Exposure Therapy is a way in which people can be supported to confront their fears. When we’re fearful of something it might lead us to avoid it. However, whilst this avoidance may reduce the feelings of fear in the short term, it can make the fear worse over the long term as we’re not addressing the fear.
The aim of Exposure Therapy, is to expose ourselves to the thing(s) we have fears of and/or have been avoiding. These might be situations, activities, or objects (e.g., spiders).
There are different ways we can expose ourselves to the things we fear, depending on what we’re comfortable with. You might want to be exposed to the fear in real-life; so, if you have a fear of giving a presentation you may decide to do this in front of a group of people.
Another way is through imagining that you’re facing your fear. You might imagine you’re presenting to a group of people, and then describe the sights, sounds, and smells within that situation. You’ll observe the emotions and physical sensations which come up for you, as these can often be as powerful as going through the situation in real-life.
Jumping right in
In a previous post we talked about mastering your fears and how, sometimes, one of the most effective things to do is to take a deep breath and face our fears head on. The thing to remember is that everyone’s different.
Exposure Therapy can be done at different paces, depending on how you feel. There may be times where jumping straight in at the deep end is going to feel most effective, and some people prefer to face their fears in this way.
For people that prefer a quicker and more “head on” approach to tackling their fears, Flooding may be good for them. The idea behind flooding is that anxiety is a learned fear that needs to be ‘unlearned’ by exposure to the object/situation/activity.
An example of flooding might be someone who has a phobia of spiders, who is given a spider to hold. During this time they’ll need to use coping skills to manage their anxiety (e.g., relaxation skills) and continue holding the spider until such time as the anxiety begins to lessen.
Another example might be someone who doesn’t like being around lots of people. They may go into a situation where there’s a huge crowd of people (e.g., a shopping centre) and use coping skills to help them manage their anxiety until it reduces.
This method is seen as quick and effective, although it might be too intense a way of dealing with fears for some people.
Dealing with anxiety step by step
For those who want a more gradual approach to facing their fears, there’s the option to do this through Graded Exposure. This does exactly what it says on the tin and gradually exposes you to the situation/activity/object that’s causing you anxiety.
In Graded Exposure, you identify the feared situation and then think about where you currently are in terms of tackling that situation. An example scenario might be that you want to go to the local newsagents to buy a newspaper, but you’re unable to leave your front door without feeling extreme anxiety.
You need to think about the gap between where you are and where you want to be, and break it down into small manageable steps. If your goal was go to the newsagents to buy a newspaper, an example of breaking this down might be:
- Opening the front door and staying there for as long as is comfortable;
- Moving from the front door to the pavement, and staying there for as long as is comfortable;
- Walking to a specific point in-between your house and the newsagents and staying there for as long as is comfortable;
- Staying outside the newsagents for as long as is comfortable;
- Going inside the newsagents, looking at the newspapers for as long as is comfortable and then leave;
- Going inside the newsagents, choosing a newspaper, paying for it, and then leaving.
This is a very simple example. You may have more (or less) steps than this. The most important thing is to come up with as many steps as you feel necessary to achieve your goal.
Working through the steps
The steps in Graded Exposure Therapy are something that you can come up with yourself or your Counsellor, if you’re working with one.
The idea is to repeat each step until you feel comfortable with it, and then move onto the next step. Your anxiety doesn’t have to totally disappear, but it should reduce to a level which feels more comfortable.
Moving to the next step may cause an increase in anxiety, but like the step before, you repeat that step until the anxiety reduces to a more manageable level and then move onto the next…and the next.
Bear in mind that this process might take a while and you may come up against obstacles along the way. Persistence is key.
For example, if you try one of the steps and it feels too much of a leap from the previous step, then rethink that step and see if that needs breaking down further.
Keep a record of your progress
When doing Graded Exposure, it’s important to keep a record of when you attempt each step, your anxiety levels before and after, and any notes you think are relevant. This can help you reflect on what went well and what you might do differently next time.
For example, when you look at the time of day that you’re doing your steps you might reflect that trying them at a different time, when there are less people about, might be beneficial.
When you review your notes you might see that your anxiety level prior to tackling one particular step has gradually decreased, even though you might still be working on the same step. This visual record of your progress will help motivate you during the times when you might be feeling you’re not making much headway.
Take a look at this worksheet we’ve put together which you can use to help you 🙂
What ways do you tackle your anxiety? Are you a “jump right in” or “step by step” sort of person? Let us know in the comments.