Specialism
Therapy for phobias
Graded exposure and CBT for specific fears that have grown big enough to shape your decisions — online across the UK, in English or Spanish.
Does this sound familiar?
There is one thing. Flying, needles, driving, dogs, spiders, heights, lifts, the dentist, blood. Most of the time it is manageable, because you have quietly built your life so you do not meet it. Then a wedding abroad, a blood test, a new job with a commute, and suddenly it is the biggest thing in your week.
You already know, in a rational way, that the risk is small. That knowledge makes no difference at all in the moment, which is often the most frustrating part — and sometimes the thing that has stopped you asking for help.
Meanwhile the avoidance quietly grows. Each time you do not do the thing, the fear is confirmed and the boundary moves in a little further.
Often there is a second layer nobody sees: the embarrassment. Adults with a phobia frequently apologise for it before they have finished describing it, as though a fear of needles or dogs were a childish thing to still have. It is not, it is common, and it has nothing to do with courage.
How I treat phobias
Specific phobias have one of the strongest evidence bases of anything I treat, and graded exposure is the heart of it. We build a ladder together, from something you could do today up to the thing you want back, and work up it step by step — staying with each step long enough for your body to learn something new rather than escaping the moment the anxiety peaks.
Around that sits the CBT: the specific prediction you are making, the images that come with it, and the safety behaviours that keep the fear intact. We also look at where the fear learned its shape, which sometimes matters and sometimes does not.
Where a phobia is rooted in a specific frightening event — a crash, a dog attack, a medical procedure — EMDR can be a very effective addition, and I am accredited with EMDR Europe. Blood and needle phobia is treated slightly differently, because fainting there is a real possibility; applied tension is added to the work.
The mechanism is worth understanding, because it explains why willpower has not worked. Every time you escape, the relief teaches your nervous system that escape was necessary — so avoidance does not just fail to help, it actively maintains the fear. Exposure reverses that lesson, and it needs to be gradual, repeated and chosen by you for the learning to hold.
What to expect
Phobia work is often short. After an assessment session we usually need 6–10 weekly sessions of 50 minutes, sometimes fewer, and a good deal of the progress happens between sessions in your own week.
Online works well for the planning, the cognitive work and much of the exposure; where a step needs to happen somewhere specific, we plan it together and you carry it out with the structure we have built. I work online across the UK and worldwide, and in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge.
If there is a deadline — a flight booked, a procedure scheduled, a course starting — tell me at the first session. We can shape the work around it, and knowing the date usually helps rather than hinders.
Common questions
Will you make me hold a spider in the first session? No. We build the ladder together and you agree every step before it happens. Exposure that is forced does not work anyway — the learning depends on you choosing to stay.
How long does it take? Specific phobias are among the quickest things to treat. Many people need well under ten sessions, though phobias tangled up with panic or trauma take longer.
Can this work online? Yes, for most phobias — planning, cognitive work, imaginal and video-based exposure all work well by video, and you carry out real-world steps between sessions with a clear plan.
I faint at the sight of blood. Is that the same? It is treated slightly differently. Blood-injection-injury phobia involves a real drop in blood pressure, so we add applied tension — a technique that keeps your blood pressure up during exposure.
My phobia is affecting my job or my medical care. Is that urgent? It makes it worth prioritising. Needle phobia that stops you having treatment, driving phobia that threatens your work, or fear of the dentist that has kept you away for years all deserve attention sooner rather than later — and all respond well.
Where did my phobia even come from? Sometimes there is a clear origin — a bite, a bad flight, a childhood fright, or watching a parent react with fear to the same thing. Often there is nothing to find, and that is fine: the treatment does not depend on knowing. Exposure works on how the fear is maintained now, not on how it started. Where there is a specific frightening memory still driving it, EMDR can take the charge out of that memory, and I am accredited with EMDR Europe.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.