rejection, social anxieties and public speaking issues.
  3. The treatment times are only for the period until the disorder is brought down to levels 0 (no anxiety) or 1 (aware of a minor heightened sense of arousal) this does not include the confidence and assertiveness phases of the programme. I firmly believe that to just treat an anxiety or fear is not enough as it leaves the client susceptible to forming similar fears and anxieties at a later date. To prevent this I usually include a confidence and assertiveness skills course to prevent this occurring.


Hits: 480
Rate this blog entry:

Please let me know what you think. Is this useful?


Hits: 70
Rate this blog entry:
Hits: 68
Rate this blog entry:

There is a growing and very strong body of evidence to show that enhancing your emotion regulation skills can make a significant difference to things like anxiety disorders, fear, nerves and general confidence and shyness issues. There is also a common perception in the medical and therapeutic circles that better emotion regulation skills can help with depression as well. However this last perception had not been scientifically tested... until now.

A study published in the Journal of Consulting and Clinical Psychology did just that. Researchers in Germany assessed 152 people who had been hospitalised with Major Depressive Disorder (MDD) for their levels of emotion regulation skills (the techniques we teach) four times in just a three week period. Over that period they showed the patients how to do a series of emotion regulation skills.

What they found was quite startling.

They discovered that learning emotion regulation skills has a clear positive effect and significantly reduced the symptoms of the disorder. Additionally they discovered that the techniques which enabled the patients to tolerate negative emotions and to actively modify undesired emotions were the most effective in reducing the severity of the depressive symptoms.

The researchers concluded with a call for emotion regulation techniques to be shown early in the diagnosis of depression.

I would add my agreement with this and go further that these should be the first line of defence. In fact teaching emotion regulation techniques at school, I believe would reduce the incidence of depression and anxiety significantly. Given the costs of these two disorders (see my last blog The Cost of Anxiety) such prevention would pay dividends to the individuals, society at large and reduce the burden on the health services.




Radkovsky. A., etal (2014) Successful emotion regulation skills application predicts subsequent reduction of symptom severity during treatment of major depressive disorder. Journal of Consulting and Clinical Psychology, Vol 82(2), Apr 2014, 248-262

Hits: 107
Rate this blog entry:

Posted by on in Research
The Cost of Anxiety

It is widely known in the medical research community that anxiety disorders are the most common disorders there is, bar none. Not only are anxiety disorders the most frequently suffered disorder there is, a research paper published in journal Neuropsychopharmacology worked out that in the US alone in 2002 anxiety cost about 100 Billion dollars or £58,326,044,000 per year, which is the last reliable estimate of the general cost of anxiety. Given that this was firstly back in 2002 and secondly just in the US, which only accounts for about 4,44% of the worlds population you can start to get some idea of the size of the problem.

The cost obviously goes way beyond the financial burden, in terms of the incalculable effects it has on people's lives on a daily basis. Especially when you take into account the reduction in opportunities anxiety causes. Right now as I write this I have personal clients who:

  • couldn't go out,
  • wouldn't fly,
  • found it hard to speak at meetings,
  • got flustered and avoided social events, meetings, dating and a whole host of other social situations,
  • couldn't go shopping,
  • wouldn't drive,
  • wouldn't be a passenger in a car being driven by someone else,
  • couldn't go for job interviews,
  • wouldn't take a promotion,
  • avoided public places,
  • avoided intimate relationships,
  • were putting off an operation,

and that is just the start. The cost to these people in terms of the reduced opportunities and social functioning cannot be put into monetary terms. Not only that the emotional cost is almost impossible to articulate. Until you have had a panic or anxiety attack, or found yourself avoiding things or had depression, it is very difficult to understand what this does inside to a person.

The cost does not end there. There is now a growing body of evidence about the direct and indirect health costs of anxiety disorders. For example people with an anxiety disorder are 3 to 4 times more likely to develop cardiovascular disease, and twice as likely to die from some form of heart problem or a heart attack as the people without anxiety. Additionally as I reported in 'People with anxiety are more likely to develop depression' people with anxiety are 50-70% more likely to develop depression than the general population. Further there are a whole host of other health problems associated with anxiety which greatly effect the quality of life like cancer and cost the individual in mental and emotional ways beyond just financial costs.

