{"id":386,"date":"2020-08-17T22:27:12","date_gmt":"2020-08-18T03:27:12","guid":{"rendered":"https:\/\/dontpanicdothis.com\/?page_id=386"},"modified":"2023-10-13T17:02:12","modified_gmt":"2023-10-13T22:02:12","slug":"what-is-gradual-exposure-therapy","status":"publish","type":"post","link":"https:\/\/dontpanicdothis.com\/what-is-gradual-exposure-therapy\/","title":{"rendered":"Gradual Exposure Therapy: THE Best Way to Conquer Any Fear"},"content":{"rendered":"

Everyone has something <\/em>that they\u2019re afraid of. Most of us accept our fears as unchangeable facets of our personalities, but this doesn\u2019t always need to be the case. Through gradual exposure therapy, or systematic desensitization, it\u2019s possible to eliminate any fear. So, what is gradual exposure therapy?<\/p>\n

Exposure therapy is a form of cognitive-behavioral therapy used to treat various anxiety disorders by exposing a person to their fears. Gradual exposure, also called systematic desensitization, eases a person into this process by starting with mild negative stimuli and gradually increasing the difficulty.<\/strong><\/p>\n

In plain English, gradual exposure therapy helps us to eliminate our fears and anxieties by slowly and safely<\/em> taking us out of our comfort zone.<\/p>\n

If this still sounds a bit confusing, or even a bit intimidating, no worries! Keep reading and I\u2019ll explain everything. Gradual exposure therapy is much easier to understand and implement than it sounds!<\/p>\n

Alright, let\u2019s dive in!<\/p>\n

Before We Start: The Basics of Fear and Anxiety<\/strong><\/h2>\n

First off, I\u2019d like to take the opportunity to remind you of our medical disclaimer<\/strong><\/a>. I\u2019m not a doctor, and the contents of this website are not intended to substitute for professional medical advice, diagnosis, or treatment. Everything on this website is based solely on my own personal experience with panic disorder and anxiety.<\/p>\n

With that said, I want to make sure you understand a few basic things about anxiety before we get into the nitty-gritty of exposure therapy.<\/p>\n

The first step to conquering any fear is to understand the nature of the beast that is fear itself.<\/strong><\/p>\n

Luckily, I\u2019ve already posted an article explaining the science of fear, and exactly what anxiety is and why we experience it<\/strong>.<\/a> That article will give you an evolutionary background and understanding of why<\/em> you have these feelings in the first place.<\/p>\n

This may seem a bit rudimentary to some of you, but if you don\u2019t know the basics of anxiety, you\u2019re going to have a really hard time with this next stuff.<\/p>\n

Seriously. Take a few minutes and read that article first if you haven\u2019t already. You won\u2019t regret it.<\/p>\n

What is Exposure Therapy?<\/strong><\/h2>\n

How I Learned About Exposure Therapy<\/strong><\/h3>\n

No one with a fully functioning brain is immune to the fight or flight response. Any man with a will to live will feel his heart race, and palms sweat, when a gun is pointed at him. Fear is our evolutionarily programmed drive to survive. Everyone experiences anxiety to some degree in their life, and there is no shame in it.<\/p>\n

During my early high school years, I used to be an extremely anxious kid. I\u2019d have random panic attacks and general anxiety that I couldn\u2019t explain or control. Nobody<\/em> knew, not even my own mother, because I told nobody; I just didn\u2019t talk about it. It’d probably have been smart for me to have seen a psychologist, but I didn’t. I managed to successfully avoid facing my fears for longer than most. But ultimately, I knew that avoidance was only a short-term answer to my problems; not the long-term solution.<\/p>\n

To really be the best we can be, we need to learn to face (and thereby eliminate) our fears. So, I began to consider the most effective way to destroy any thoughts of fear or anxiety in my brain. The solution I found most effective? Exposure Therapy.<\/p>\n

<\/strong><\/p>\n

The Two Strategies for Exposure Therapy<\/strong><\/h3>\n

<\/strong>While there are many ways to cope with anxiety, hands down the best way to eliminate situation-specific anxiety, or phobias, is through exposure therapy. In fact, exposure therapy is massively useful when applied to just about any anxiety disorder.<\/p>\n

There are typically two main strategies for implementing exposure therapy:<\/p>\n

    \n
  1. Flooding<\/strong> \u2013 this is the \u201cdive right into it\u201d method, where a person is thrown into a highly anxiety-provoking situation (under safe conditions) in an attempt to rapidly become desensitized to their fears and unlearn their associated anxieties.<\/li>\n
  2. Progressive Exposure<\/strong> \u2013 also known as systematic desensitization, or gradual exposure therapy. This method starts a bit slower, allowing a person to slowly take steps outside of their comfort zone over time. Starting with stimuli that only cause mild anxiety, a person is progressively introduced to more difficult situations as they unlearn their anxieties over time.<\/li>\n<\/ol>\n

