How to face a fear step by step: the fear ladder

2 min read · 6 steps · Updated 3 October 2026

Whether it is dogs, lifts, phone calls or speaking in front of people, the natural reaction to a fear is to stay away from it. That brings relief today and a bigger fear tomorrow. The method below, gradual exposure, is described here as the NHS in England teaches it for self-help.

This is general information, not medical advice. If worry, fear or low mood lasts for more than two weeks or affects your daily life, speak to a doctor.

Step by step

1. Notice what fear does to you

   When you are calm, think about how the fear feels in your body and what it makes you do. For example on a bus: hot, shaky, thoughts of what could go wrong, getting off before your stop, or not travelling at all.

   Done

2. See fear for what it is

   The racing heart and the urge to escape are the fight-or-flight response, an alarm that prepares the body for danger. In some of us it is over-sensitive and goes off in situations that are not dangerous. The feeling is unpleasant, but it is not harmful, and it passes.

   Done

3. Break the fear into situations and rate them

   Write down the situations that involve your fear and give each a score from 0, not difficult at all, to 100, the most fear you can imagine. Taking the bus two stops with a friend might be a 10; the same trip alone a 50. Put them in order from the lowest to the highest. That is your ladder.

   Done

4. Start with the easiest

   Put yourself in the lowest-scoring situation. It will be uncomfortable at first. Stay with it, and repeat it on other days, until you would rate it at about half of its first score: a 10 becomes a 5.

   Done

5. Let yourself feel it

   Do it without the things you normally use to get through: looking at your phone, asking for reassurance, sitting next to the door. Feeling the fear and seeing that nothing bad happens is what teaches you that you can cope.

   Done

6. Move up, without rushing

   When the score has halved, go to the next situation on the list. The higher steps take longer. A hard day or a step that needs many repeats is normal and does not undo what you have done.

   Done

Good to know

Every time you enter a situation you find difficult, however small, counts as a step. Write the scores down: seeing a 60 turn into a 30 keeps you going.

If a step is too big, split it. Between "bus with a friend" and "bus alone" there is "friend sits a few rows behind".

For fears that follow a trauma, for panic that comes out of nowhere, or if the fear rules your daily life, do this with a therapist rather than alone.

Helpful alongside: a breathing exercise to calm down in 5 minutes and what to do during a panic attack.

If you are in immediate danger or thinking of harming yourself, call the emergency number now (112 in the EU). In Germany the Telefonseelsorge is free and open around the clock on 0800 111 0 111.

In short: Notice what fear does, list the situations, rate them 0 to 100, start with the easiest, stay without distractions until the score halves, then move up one step at a time.