Let’s do a walkthrough on how to start using exposure therapy
And now it’s my favourite thing to do for fun.
Any techniques and types of exposure I’m outlining today have different effects on different people. While you might benefit from graded exposure, someone else might love flooding and die on that hill. Only a trained therapist can evaluate your personalized needs and the best approach!
That being said, I’m not a licensed therapist; I’m just here to tell you what has worked for me and my experience with exposure therapy.
And it feels like much of the scientific terminology coming out of psychology is not human-friendly or accessible to most of us.
So, if you’ve also been intimidated and on the fence about exposure therapy and you’re not exactly sure what it is, I’ll do my best to walk you through and give you a proper step-by-step walkthrough on how to start thinking about implementing it in your life.
It might feel like you’re going in all naked (I should know; I’ve been going to naked spas here in Europe, and dang, there’s nothing more exposing than that!), but it’s all evidenced-based so you can be reassured that it will help you manage your social anxiety if done correctly.
So let’s go back to basics with a one-sentence umbrella definition of Exposure Therapy:
That’s the core of it. You might not be surprised to hear that it originated from the work of behaviourists Ivan Pavlov and John Watson in the early 1900s. If you’ve heard of Pavlov’s dog, that’s the root of exposure therapy.
FYI: Exposure therapy is the most effective psychological technique for treating anxiety disorders, and it is an essential part of evidence-based cognitive-behavioural therapy (CBT).
The reason why it’s part of CBT is that exposure needs to be combined with unlearning negative thought patterns and associations and replacing them with new, non-threatening ones.
I’ll only touch on three of these for time constraint purposes and to focus on the techniques most frequently used for social anxiety specifically.
Let’s say you have a fear of sharks. Sharks terrorize you. You probably live in Florida (I know the feeling). So, any action you take to face a shark or be near one is practicing exposure therapy.
But if you were to use the Flooding technique, you’d do a cannonball into a pool full of sharks and stay in as long as you can.
This is called Flooding (also known as implosion therapy). My goodness, the word implosion made me think of the imploded submersible. They need to change the terminology because I wouldn’t want to tell people I’m doing Implosion Therapy!
The reasoning is to be in a situation where your body’s fight-or-flight response exhausts itself so your brain can recognize that nothing bad has happened to you.
You get so tired of being scared that the sharks desensitize you. We can see how this can potentially work with phobias or PTSD but not necessarily with social anxiety.
Anyone with Social Anxiety will tell you that it won’t do much good no matter how much they simply expose themselves to an office environment or with a group of friends without any thought behind it.
Because here’s the catch with Flooding – it relies on the idea that no negative outcome shall arise from it.
But we all know that social anxiety has to do with people (whether talking to them, hanging around them, presenting to them), which means you will get side-stares, comments, and so on that might set you back.
It’s for this reason that it’s not my preferred technique.
There’s no substitute for effort, but you can speed up the process if you understand and take these 5 ways seriously. This is your starter pack; what you do with it is up to you.
This involves gradually exposing yourself to the source of your fear by going up the ladder one step at a time. So, you write down a list of activities you can do to reach a potential goal.
This is called the fear hierarchy ladder (I call this social anxiety ladder), where you start with the least fearful activity and work your way up (or, in this case, down into the pool).
It might be that putting your toe into a pool of sharks is step #9 for you, with the first one being visiting an aquarium.
Ok, but we’re not here to talk about sharks, are we? Let’s make this relevant to social anxiety and give you a proper example of a fear hierarchy ladder.
Now, this isn’t done in a vacuum. As I mentioned earlier, simply showing up for the sake of it might not get you anywhere because the activities on the ladder don’t consider what happens while you’re out—the conversations, the thoughts, the feelings, the conflicts, and so on.
Sure, your body might be able to get itself to stay the whole night at the bar, but your mind might be traumatized, so then what good is it? Here’s where the bigger picture comes in.
See how this is more holistic than simply checking activities off the fear hierarchy? You have a much higher chance of recovering from social anxiety if you do all these steps.
This is technically a subtype of Graded Exposure because it combines Graded or Gradual Exposure with relaxation techniques.
Using counter-conditioning, the idea is to break the conditioned response of fear and replace it with a relaxation response. What this means is that you’ll train yourself to have a new response to the fear (a more relaxed one).
So, as you go through the fear hierarchy ladder, you confront your fears with breathing and muscle relaxation techniques.
There are 3 steps to it.
You can see how this also can be beneficial if incorporated into a bigger picture, as we’ve seen with Graded Exposure.
Otherwise, you’re simply going through the motions. But you should research which Exposure Therapy techniques might be more relevant to you and your challenges.
When I started my journey with social anxiety, I created an action plan with specific action items related to one task. I built my social anxiety ladder for each goal and kept to it.
It was the biggest game changer for me.
So when I sat down to design and create my Challenge Your Social Anxiety 35-task Workbook, I wanted each task to have multiple exercises attached to it, so now each task has three difficulty levels, and they are related to the task itself.
If you want to try it out first, I have a 5-day social anxiety challenge so you can get a taste of exposure therapy.
I went from being scared to ask a question out loud to hosting summits online. I love coffee, french crepes, and working from home. My mission? Help others build their social confidence to make friends, have conversations, and be comfortable around people!
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