    Regardless of the method you prefer, the way that exposure therapy works is by facing your fear head-on. This can be done quickly with Flooding, or slowly with progressive exposure \/ systematic desensitization \/ gradual exposure therapy.<\/strong><\/p>\n

     <\/strong>Now, trust me, I understand.<\/p>\n

    When you truly<\/em> fear something, the thought alone of facing it head-on makes your stomach drop.<\/p>\n

    \u201cHow does this guy think he\u2019s going to get me to willingly enter the one situation that stresses me out?\u201d<\/em>For most people, the thought of engaging in exposure therapy can cause a bit of anxiety. And I totally get that. This is why, for most people, I personally<\/em> believe that progressive exposure via gradual exposure therapy is the smarter way to go.<\/p>\n

    I personally wouldn\u2019t recommend that a person who is afraid of snakes immediately take a stroll through a field of snakes (even if they\u2019re friendly snakes!). This might work for some people, and more power to those people. But you always run the risk of things not going so well, experiencing retraumatization, and ultimately reinforcing your fear and making it even worse than before.<\/p>\n

    To mitigate these risks, I typically advocate for gradual exposure therapy rather than flooding. Perhaps in the future I will write about some strategies for flooding, but for the purpose of this article we will be only be focusing on systematic desensitization, or gradual exposure therapy.<\/p>\n

    <\/strong>Gradual Exposure Therapy\u2026 Like Mental Vaccinations<\/strong><\/h3>\n

    The human mind and body are impressively resilient.<\/p>\n

    If we wanted an individual to develop immunity to an illness, we might inject them with a small, weakened amount of that illness; a vaccine. This would provoke the individual\u2019s immune system to adapt in such a way that it will know how to fight such an illness in the future.<\/p>\n

    You can think of exposure therapy as a vaccine for the human psyche; it\u2019s like a series of anti-phobia shots.<\/p>\n

    We wouldn\u2019t shoot a man with live rabies for living near a squirrel nest; and we won\u2019t throw a man in a snake tank to cure his fear of snakes.<\/p>\n

    Instead, through gradual exposure therapy, we will gradually<\/em> conquer a fear through small, but increasingly larger<\/em> doses of situational exposure.<\/p>\n

    You\u2019re going to step out of your comfort zone like entering a cold pool; one slightly unpleasant step at a time until you\u2019re swimming.<\/p>\n

    Fear Extinction \u2013 Why Exposure Therapy Works<\/strong><\/h3>\n

    The human brain is comprised of over 100 billion neurons, connected by over 100 trillion synapses; and these neural pathways are constantly<\/em> changing. Every day, every second, every action, every thought you have alters these connections.<\/p>\n

    This is why practicing a sport each day will make you progressively better at that sport. Your neural wiring is adapting to learn and understand the motions and responses more effectively and efficiently. Similarly, if you avoid a fear, the neural pathways for fearing that stimulus will be reinforced and strengthened.<\/p>\n

    But, when you face your fear successfully<\/em>, your brain will realize that the situation\/stimulus never really posed a threat to your safety. The neural pathways associated with fearing the stimulus will be weakened. This is called fear extinction, and to achieve fear extinction is what we strive for when we face our fears in small, controlled doses.<\/em><\/strong><\/p>\n

    We want to unlearn the fear slowly, without slipping up and throwing ourselves deeper into the abyss.<\/p>\n

    Take baby steps in the right direction and fear extinction should occur over time. <\/strong><\/p>\n

    How to Use Gradual Exposure Therapy<\/strong><\/h2>\n

    By this point, you should have a good idea of what exposure therapy is and why it\u2019s so effective. When it comes to unlearning a specific fear or anxiety, gradual exposure therapy is one of the most practical and effective methods that anyone could employ.<\/p>\n

    While exposure therapy is best done under the guidance of a licensed therapist or psychologist<\/strong><\/a>, most of the principles are pretty easy for anyone to understand.<\/p>\n

    If it\u2019s asking a woman for her number that you fear, perhaps you could start with a \u201chello<\/em>.\u201d<\/p>\n

    If you\u2019re afraid of dogs, ask yourself\u2026 \u201cCould I pet a puppy?<\/em>\u201d<\/p>\n

    For a fear of speaking in front of the classroom, could you lead the conversation in a group of three friends? How about five?<\/p>\n

    Whatever fears have you cornered, ask yourself what kind of steps you could reasonably take outside of your comfort zone, and start there.<\/p>\n

