Not long ago my girlfriend stumbled across a YouTube video from Animal Planet’s show “My Extreme Animal Phobia.” It features a segment from the show involving a tough-looking, heavily tattooed man who is terrified of pit bulls. The fear is so intense the man breaks down in tears when a psychologist takes him to a park and confronts him with a pit bull puppy.
Since then, I continue to see the video pop up in unexpected places and thought I’d comment on it.
What Kind of Therapy is THAT?!
The man’s name is Marvin. He’s 47 years old, and according to his interview, he’s been terrified of pit bulls since he was a young child and he watched a neighbor friend viciously attacked.
The man in the video received some form of what’s called exposure therapy. Exposure therapy has been around for several decades and is one of the most effective treatments out there, particularly for fear and anxiety-related problems. For someone interested in getting over an extreme fear of dogs, some form of exposure therapy is the best bet.
However, I was little concerned by how the exposure therapy comes across in this segment. My concern: although I think it’s great that a well-researched, effective treatment such as exposure therapy is getting press, I worry that the way it is dramatized on TV may scare people away from it.
Full disclosure: I turned down an offer once—for many reasons—to conduct on-camera exposure therapy for a TV show about people who claim to have experienced some sort of supernatural or paranormal experience.
According to her website, the therapist Robin Zasio, Psy.D. is a licensed clinical psychologist and licensed clinical social worker. Dr. Zasio appears to have reasonable credentials and seems to specialize in exposure-based treatments.
Exposure Therapy is Usually Conducted in Graduated Steps
When conducting exposure therapy, it’s common for the therapist to come up with a list of feared situations or experiences–commonly called a “fear hierarchy”–and rank them. Collaboratively, they then choose exposure sessions of increasing difficulty.
In the video, as they enter the park, Dr. Zasio says something really striking: “You don’t go to parks, do you?” Marvin says he stays away because “they’re dog friendly.” It’s quite likely Dr. Zasio already knew this, and that her question was for the audience—Marvin mentions in another part of the segment that he doesn’t go to parks with his family because of his fear. Regardless, if I were working with this person, going to the park would be an exposure exercise in itself. Given Marvin’s fear of parks, I think that most exposure therapists would discuss with him to possibility of having him visit the park several times as an exposure exercise in itself. The goal might be to eventually have going to the park be an enjoyable activity for him and his family.
However, this isn’t how it plays out on the show. Instead, while Marvin is seen reeling from being at a park, someone suddenly comes up with a pit bull puppy on a leash. The segment is obviously edited down, so it’s unclear how much time it takes for the puppy to get to Marvin. Dr. Zasio comforts Marvin as he reacts with fear and cries.
It’s a little stagey, but okay. Then Dr. Zasio says something that disturbs me. She tells Marvin, “I know you’re going to be scared but you’re going to have to touch the dog before you leave, I’m sorry.”
Excuse me? He’s going to “have to touch the dog?” I still tense up as I write this.
Even with a graduated approach, exposure therapy is often very intense for people. It’s part of the therapist’s job to gently guide the client through it. The details of it are agreed upon in advance (e.g., “For 30 minutes, you’ll stand within 5 feet of the snake”). It’s possible that Dr. Zasio and Marvin agreed in advance that Marvin would pet the dog. It’s not implied in her command, but it’s quite possible. The way she phrases it though—“you have to”—veers dangerously close to bullying, in my opinion. Marvin doesn’t “have to” do anything. He may choose to. He may even have agreed to. But he doesn’t have to.
I realize that it makes for better TV for fewer to watch an intensely distraught Marvin get over his fears by petting a pit bull puppy in the park. I get it. It doesn’t make for good therapy, though. My concern is that viewers watching don’t get a sense of how gradual and collaborative exposure therapy should be. Ideally, the therapist and Marvin would plan out steps in advance while gradually working up to Marvin petting a pit bull. There would be no surprises and nothing would be planned without Marvin’s explicit consent. As I mentioned, it’s quite possible that this all happened and was left on the cutting room floor.
Exposure therapy can be very intense for people. No doubt about it. At the very least, I hope the show is able to humanize how painful these sorts of experiences can be for people like Marvin. (Sadly, from comments I’ve read, some people find the juxtaposition of a tough-looking guy brought to tears by a puppy amusing—which is really unfortunate.) For these reasons, it’s important that exposure be conducted in a safe and collaborative fashion—with no surprises.
What I hope people take from this is: 1) yes, exposure is a remarkably effective treatment for a range of fear and anxiety-based problems and 2) exposure should always be conducted safely and collaboratively.
Author: Brian Thompson Ph.D.
Brian is a licensed psychologist and Director of the Portland Psychotherapy Anxiety Clinic. His specialties include generalized anxiety, OCD, hair pulling, and skin picking.