If something causes us worry and anxiety, we tend to avoid it. Afraid of public speaking? You may never agree to them for various reasons. Worried about going out with a friend? You could say you’re ill and not go. The more we avoid, the scarier it becomes the next time we do the same thing. So gradually, by giving in to the urge to avoid again and again, we reinforce our belief that the danger is serious. So, little by little, avoidance steals our space to live. This is what happens with PTSD, social anxiety, obsessive-compulsive disorder, panic disorder, phobias – and more.
What is the treatment in such cases? Exposure.
Exposure therapy is a type of cognitive behavioural therapy (CBT). It helps people overcome anxiety by gradually exposing them to the things that make them anxious. This can be done in different ways:
- Imaginal Exposure. This is where we describe in detail and visualise what is terrifying (e.g. contracting a deadly virus in the case of OCD or a history of trauma in the case of PTSD).
- In vivo exposure. It involves encountering a frightening object or situation in real life (this could be a trip to a doctor’s office or a small-talk with a colleague).
- Exposure using virtual reality. Using a VR helmet helps you to encounter frightening things in a safe and controlled environment (for example, being in the company of snakes or spiders).
Here is a simple example of exposure therapy in CBT:
A person with a fear of spiders (arachnophobia) might start by looking at pictures of spiders. Once he can do this without feeling too anxious, he might move on to watching videos of spiders. Finally, he may try to hold a spider in his hands.
The therapist provides support and guidance throughout the exposure process.
A person with a fear of public speaking might start by speaking in front of a mirror. If he can do this without too much anxiety, he may move on to speaking in front of one person. Eventually he may try speaking in front of a small group of people.
There are two types of exposure:
- Formal – when the therapist and client make a step-by-step plan of work.
- Informal – when we approach the frightening thing as the opportunity arises, without a plan made in advance.
How can you use the exposure method on your own?
There’s a cool term exposure lifestyle that means you:
- The first thing you do is learn to notice how your fear and anxiety manifest. What do you usually feel in your body when you feel anxious? What do you usually start to do in those moments? Some make a phone call, some amuse the people around them, some go to the fridge and so on. What thoughts do you have when you’re anxious?
- Practice noticing when some everyday things make you feel anxious or fearful.
- If the object or situation is safe, catch yourself wanting to avoid it – instead, approach it.
- Repeat this at random moments, anywhere, anytime, as if your whole life is your training ground.
For example, walking past the coffee shop and thinking, “It would be awkward to go there alone. And you catch yourself in that thought – you turn towards the cafe and go in for a latte.
Exposure therapy is challenging and scary, but it’s very effective. And an exposure lifestyle can bring adventure, new stories and joy to your everyday life – from its courage.