Exposure Therapy for Anxiety Disorders, Panic Attacks

Exposure therapy is suggested to be one of the best ways to overcome your anxiety. To master something in life it is necessary first to think about it, and then actually practice doing it. Remember when you first started to learn how to drive. The more you practiced the better you became. This is the basis of exposure therapy. You actually need to go into the situation and think about it in a different way, implement the other skills and knowledge you have to mange your anxiety, and then reflect on how it went.

There is a word of caution here. Some research suggests to 'face the fear and do it anyway'. For some people this may work, however for others it doesn't. Learning the skills and techniques of cognitive therapy and educating yourself on where your anxiety is actually coming from in the first place, prior to exposing yourself to the situation, can often have better outcomes as you can feel more in control before you enter the situation, rather than going in feeling absolutely terrified.

When you feel anxious, it is suggested that you go through it firstly in your mind (realistic thinking/skills of cognitive therapy), and secondly, put yourself in the situation that you fear. This part is called exposure therapy.

If you continue to avoid situations because you are feeling anxious, it only makes it harder to overcome your anxiety. When you avoid doing something, you often convince yourself that there is a very good reason why you are not doing it. If you continue to avoid situations, no amount of thinking about it in another way will actually help you overcome your anxiety in the situations. The more often you do something, the easier it becomes each time. Remember the learning to drive?

There are some helpful techniques suggested to use when engaging in exposure therapy. Ron Rapee in his book, 'Overcoming Shyness and Social Phobia' suggests the following techniques that can also be applied to all types of Anxiety Disorders. These include:

1. One step at a time - don't jump in the deep end first. Take a small step and work your way up to the most uncomfortable situations.

2. Stay in the situation - try not to leave if you suddenly feel anxious. Rather, implement some of the other techniques such as rational thinking, focusing, breathing, and relaxation. Of course, if you absolutely have to leave, then do - it is suggested that you try and do it again as soon as possible. Alternatively, try and back away a little bit, instead of leaving the situation completely.

3. Repeats - doing something once can be interpreted as a fluke! The more often you do something, the more you will start to feel more comfortable (the more techniques you implement, the greater the ability you will have to control your anxiety)

4. Ups and Downs - these are a part of life, and some days you will have good days, and some days you will not have such good days. Try not to beat yourself up on the not so good days by engaging in negative self-talk. Rather, accept it for what it is - a not so good day!! Go back to the drawing board and set your goals a little lower until you are feeling stronger and more confident again.

5. Be aware of avoidance - try and be aware of all your avoidances. By not doing something that you fear, you are only making it harder for yourself. Avoidance is only an excuse and keeps your fears going. If you have engaged in some anxiety education, you will be more aware that it is you who is controlling your anxiety, so it is you who can decrease and manage it as well. It just takes some practice (and patience!!!) It is also important to try and be aware of subtle avoidance when overcoming high levels of anxiety. For e.g. You might go to a party and talk to only a few people you know well, avoiding meeting new people. Or you might travel 10 miles to go to a shop rather than visit the large shopping center 1 mile from your home.

Everyone has different fears and experiences different levels of anxiety in different situations. It is important to try and overcome all your avoidances using the techniques of exposure therapy.

Reference

Rapee,R.M., (1998), Overcoming Shyness and Social Phobia', Chapter 6, pg. 61-75, passim, Lifestyle Press.