    This is what gradual exposure therapy looks like in a clinical setting:<\/p>\n

    Gradual Exposure Therapy in 3 Simple Steps<\/strong><\/h3>\n
      \n
    1. Establish an Exposure Hierarchy<\/strong> \u2013 Identify the source of anxiety by choosing a specific anxiety trigger (e.g. Snakes). Create a list of events related to that list, and rank them in order from least stressful to most stressful (e.g. from hearing the word \u201csnake,\u201d to holding a snake). This list will be subjective, with the event that would be <\/strong>most <\/em>stressful to you ranked highest.<\/li>\n
    2. Learn Coping Mechanisms<\/strong> \u2013 A therapist can teach you coping and relaxation techniques to help you deal with your anxiety response. These techniques could include deep muscle relaxation, meditation, or other strategies for putting the mind in a relaxed and non-anxious state (There are many resources for such coping strategies elsewhere on this site!).<\/li>\n
    3. Connect the Stimulus to the Coping Method <\/strong>\u2013 Now, you would practice your preferred coping mechanisms until you felt completely calm and at ease. Then, starting with the least stressful event listed on your exposure hierarchy, you would be presented with a minimally stressful stimulus (e.g. Hearing the word \u201csnake\u201d). If you were able to handle this without being thrown into a state of panic and anxiety, you would move up the list and be introduced to the next stimulus (e.g. Looking at a photograph of a snake). This process would continue until you made it through the list, or until you reached a point where the presented stimulus was evoking significant anxiety. In future therapy sessions, you could attempt to break past the previous session\u2019s \u201ccomfort zone.\u201d<\/li>\n<\/ol>\n

      In other words, gradual exposure therapy is implemented by having you make a list of stressful events that are related to a specific anxiety or phobia of yours. You rank this list in order of which events stress you out the most, to which stress you out the least. Then, you learn relevant coping mechanisms to help you reach a state of calm relaxation at will. These coping mechanisms are used and, once in a state of calm, you are presented with progressively more stressful events in an attempt to gradually eliminate your fears.<\/strong><\/p>\n

      Many people will benefit most from this if they work alongside a therapist. But, in case this is not an option for everyone, let\u2019s discuss how a person might do this themselves from home.<\/p>\n

      1. Establish an Exposure Hierarchy<\/strong><\/h4>\n

      The first step to systematic desensitization is to create your exposure hierarchy. If you\u2019re doing this by yourself, you\u2019ll have to think critically about setting realistic and achievable goals for yourself. The least stressful event on this list should be a relatively small step outside your comfort zone; while the most stressful event on this list should be probably be your end goal, or what you hope to be able to do without anxiety by the end of the process.<\/p>\n

      To give you an idea of what this might look like, I\u2019ve come up with a (completely hypothetical) example of an exposure hierarchy using snakes as the anxiety trigger (sorry, readers with ophidiophobia!):<\/p>\n

      Remember, you\u2019re just making a list. Yours doesn\u2019t need to be in the shape of a pyramid or anything like that, but if it\u2019s easier for you to visualize that way, go for it!<\/p>\n

      Please remember to never put yourself in a dangerous situation throughout this process. For example, holding a wild <\/em>or<\/span> venomous<\/em> snake is not<\/em> a smart way to eliminate your fear of snakes!<\/p>\n

      2. Learning Coping Mechanisms<\/strong><\/h4>\n

      As I\u2019ve said before, if you\u2019re fortunate enough to have a psychologist help you with this that\u2019s great. If not, there are still plenty of resources on this site that can help you to understand and establish coping mechanisms for putting your mind in a state of calm relaxation.<\/p>\n

      I generally suggest that anyone looking to beat panic disorder or another anxiety disorder go through all of the steps in order on the Start Here<\/strong><\/a> page. If you\u2019ve done so already, you should be familiar with these anxiety prevention methods<\/strong><\/a>.<\/p>\n

      Amongst these methods, I particularly recommend you read up on meditation<\/a> and on how to stop a panic attack<\/strong><\/a>. For starters, these can serve as effective coping mechanisms to help one achieve a calm and relaxed state. Alternatively, feel free to explore the site on your own for more options.<\/p>\n

      Whatever coping mechanisms you decide to roll with, make sure you know them well and that they are effective for you. You\u2019ll need them for the next step.<\/p>\n

      3. Connect the Stimulus to the Coping Method<\/strong><\/h4>\n

      When you\u2019re feeling ready to test your limits and work towards fear extinction, use your coping mechanisms to help yourself feel calm and relaxed.<\/p>\n

      When you\u2019re ready, you can start working your way up your exposure hierarchy, starting with the least stressful event you listed. Utilizing your practiced coping mechanisms while the stimulus is presented, try and remain as calm as possible throughout the event. If all goes well, take some time to regroup, and present the next event when you are ready for it. Continue exposing yourself to each stimulus, and see how far you can go without panicking.<\/p>\n

      You may also wish to experiment with the time frames a bit. If, for example, you panic after holding a snake for a minute, perhaps you could practice holding a snake for smaller periods of time and eventually build up to a full minute or longer over time. <\/p>\n

      It\u2019s important to keep in mind that you are not expected to complete your whole exposure hierarchy in one sitting. Go as far as you can comfortably go, and be proud of your progress. Next time, you can challenge yourself to go even farther!<\/p>\n

      Bonus Tip: Alternative Forms of Exposure Therapy<\/strong><\/h4>\n

      While utilizing systematic desensitization, you may find it useful to experiment with some of the alternative forms of exposure therapy. These include:<\/p>\n