And yet if you go to the doctors with any anxiety disorder the frequent response is to be put on a waiting list for online CBT or anti-depressants. Whilst I understand the primacy physical illnesses like coronary and cancer ( See 'Links between anxiety and cancer' ) care has, it is about time anxiety disorders also got the attention and priority other illnesses have form the medical professions. Anxiety which often either underlies, predicts or complicates the physical illness or as reported here '(The effects of pre-operation anxiety on the recovery of heart surgery patients') actually exacerbates or worsens the prognosis of the patient.

Anxiety treatment and prevention needs to become a priority for all of the health services. It's not like there is a lack of evidence.




Bardeen, J.R. etal (2014) Exploring the relationship between positive and negative emotional avoidance and anxiety symptom severity: The moderating role of attentional control. Journal of Behavior Therapy and Experimental Psychiatry. Volume 45, Issue 3, September 2014, Pages 415–420

Chalmers J, Quintana DS, Abbott MJ and Kemp AH (2014). Anxiety disorders are associated with reduced heart rate variability: A meta-analysis. Front. Psychiatry 5:80. doi: 10.3389/fpsyt.2014.00080

Fagundes, C.P. etal (2014) Attachment Anxiety is Related to Epstein-Barr Virus Latency. Brain, Behavior, and Immunity (2014), doi: http:// dx.doi.org/10.1016/j.bbi.2014.04.002

Jacobson N.C. & Newman, M.G. (2014) Avoidance mediates the relationship between anxiety and depression over a decade later. Journal of Anxiety Disorders. 28 (2014) 437-445.

Kessler, R. C., & Greenberg, P. E. (2002). The economic burden of anxiety and stress disorders. Neuropsychopharmacology: The fifth generation of progress, 67, 982-992.

Kravitz HM, Schott LL, Joffe H, Cyranowski JM, Bromberger JT (2014) Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS). Psychological Medicine [2014:1-10] DOI: 10.1017/S0033291714000075

Mohanty, S. et al (2014) Baseline anxiety impacts improvement in quality of life in atrial fibrillation undergoing catheter albtion. J Am Coll Cardiol. 2014;63(12_S):. doi:10.1016/S0735-1097(14)60395-8

Rubertsson, C et al. (2014) Anxiety in early pregnancy: prevalence and contributing factors. Archives of Women's Mental Health June 2014, Volume 17, Issue 3, pp 221-228

Hits: 313
Rate this blog entry:
Why some babies cry a lot and how it causes later problems

Anyone who has had a baby that cried excessively can probably attest to the stress and anxiety this can cause.

Obviously people's tolerance for crying babies differs, however excessively crying has been defined as crying for more than 3 hours a day on at least 3 days a week over a period of 3 weeks or more, when that crying is not associated with hunger or physical pain.

A study just published this week by researchers at the Institute of Clinical Psychology and Psychotherapy, at the Technical University of Dresden, Germany looked at 306 expectant mothers and followed them from just after they became aware they were pregnant until 16 weeks after the birth of their child. Two of the factors they measured was the mothers level of anxiety and depression both before and after the birth of the baby. Firstly they found that just over 10% of the mothers reported excessive crying in their infants according to the definition above.

What they discovered was that there was a significant link between the level of anxiety the mother experienced before the birth and the chance of the baby engaging in excessive crying in the 16 weeks after birth. Additionally there was no link with depression and excessive crying.

Another study published in the Journal 'Pediatrics' on the 6th of January this year, by a team of scientists from Finland showed that excessive crying in babies has significant links to later behavioural problems for the child and also (not surprisingly) increased stress for both the mother and father as the child grows.

Mothers who suffer from any form of anxiety during pregnancy are 3-7 times more likely to have a baby that cries excessively than the rest of the population of mothers to be. The researchers recommend early identification, monitoring and treatment of anxiety in all mothers to be.



Korja, P., etal (2014) Preterm Infant's Early Crying Associated With Child's Behavioral Problems and Parents' Stress. Pediatrics 2014; 133:2 e339-e345; published ahead of print January 6, 2014, doi:10.1542/peds.2013-1204

Petzoldt, J., etal (2014) Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study. Archives of Disease in Childhood. June 2014 doi:10.1136/archdischild-2013-305562

Hits: 2515
Rate this blog entry:
Episode 12 of the Emotional Resilience Podcast

 Here is episode 12:

 Download this episode (right click and save)

Download at itunes

For all the notes and references from this podcast go to Podcasts.

Hits: 268
Rate this blog entry: