Exposure therapy is one of the most common forms of therapies used to treat anxiety disorders.
However, when this is discussed with clients, they often recoil at the thought.“Why would I want to deliberately expose myself to the thing that makes me anxious?” “Can’t you just help me to get over it?!” The truth is, research shows that exposure therapy can be one of the most affective ways to treat anxiety, but to understand why, first we need to understand a little bit more about our friend anxiety.
Despite its bad publicity, anxiety is actually something we all need to survive. Without it, the human race wouldn’t have come as far as we have; actually; we would have died out as a species pretty quickly. Have you ever had a thought reminding you to look both ways before you cross the road? That is anxiety. Have you ever scheduled in time to complete a project because the deadline was approaching? That is anxiety too! Have you ever rushed to get your toddler away from a hot oven? You guessed it – anxiety. Anxiety, and its accompanying physical symptoms, are our brains’ way of alerting us to perceived danger. Back in the caveman days this mostly surrounded things that could kill us – a lack of food and shelter, and the very real presence of predators. Nowadays though, our brains now also consider other things to be dangerous (such as things that might potentially embarrass us, for example). So a lot of the time, anxiety is helpful. But we don’t need to worry about that type of anxiety.
Obviously, anxiety can tip over into the realms of being unhelpful. Specific phobias (spiders; clowns; germs etc); social anxiety (a fear of judgement and/or negative evaluation); and generalised anxiety (apprehensive expectations about a number of different situations) are just some of the ways anxiety can be unhelpful. So how does anxiety work? Well, regardless of the specific type of anxiety, the pattern is relatively similar.
First, when we are calm, we are at what we call a baseline. This is the emotional experience when we aren’t necessarily happy, sad, worried, or angry; we just are. Then we encounter the anxiety-provoking stimulus. For illustrative purposes, I am going to use the example of a phobia of clowns. When I see a clown, my anxiety goes from a zero to a 10, I get hot; my heart races; and I feel nauseous. This obviously feels horrible, so I run away as fast as I can. When I realise I am away from the clown and no longer in “danger”, my anxiety comes back down to baseline and my symptoms go away. However what has also happened is that my brain has learned that avoiding this object is what kept me safe (not that I wasn’t actually in danger at all). Therefore, next time I see a clown 9or even think I might see a clown), my brain will need to tell me earlier, and more intensely that I am in danger and need to run away as fast as I can, all to keep me “safe”. To be blunt, every time I avoid the clowns, it makes the immediate symptoms go away, but makes the overall anxiety worse.
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