Embracing fear is often necessary for change to take place. It is one of the reasons why there are so few who participate in counseling. A very small percentage of the community actually engages in individual psychotherapy. It is commonly felt that therapy is not going to make a significant difference in their lives. Most beginning therapy believe that, at most, it will allow them to cope with their anxiety, mood, conflicts, sleep deprivation, addiction, or other symptom that they struggle with. It is necessary that tools be provided to help cope with them, but the primary purpose of therapy is to have the symptom go away. Yes, in many cases this includes depression and addiction. To deal with the causes of mental health challenges it is usually necessary to process previous unpleasant experiences, whether it is trauma, neglect, or abuse. The biggest challenge with new clients is getting them to a place of hope. Selling the client on a path forward with the hope and expectation of a different relationship with their environment is necessary for change to take place. The goal is always to get to a place where they feel safe in present time. They can then allow themselves to experience being content. Being content in present time is something that a lot of people have never experienced. Many people have a base line level of distress that rarely, and sometimes never, gets below a 3 or 4 on a scale of 10. For some they have never experienced a 1 or 2.
I always connect the physical and emotional response with the cognitive response. Clients often report they have only done cognitive therapy. This is often never under the surface of conscious thought. It can be very difficult to process their emotional or physical experience, because they have spent so much of their lives repressing those experiences. I have worked with a lot of male and female law enforcement and combat military personnel. The males from these disciplines have always been the ones who have the most difficulty processing their physical response to the past. I have had much greater success with female clients from these disciplines because they are less afraid of processing the physical response.
My primary responsibility as a therapist is to not have a client go to such a high level of distress (8, 9, or 10) that they are not able to ground themselves before they leave the session. This requires them to process the less fearful triggers and memories and learn to trust the process before going on to core issues where they learned the coping mechanisms and defenses they use to manage daily stressors. Those who have the most effective coping mechanisms are the most resilient and the most challenging to work with. They are also the ones who are most resistant to letting those copying mechanisms down for therapy to effectively affect change.