Yesterday we talked about why the people who can most benefit from exposure therapy tend to hate exposure therapy.
When people recoil at the mention of exposure based recovery methods, they are often missing the part where we start with very tiny steps.
If you’ve been stuck on your sofa for the last 6 months, you’re not going to be driven into the woods 100 miles from home and left. That’s not exposure.
Effective exposure incorporates two main principles that can really bring down the “terrifying factor” in a big way. So if you’re imagining that doing exposure work would be like having a continuous panic attack for 6 months, you’re mistaken. Here’s why.
Exposure is based on incremental progress. There is a reason why it is called GRADUATED or GRADED exposure. When treating something like agoraphobia, exposure work can often start with simple visualization exercises, or practicing the act of putting on one’s coat or tying one’s shoes. There is no need to start with “moon shot” exposures. In fact, the vast majority of therapists would simply not allow that. Starting with very small steps is the most effective way to get the recovery ball rolling and to build a strong foundation that more challenging tasks can rest on.
If you’ve ever seen the hilarious movie “What About Bob?”, you know the value of “baby steps”. Baby steps aren’t nearly as scary or difficult as what you are imagining!
Exposure can be anything at all. A good counselor or therapist will understand that you are not really afraid of the supermarket, but rather that you fear the discomfort of anxiety or panic in the supermarket. This being the case, an exposure plan won’t necessarily involve being forced to sit in the frozen food aisle for 40 minutes, but might instead find easier to execute ways to trigger discomfort even in your own home.
Sometimes simply changing a morning routine, or working on modifying the way you talk about your anxiety can be difficult and triggering. These smaller more subtle tasks and modifications are perfectly acceptable, effective, and quite common in the early stages of an exposure based therapy plan.
If a trip alone to a crowded shopping mall makes you want to run screaming from any discussion of exposure therapy methods, consider that sometimes just changing your toothpaste or sleeping with your phone in a different room can be effective and less daunting ways to start you down the path to recovery. Anything can be an exposure. It doesn’t all have to be challenging and terrifying at an epic level.
Of course, a successful exposure based therapy will involve an incremental and systematic increase in the level of difficulty of each exposure over time. This is part of the deal and without it, there is no lasting progress. Starting small and being resourceful and creative in the beginning means that you’ll build a stronger base to stand on, making the larger tasks and challenges you’ll face down the road less difficult and frightening than you are imagining them to be right now.
Exposure therapy is hard. It involves being afraid and uncomfortable intentionally and by design. In reality, though, exposure is not torture.
When properly designed and under the guidance of a good therapist or counselor, exposure can be far more manageable than you think, and will therefore be far more fruitful and rewarding in the long run. Take some time to look past your initial distaste and disapproval of this type of recovery plan. You may find yourself feeling empowered to give it a fair try once you do.
Tomorrow we’ll take a look at the concept of courage and how it’s often misunderstood.
I’m currently reading Atomic Habits, by James Clear. This is a good one! I’m taking a copious amount of notes as I go through each chapter because a whole lot of this wildly popular book will relate directly to the recovery process. Can’t wait to start sharing about it!
Every Tuesday I’ll let you know what I’m currently reading. I read quite a bit on psychology and philosophy, but really you never know what I’ll have in my Kindle or Audible libraries! If you’re on Goodreads and into books, you can follow/friend me over there. Here’s a link to my “currently reading” shelf. I’d love to see what you’re reading and what you recommend.
12. Exposure Therapy Might Not Be As Scary As You Think