What is Exposure?
We are going to talk about facing your anxiety head on. This is called exposure. In my professional work, I have noticed that many people are held back by a very low tolerance for anxiety. It is hard to push forward and eliminate the control that anxiety has over you when you are still very sensitive to having anxiety in the first place. Research has demonstrated time and time again that exposure is one of the most powerful tools for recovering from anxiety, and exposure often serves as the backbone for supported anxiety treatment models.
You need to remember that anxiety itself is not dangerous. It will try to convince you that you are in danger or that potential scenarios carry a great deal of risk. What you can do with exposure is prove anxiety wrong. In exposure work, we want to harness our body’s ability to regulate itself and find a nice cozy homeostasis. We want to give ourselves the chance to experience anxiety without running from it.
The information in this post is derived from my online course, Kick Anxiety’s Ass, but you can find a free ai-based tool below to help you develop your own courage ladder.
Avoidance is the fuel of anxiety.
Anxiety wants you to think that situations are dangerous. That you’re not going to be able to handle yourself. That you will freak out and lose control. This leads to avoiding scenarios that might be anxiety provoking. When you avoid something, anxiety says, “See that? I kept you safe. That would have been bad news. Feed me!” Anxiety gets stronger and stronger when you keep letting it influence your decision to avoid things.
Exposure activities are a way to call bullshit on your anxiety.
By allowing, or even inviting anxiety, to happen without running away, we can actually reduce the impact that anxiety has and build a tolerance to it.
Approaches to Exposure
There are two main approaches to exposure work:
- Dive directly into the situation that causes you anxiety.
- Wait for your body to do its thing and self-regulate.
- Eventually your body will get sick of being anxious and you will realize that the thing that is making you anxious won’t hurt you.
- This is one of the treatments of choice for phobias.
- AKA gradual exposure, AKA courage ladder.
- Rather than diving in head first, you develop a plan to systematically build tolerance.
- Start off small and gradually work your way up to the real thing.
Important Points About Exposure
Exposure isn’t a pleasant process. Don’t expect it to be. You’re going to feel discomfort and anxiety during this process, but it works. The research is clear. You can make some serious progress using exposure techniques.
Developing a Hierarchy
In this section, we are going to get into the nuts and bolts to develop an actual anxiety hierarchy. I like to call this a courage ladder. Using this, we will start from the bottom rung and work our way up bit by bit to develop a strong tolerance for anxiety.
As you go through the process of developing and working through a courage ladder, you will need to track your anxiety level. We will be doing this with a SUDS rating. SUDS stands for Subjective Units of Distress. It’s a fancy term for a numerical rating. In this case, we will use a 0-10 rating of anxiety, where 0 is totally calm and 10 is having extreme anxiety or a panic attack.
The Courage Ladder
Once you have identified the anxiety provoking scenario that you are going to be targeting, the next step is to determine the first rung on your courage ladder.
- Your first step should be something that generates a moderate amount of anxiety.
- It should not cause a full blown panic attack.
- Moderate anxiety is defined as a 4-6 SUDs rating.
- Once you had identified that first rung on the ladder, the next step is to develop a full hierarchy.
- List all possible exposure activities that are related to your anxious situation.
- Rate their anxiety potential 0-100 and then rank them.
- Decide on 10-15 steps that you can work through.
Now that we have developed our courage ladder, it’s time to actually get moving and put the plan to action. What we want to work toward is mastery of each step along our courage ladder.
- For each exposure exercise, you are going to track your anxiety rating at the beginning, middle, and end of the exercise, using the 0-10 SUDs rating.
- “Mastering” a step means that you are able to reduce your anxiety rating by half, consistently for 3-4 sessions.
- For example, if the current step on the ladder is generating a 6, you want to be able to reduce it to 3 by the end of the exposure session for at least 3 sessions. Then you know it’s time to move up to the next step.
- If you can’t make any progress at the step you are working on, you can modify the step or go back one step.
- It’s normal to go back and forth a bit. As long as you are trending in the right direction, that’s what matters.
Treat this like a job.
Consistency is important. If you can treat this like a job and show up each day, that is going to greatly improve the gains that you get from doing exposure exercises. One good way of putting the plan into action is to give yourself a 30-day challenge, in which you work on your courage ladder each day.
Remember that the point is not to recover from anxiety as quickly as possible and get it over with. We are looking for prolonged exposure and endurance. Rather than trying to distract yourself, I want to challenge you to engage and immerse yourself in the activity.
An Actual Exposure Session
So what does an actual exposure session look like?
Spend 20-30 minutes per day doing your exposure exercise.
- Review your normalization cards before you start your exposure exercise and maybe even bring them with you.
- Try to stay fully engaged and don’t check out while you are going through the process.
- You don’t need to do anything else. This is the job.
- Keep track of your progress in the journal.
It can also help to build in rewards. Give yourself small rewards for each step along the courage ladder and then BIG rewards when you reach your bigger goals.
A Free Tool for Creating a Courage Ladder
Simply type in your feared situation and allow the app to help you figure out some possible gradual steps to take as you approach your anxiety and build that tolerance.