today i'm going to be talking about exposure therapy the number one most
effective way to overcome anxiety we're going to be talking about what it is what
makes it so incredibly effective against anxiety and how to do it
hi everyone in today's video we're going to be discussing exposure therapy the gold standard
number one tool to overcome anxiety and although it can seem simple it's important to understand
where what exposure therapy is and where it comes from but before i get into that just a
couple of disclaimers to go over i'm a registered psychologist in the province of british columbia
canada and this video is for informational purposes only it is not intended as a substitute
or replacement for advice from your doctor or mental health professional now with those
things out of the way let's start talking about exposure therapy now the internet is filled with
uh do this simple hack to stop anxiety or three simple steps to eliminate anxiety right now
the problem is none of this stuff works because if it did no one would ever experience anxiety
what we know is that exposure therapy and exposure is the best way to overcome anxiety and it's
been around for decades it still works and it still works great now in order to understand
how exposure works you need to understand how anxiety works and what keeps it what
keeps anxiety going because once you have this understanding of how anxiety works
it makes a lot more sense as to why exposure therapy is so effective
now the thing is anxiety is an emotional response to a feared trigger situation or trigger event
so in specific phobias it can be things like spiders heights needles even driving
social anxiety it's social situations in generalized anxiety disorder it's uncertainty
uh emphatic disorder is physical sensations so these are all the the feared stimuli the feared
situations the feared objects that uh cause a person a great deal of anxiety and distress
and so when a person encounters the feared object what happens well their anxiety increases and this
is really uncomfortable it it doesn't feel good so it's natural to want to eliminate that feeling and
the quickest and seemingly easiest way to do this is to escape or avoid that situation or object
but the problem is well the upside is that avoidance makes the anxiety goes away and go away
which makes it which makes you feel good so avoidance it's sort of a problem but it isn't
because avoidance is the quickest way to eliminate anxiety so that seems like a pretty good solution
right if avoidance eliminates my anxiety quickly maybe i just need to engage in more avoidance
the problem is as you can probably guess is that avoidance limits a person's life so i
maybe won't get together with people it limits what types of jobs i can have it limits where
i can go it limits what i can do this avoidance makes my world a lot smaller the second problem
with avoidance is it also keeps the anxiety going because the next time i come into contact
with that trigger situation or trigger object what do i have to do i have to avoid it and so
this avoidance becomes self-perpetuating and it drives the anxiety which becomes self-perpetuating
so what happens is the more i avoid is that it keeps reinforcing my beliefs that the trigger
or the object is dangerous and that something bad will happen and that i'm unable to cope
and so this is how it keeps driving my anxiety
so avoidance in essence is short-term gain in exchange for long-term suffering
so this is where exposure comes in rather than avoiding exposure is all about coming into contact
with the feared situation and seeing what will happen seeing if something bad will
happen seeing how i will respond when i come into contact with that situation
so think about what happens if i'm engaging in exposure i come into contact with the trigger
situation the trigger object and i forced myself to stay in the situation what's going to happen
to my anxiety well my anxiety is going to go up but the thing is my anxiety can't
go up forever and ever and ever until my head pops off eventually the anxiety is going to plateau and
if i give it enough time eventually it'll go down by itself so in essence the alarm goes off but
the alarm then shuts off when i start to recognize and start to realize that nothing bad is happening
so the idea is i repeat the exposures over and over again over time and as i do this
what happens is the intensity of the anxiety decreases and the time needed for the anxiety
to go away decreases so exposure is really difficult in the short term um you have to
tolerate a lot of distress you have to tolerate a lot of anxiety it certainly isn't quick and easy
but in the long term it's a really sustainable and permanent solution to make the anxiety go away
so whereas avoidance is short-term gain for long-term sort of suffering and pain
exposure is about short-term pain and distress for long-term benefit
so the question is how do you go about doing exposure how do you go about doing exposure
properly um the key is one thing people will sometimes do is say okay if i need to do
exposure i'll just jump in and and do exposure to the scariest thing and just face my fears
so if i have a fear of spiders i'm gonna go hold a tarantula
the problem with this this is something we call flooding and flooding can make anxiety a lot worse
what happens in these types of situations is that it makes the anxiety so high that my anxiety
when i come into this high anxiety provoking situation my anxiety gets so high that i can't
take it anymore i can't tolerate that level of anxiety and so i stopped the exposure early
and so what happens is my anxiety comes down really quickly because i've
avoided and i've escaped the situation but what it does is it reinforces that avoidance
and it reinforces that belief that i can't cope so this flooding has actually made the
situation worse for the next time i come into contact with that feared situation
so flooding while on the surface may seem like hey this will be the quickest way of getting
over it it doesn't really work and actually can make the anxiety worse so in exposure therapy
and sort of effective exposure the step is to come up with a fear hierarchy or an exposure
ladder and the idea with this is to rate exposures from a scale of zero to a hundred starting with
smaller exposure numbers and working your way up to harder exposure numbers
so for example if i have a phobia of dogs my exposure hierarchy may look something like this i
it may start with reading about breeds of dogs then maybe doing a google picture search of
friendly dogs then doing a google picture search of just dogs then maybe watching videos of puppies
on youtube then videos of dogs in general then maybe going to a dog park and watching dogs from
inside my car then maybe walking next to a dog park then walking inside a dog park
then approaching a small dog on a leash then a large dog on a leash then petting a small dog
then petting a large dog and then maybe at the very top of my hierarchy is watching a movie like
cujo which involves a really vicious dog and so what i've done is i've taken all of the potential
ways in which i can have some exposure to dogs and i've rank ordered them from some of the easiest
to some of the hardest exposures and so once i have my exposure ladder the idea is to start with
doing exposure to the lowest anxiety items and doing exposure to them staying in the situation
until my anxiety comes down so if i start by reading about a reading about different breeds
of dogs i may feel anxious but the idea is to continue reading about them until
i notice my anxiety has reduced significantly and then the idea is to repeat this exposure
multiple times over the course of days or even weeks until the anxiety is minimal
until i can be reading about breeds of dogs and it doesn't cause a whole lot of anxiety for me
then what i do is i move on to the next item up on the exposure hierarchy or the exposure ladder
and i do the same process again so i engage in that exposure over and over again multiple times
until i notice that it's not causing me a lot of distress and then i move on to the next one
so at first when i introduce this idea to my clients they they look sometimes
can look discouraged or sometimes can look upset because at first it may seem like this is going
to take a really long time it's going to take forever but the thing is the process accelerates
as you move up the ladder what happens as you do these exposures is that you learn that what you're
afraid of isn't happening and you learn that you're able to cope a lot better than you thought
and so the first items on the hierarchy may take a while but once you start getting those experiences
it gets easier as you go up even though those are harder exposure items so with time and practice
you overcome your anxiety and what this does is it gives you a lot more freedom to be able to live
the life that you want a lot more freedom to be able to do things that you may have never imagined
that you'd be able to do so although this process of exposure seems straightforward
it's not easy it requires effort it requires work it requires you to tolerate distress
but like with anything meaningful in life there's no simple shortcut
yes exposure therapy is difficult but the key is it works
so uh i hope that makes sense i would love to hear some of your thoughts and ideas
about this have you done exposure therapy like this before if so please leave me some
uh some of your thoughts and comments in the comment section down below if you've been enjoying
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