Facing Your Fears: Exposure Therapy For Anxiety.
Do you struggle facing certain fears or anxieties? Try Exposure Therapy.
We get a lot of clients asking for ways to face their fears and anxieties in their lives. One approach that has been researched extensively is exposure therapy. In this post, we will discuss what exposure therapy is and how to implement it.
What is Exposure Therapy?
Exposure therapy is a structured approach that gradually allows you to face your fears and anxiety. As you gradually face an increasing intensity of anxiety, you gradually realize that you don’t need to be as fearful of the object or situation. In other words, you take small steps, starting with something less anxious and gradually work your way up to more anxious situations.
How to Implement Exposure Therapy.
Step 1: identify what you’re anxious or scared about.
First, write down the situations or things that make you feel anxious or scared. Some examples would include specific places, situations, or activities. Here are some common examples:
Speaking in front of a large group of people
Social situations
Going to a crowded place
Insects such as spiders or roaches
Taking a test or having an evaluation at work
Step 2: Create an Exposure Ladder
An exposure ladder is a list of situations or activities that would be ranked from least anxious to most anxious. The goal of this step is to start creating a sequence that you could move through to help address your anxiety or fear.
For each rung of the ladder, it is helpful to rate how scared or anxious you would feel. This allows you to measure your anxiety and track your progress as you progress through the process. While there’s no exact answer to how to do this, here is a rough scale to track your anxiety or fear.
0-3: Little or no anxiety; mostly feeling calm and comfortable
4-6: Moderate anxiety; feeling nervous but able to cope with the situation.
7-8: High anxiety; feeling very anxious, but still overall in control.
9-10: Extreme anxiety: very intense feelings of anxiety and sense of feeling, overwhelmed and unable to cope.
For this step, go ahead and write down various activities and events you could do to eventually overcome your anxiety or fear. Start with something easy, and gradually move up the ladder to the final most challenging situation you would like to work on.
Example Anxiety Ladder for Social Anxiety
Smile at a stranger (Level 2 for anxiety)
Ask someone for directions in person (Level 4 for anxiety)
Make small talk with someone at work or school (Level 5 for anxiety)
Speak up in a meeting (Level 7 for anxiety)
Give a presentation and for a large group (Level 9 for anxiety)
Step 3: coping skills to use during exposure
Facing your anxieties and fears can be difficult and challenging for all of us. This step will really help you come up with ideas regarding how to cope with the sense of anxiety and fear. Here are some things to try.
Grounding Techniques
5-4-3-2-1 Senses: Name 5 things you see, 4 things you feel, 3 things you hear, 2 things
you smell, and 1 thing you taste.
Positive Self-Talk
Say things like “I am brave” or “I can handle this” to remind yourself that you can do it.
Breathing Exercises
4-7-8 Breathing: Inhale for 4 seconds, hold for 7 seconds, and exhale for 8 seconds.
Repeat until you feel calmer.
Belly Breathing: Place one hand on your belly, and take a deep breath in so your hand
rises. Slowly breathe out, feeling your hand lower.
Distraction Techniques
Listen to music
Count backward from 100
Play with a stress ball
Step 4: Exposure Practice
Once you have created your exposure ladder and practiced your coping skills above, it is time to start facing your anxiety and fears. Here is the step-by-step process to begin this sequence.
A good rule of thumb is whenever you rate your anxiety at a 9 or 10, you should stop the exposure and focus on your coping processes until feeling calmer. In many cases, you want to stay exposed in the 5 to 8 range for best results.
Start small: Begin with the easiest thing on your ladder.
Repeat: Do it over and over until it feels less scary in the range of 0-4.
3. Move up: When you're in the 0-4 range, move to the next step on your ladder.
Final Thoughts
Exposure therapy can take time, and it is OK to move at your own pace. Facing anxieties and fears can be uncomfortable, but with practice the things that scare you now will feel a lot easier in the future.
Need Help Setting Up Exposure Therapy?
If you are having difficulty with anxiety or fear, consider anxiety therapy at Sequoia Counseling Group. We offer free 15-minute consultations to help answer any questions or concerns you have. In Las Vegas, we have in-person and virtual sessions. We also have virtual sessions across the states of California, Nevada, Georgia, and Virginia.
Dr. Philip B. Gnilka is the Clinical Director and Founder of Sequoia Counseling Group, a boutique mental health practice that serves clients in Las Vegas, NV. His experience as a tenured professor in mentoring students about counseling approaches and theories reinforced his passion for helping individual clients directly. He specializes in anxiety, stress management, and perfectionism.