Exposure therapy is one of the most common forms of therapies used to treat anxiety disorders.
This is where exposure comes in. If we can expose ourselves, or habituate to the stimulus (in this case, clowns), we can re-teach our brain that this particular stimulus is NOT something that poses a genuine threat to safety. It’s almost like diving into a cold pool – if you stay in, after a few minutes you don’t feel the cold any more. What people don’t tend to realise is that even if our anxiety peaks, provided we are in a controlled environment (that is, safe from actual danger); our anxiety will eventually go away on its own. It’s physically impossible to permanently stay in hyper-arousal for extended periods of time because it uses so much energy (and we would eventually fall asleep). The tricky part is getting through the uncomfortable peak. So how do we do it?
In sessions we develop an exposure hierarchy. This is a ladder of objects or situations related to the primary stimulus that cause anxiety, and rank them from the least, to the most anxiety-provoking. Earlier I mentioned that seeing a clown in real life sends my anxiety to a 9; however just thinking about clowns might take me to a 3. Seeing a picture of a clown might take me to a 5; and seeing one on a movie might send me to a 7. Following the rules of exposure, I would need to – you guessed it – expose myself to each level of the ladder, starting with the “easiest” option. The trick here is being able to do so withoutengaging in avoidance behaviours. That’s right – I need to fully embrace the anxiety I am feeling, in order to let my brain learn that this stimulus is NOT a genuine threat to me. I will know I have done this when I feel my anxiety subside on its own. At each level, I have to repeat this same step until the stimulus (in this case, thinking about a clown) sends me to a 1 or 2 level of anxiety. That is when I know it’s time to go to the next rung of the ladder.
Obviously this is something we do during in sessions, however it is vital that clients allow themselves to practice outside of session as well. The more we can practice, the quicker we will habituate to the stimulus and ultimately overcome the anxiety. It can absolutely sound daunting at first glance, however the benefit of doing exposure with a registered psychologist is that you are working with someone trained in the practice who has one goal, which is to help you to achieve yours.
If you are interested in discussing any of the points further, we would be more than happy to hear from you. Feel free to send an email to firstname.lastname@example.org and we will answer any questions you may have.