Exposure Therapy for Anxiety Disorders

Exposure therapy is often essential if you are to overcome your anxiety disorder.The cognitive behavioural treatment of  conditions such as: panic with agoraphobia, simple phobias, social anxiety, obsessive compulsive disorder and post traumatic stress usually entails an exposure component. That is, you must subject yourself in the situations you are worried about. Although this sounds frightening, your therapist will give you the tools to cope with confronting your fears (e.g. rational thinking, slow breathing and isometric relaxation).

The guidelines for exposure are that the sessions must be

  • graded
  • repeated and regular
  • prolonged

Graded:
Your therapist will work with you to determine what would be an appropriate first step; it should be difficult enough to provoke some anxiety but easy enough for you to be fairly confident you can do it. Once you can cope with Step 1 confidently, then you can move onto a more difficult situation and gradually work up your most feared scenarios.If someone was frightened of dogs they might consider that smaller dogs were less threatening tyhan large ones and particular breeds were less aggressive than others. Someone with a dog phobia might therefore start off exposure therapy by interacting with a Cavalier King Charles puppy and gradually work up to patting an adult rottweiler.

It is important not to confront a feared situation that is far too difficult for you, as if you tackle something too stressful, without sufficient preparation, you may become extremely anxious or even have a panic attack. Such a negative experience would only strengthen the association between fear and the setting.

Repeated:
You need to confront your feared situations frequently and regularly if you are going to overcome your anxiety. If your exposures are too far apart your fear will have risen again by the next time you do it.

Prolonged:
Generally, it is advised that you stay in the feared situation until your anxiety starts to decrease. Anxious people often approach or attempt a feared situation but then choose to escape from the feared social or performance situation. When you avoid or leave feared situations your fear of them increases because the decrease in anxiety which follows escape gives you the idea that avoidance was a helpful strategy. However, if you stayed in the feared situation your anxiety would eventually decrease and the next time you confronted the situation you would be less anxious.

Therefore, it is important to your recovery that you stay in the situation you are attempting. Try not to panic or flee if the anxiety becomes severe. If your anxiety is high, you may feel you temporarily need time out from your feared activity, e.g. if you were attending a house party you might go to the bathroom or sit outside in the garden, do some slow breathing, develop some rational thoughts and wait for the fear to decrease for going back into the party.

Remember exposure is necessary for your recovery.

Andrews, G., Creamer, M.,  Crino,R., Hunt,C., Lampe, L., & Page, A. (2003). The Treatment of Anxiety Disorders. Second Edition. Cambridge, England. Cambridge University Press

The information provided on this site is  not intended as a substitute for treatment. You should seek treatment from a qualified mental health practitioner such as e.g. a clinical psychologist.

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