Phobias are among the most treatable anxiety conditions. A step-by-step guide to the evidence-based approach that worked for my son.
One evening, I walked past the bathroom and caught a strange sight out of the corner of my eye: One of my children, brushing his teeth in the dark, crouched on the floor with his gaze fixed on the tile.
When I asked him about it, my son let me know that, actually, it was no big deal. He reminded me that he doesn’t like reflective surfaces. He finds them terrifying. So he figured out how not to see them.
Suddenly, I flashed on related moments — of him scurrying to his bed, contorted awkwardly away from the glass-covered framed art on the walls; of him opening the fridge with his head craned all the way to the side. He’d figured out what worked and ran with it.
That day in the bathroom, I could see how my son’s fear had literally made him smaller.
You could call this pattern a phobia, a type of anxiety disorder. There are clinical-grade names for fears like his: eisoptrophobia, spectrophobia, catoptrophobia. But you could also say that he’s a person who learned something clever about how to handle what scares him — and used it right up until the edge of its usefulness.
This is where I want to be careful about language. I work in health and science journalism, and I’ve watched the word “phobia” — along with “trauma,” “OCD,” “ADHD,” and a growing list of others — migrate from clinical settings into everyday conversation.
That’s not always a problem. Shared vocabulary helps.
But when we label emotions and behaviors as “disordered,” we’re also tagging the experience as something beyond what’s normal. Over time, a person might start to feel like they, themselves, are beyond what’s normal. Beyond belonging.
A label, at its best, should do the opposite. It should clarify that these patterns are so much a part of the human experience that we have a name for them. Other people have been here before. We have ideas for what helps.
Here’s what helped us.
Childhood anxiety, including phobias, responds well to a clear, structured approach — and research suggests parents can play a meaningful role in the process. An analysis of 29 studies found that children benefit about as much from parent-guided anxiety interventions as when kids work directly with a therapist. Professional support is one tool. It’s not the only one.
One study found that children who practiced exposure at home — guided by a parent, with some therapist support in planning — had the same long-term outcomes as kids who practiced in a therapist’s office. There’s one caveat: If you’re an anxious parent yourself, some professional guidance can help you be a steadier coach.
To use any fear-busting tool well, it helps to understand a bit about the mechanics. Fear is a teacher. It’s so unpleasant that whatever we do to relieve it gets encoded as the solution — our blueprint for what to do the next time we feel afraid.
When my son learned that he could get rid of that awful feeling by avoiding reflective surfaces, he learned that escape worked. But he also never got the chance to discover that he could feel better by staying with the fear until it passed.
Treating phobias means filling in that missing experience. The process is called exposure: Staying with a feared situation until anxiety subsides, rather than escaping it. Each time you practice exposure, you get something that avoidance never gives you — evidence that you can handle things that first seem threatening.
I saw it this way: My son has a very good brain. It had learned what to do. It could learn something new.
We built a plan adapted from traditional exposure therapy, the gold-standard treatment for phobias. You can find worksheets for kid-focused Bravery Ladders online, but I just made my own table in Google Docs.
If you’re parenting through hard things more broadly, I made this free resource for you.
The table listed the fear (reflective surfaces) and every situation that might trigger it, including particular framed pictures, dark computer screens, the stainless steel refrigerator, brushing his teeth in front of the mirror, and showering in the glass-enclosed shower. For each one, I had my son assign a SUDs score — Subjective Units of Distress, a number from 0 to 100 reflecting how scared he felt (0 = Who cares, 100 = I feel like I’m gonna die).
We sorted the list from lowest to highest and got to work. Each day, we tackled one situation, starting at the bottom. Easiest stuff first. We set a timer for two minutes. Every so often, I asked for his SUDs score and wrote it down. My notes from one session: 100, 10, 15, 10, 30, 10. Importantly, the number didn’t stay the same. The feeling wasn’t permanent. Mostly, in time, fear went down. We also recorded what helped — laughing at himself, deep breathing. We practiced each situation until his starting scores were reliably low, then moved on to the next-hardest one.
Before long, my son could stand tall while he brushed his teeth.
The label “phobia” told us something, but not everything — not who he was, not what he was capable of. It worked the way trail signage does. Not a verdict, just a heads-up. And a reminder that others have walked this way before.
A note: I try to get meaningful consent before publicly writing about my kids. In this instance, I read my son this draft, he suggested changes for accuracy, and he approved sharing it — his words — “to help someone.” His dad/my husband, also reviewed this essay and consented.
What I’ve Been Working On
The bipolar research you should know about. Two months, two roundups for bpHope, a lot of new science. February covered DSM updates, lingering between-episode symptoms, and joint health. March went deep on mania genes, teen cannabis use and psychiatric risk, and pregnancy sleep. All of it translated for real life.
Teaching teachers about anxious kids. The essay above is about what happens when you take clinical knowledge out of the clinic and put it to work at home. Earlier this month, I did something similar in a professional setting: I led a professional development training I created for early childhood educators called “Science-Based Strategies to Build Independence in Anxious Preschoolers.” We read primary research together, pulled out what matters most for the classroom, and had exactly the kind of conversation that happens when experienced teachers bring their own knowledge to meet the science. If you work with educators or parents who might benefit from deep, practical, mental-health training, I’d love to connect.
Book Recommendation
Get the Wiggles Out: Playful Ways to Embrace Every Feeling, by Anna Anderhagen (Author), Hisashi Maeda (Illustrator)
The book is self-help for the preschool set. Told through vignettes featuring familiar faces from Sesame Street, kids will learn to identify their feeling and how to cope. It’s more of a teaching book than a story book, but within that category, it succeeds, eliciting an “Oh man, I can relate” from my 10-year-old, who — along with his 8-year-old and 4-year-old brothers — were my read aloud guinea pigs. When I asked my fifth-grader to explain more, my son said that even though the book was a bit young for him, he liked how “the descriptions of the emotions match how you actually feel during the emotions.” My younger boys like it too, especially that the book gave you “good ideas to calm you” and the famous characters appearing throughout the book. Books like this can be a meaningful way to support mental health at home, and my kids seem to agree.
*Thank you to Mayo Clinic Press and Smith Publicity for the advance review copy. See my disclosure statement for my policy on accepting books for review.
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