How To Conduct Exposure Practices

Preparing For Exposure Practices

First, do an initial self-assessment. For you to plan the appropriate exposure practices, you must know what kind of situations and sensations you fear.

Consider your short term and long term goals. How can you tie in your practices to best meet these goals?

Next, develop a social anxiety hierarchy.

Lastly, consider the outcome of your exposure practices. What do you think will happen before, during, and after your exposure event? When you have a sense of control over the situation you are putting yourself into, the exposure practice will work better.

Do any anxious thoughts come to mind when you think about what may happen during an anxiety provoking situation? Can you apply some of the cognitive strategies you learned to combat these anxious thoughts?

Having a good idea of what may happen will keep you feeling in control and you won’t be blindsided by some surprise.

It is important to plan your exposure practice well in advance so that it is predictable and under your control.

Things To Keep In Mind

Duration of exposure – your exposure should last long enough for you to learn that your feared outcome doesn’t occur. That’s what crushes fear – when you discover that the thing you fear is just in your head and not a reality.

Stay in exposure practices as long as possible. Even if you feel anxious throughout the entire practice, stick with it. It will get easier over time. Do not leave the situation! If you leave the situation, your body and mind will think, ‘I left because there is a threat’.

Leaving will teach you to continue fearing that situation. You won’t learn that the situation is nothing to fear.

If it is a relatively short exposure practice, just do it repeatedly. Do it so many times that it becomes second nature. This is called overlearning.

Keep practicing the exposures until you go down to a 20-30 out of 100 fear level. Once you get down to a level you’re happy with, move on to another type of exposure.

Practice frequently –The more frequently you perform the exposure practices, the better. The best way to ensure this happens is to set aside an hour each day to practice the exposures. Or, figure out a way to work them into your day. The closer together the practices, the more likely you are to not lose traction.

Practice in a variety of situations – Although you may only fear a couple specific social situations, you should conduct your exposure practices in a variety of situations. Try and mix up the location, the people, the environment, and the context of the situation. The small wins in one are will leak over into other areas of your social anxiety.

Choose practices that are challenging but not impossible – You will feel some discomfort when conducting exposure practices. It’s how we grow. Before you get started, look at your hierarchy and gauge how much discomfort you think you can handle.

Decide if you want to do gradual or rapid exposure. With rapid exposure, you will take on more challenging situations more quickly. Rapid exposure is the quickest way to overcome your social anxiety, but it carries a bit more risk. If you jump in too deep, you may become overwhelmed and this can set you back. If you feel committed and can tolerate more discomfort, then go for the rapid approach.

If, on the other hand, you are a bit more timid out of the gate, the try the gradual approach. The gradual approach starts with a situation you feel slightly uncomfortable with and then slowly builds up from there. This is still a great way to reduce your fear, but it may take a bit more time. The chances of you becoming overwhelmed with this approach is significantly less.

If you’re feeling overwhelmed, try something lower on your fear hierarchy.

Choose practices with minimal risk – You do not have to take unnecessary risks to have challenging exposure practices. You don’t have to risk making a complete fool out of yourself, or be rude to people to get what you want and need out of the exposure practices. You can get by by choosing practices with minimal risk.

What I mean by minimal risk is that you may feel slightly embarrassed or foolish for a short period of time. Everyone feels that way from time to time, so if and when it happens to you, remember, it’s not the end of the world. It’s just another human emotion like happiness or sadness. There are many ways to push yourself out of your comfort zone without accepting a lot of risk.

Include a coach or friend to help you plan, develop, and execute your exposure practices. They will be a good source for role-play and feedback.

Keep you expectations realistic – Do not expect your social anxiety to go away overnight. Overcoming social anxiety takes commitment and it takes time – months to years in some cases. You have to be in it for the long haul and cannot expect it to go away in a week or two.

This doesn’t mean you won’t see improvements though. You will probably see improvements right after you learn how anxiety works and how to challenge and change your anxious thoughts. You may see a lot of progress in some areas and very little in others.

Expect that you may make a mistake or two during your exposures. That’s ok! You are not striving for perfection. Also, expect that you will feel a bit uncomfortable during your exercises.

Again, the question is, are you willing to undergo a bit of uncomfortable-ness in the short term to benefit in the long term?

You may have the occasional set back, but that’s ok. keep pushing and you will overcome.

Don’t fight your feelingsAnxiety is a trickster. It tricks you into doing the opposite of what you should. You instinctively believe that running away from the feared situation or fighting your feelings of anxiety is the right thing to do, but it’s actually the opposite of what you should do.

You cannot fight the feelings of anxiety because it only makes the anxiety stronger. You must learn to accept those feelings instead of resisting them or trying to control them. I know, from experience, that this is sometimes difficult to do, but over time, you can learn to let the anxiety be there without fighting it.

When you stop fighting the feelings of anxiety and allow them to be there, you will stop fearing them as much and you will be much more comfortable in social situations when those feelings surface. Accept those feelings instead of judging them.

The feeling of anxiety becomes much worse when you tell yourself to stop having those feelings. The anxiety + the resistance = overwhelming fear. See ACT and mindfulness meditation for more on this topic.

Eliminate subtle avoidance behaviors – Remember those subtle avoidance behaviors? Pay attention to your actions and behaviors during your exposure practices to see if you’re engaging in any of them.

  • Here are some examples of subtle avoidance behaviors that may be contributing to your social anxiety:
  • Standing behind a podium in order to “hide yourself” during a presentation
  • Avoiding eye contact with the audience during presentations
  • Using a lot of visual aids during a presentation to keep the focus off of you
  • Wearing certain clothes to hide features of your anxiety
  • Staying close to someone you know so you don’t have to interact with strangers (at party)
  • Offer to help clean up in order to avoid talking to people (at party)
  • Get buzzed before a party to get rid of your social anxiety
  • Take lots of bathroom breaks to get away from people

Pay attention to see if you’re doing any of these and if you are, do the opposite. Move away from the podium and walk around, force yourself to make eye contact, don’t rely on visual aids, and so on.

Measure your improvement as you progress through the exposure exercises to monitor your progress. You can do that by looking at your initial self-assessment, exposure records (see below), and your goals.

Use exposure records and diaries – Use monitoring forms to see how you’re progressing. It is easy to forget how you were feeling right before or after an exposure practice, so keep a record and take notes as soon as possible after the exposure.

After exposure – Pushing yourself to engaging in the exposure practices may make you feel tired, but you should feel good about what you have accomplished. Pushing yourself out of your comfort zone is tough, but rewarding. Remember why you are doing this in the first place (costs and benefits).

After an exposure practice, do you best to use your cognitive therapy skills to kill any anxious thoughts about the event. Find a way to focus on what was positive about the event and what you learned rather than dwelling on any minor mistakes.

If real life exposure is too difficult for you, consider imagined exposure

Imagined vs live exposure – live exposure is preferred, but imagined exposure can be beneficial for some, especially if you have severe anxiety. Imagining yourself in the anxiety inducing situation and acting calm and confident will help reduce your fears. Imagined exposure can also be helpful when you can’t conduct the exposure in real life.

Additional tips:

  • Plan exposure practices thoroughly, make plans early, and have a back up plan.
  • Anticipate the obstacles you may encounter ahead of time so that you can overcome them – this will reduce the likelihood of excuses to not do it.
  • Set aside blocks of time to do your practices – getting over social anxiety takes commitment.
  • Challenge your anxious thoughts before entering into an anxiety provoking situation.
  • Any situation that you make it through is a success. It doesn’t matter how anxious you feel, what matters is that you completed the practice exposure.

Next: Exposure to Social Situations

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