Exposure therapy is a part of Cognitive Behavioral Therapy.
CBT is a lot about changing behaviors to achieve whatever we’d like to achieve, rather than doing what feels good at this very moment.
The exposure strategy is useful to treat a lot of things to regain freedom in life. I’ve helped guide people through a few different horrors. Some of them are:
Fear of the dark
Fear of water
Fear of needles
Fear of driving
Fear of social situations/social anxiety
Ruminating and brooding
… With or without panic attacks
When we do things, shouldn’t we reason and reflect for a moment about why we do so? Reflect a second of if it’s a good or bad habit?
It’s not unusual for people to make choices with really comfortable short-term results – and awful long-term ones. We’re likely “wired” to do so. Candy and plenty of fattening food? Yes, please! Dopamine from Facebook likes? Yes, please! Opioids and other addictive, lovely things? Yes, please! Avoid the things that give anxiety and challenging things that are initially hard or uncomfortable – but might be what’s actually important? Yes, please! YES, PLEASE!
… Thanks, evolution.
If we try to be somewhat higher creatures than deer and rabbits that give in to the first spontaneous impulse – and flee at the sight of almost anything – we have to make an effort. We ought to use that particular part of the brain we mean when we say frontal lobes. That seems to be the part that makes us better at thinking ahead and really think things through better than most other known animals… as far as we know.
We must use our higher cognitive reasoning to change and progress these things. We must withstand hardship and sometimes quite an outdrawn discomfort. Use the ability to stay put, think through a situation, and reflect upon the consequences of our actions. It seems as if that ability is too often ignored to benefit something pleasant in the short term. That something is done with dire consequences.
Isn’t it worth the effort to turn into something greater? A thinking being. Someone who reflects upon the consequences of your actions and what’ll happen when you do the right things?
Short-term “pleasant” results and long-term bad ones sure sound like a bad habit.
Short-term “unpleasant” results and long-term good should be a good habit, like Brussels sprouts.
Short-term good results and good long-term results AS WELL are ideal. Find them. Cherish them – if you’ve got the chance.
“I love broccoli – and responsibility!”
“Working out? A decent amount and without breaking things? Woohoo!”
Or just going to bed at bedtime…
This is where we get into exposure therapy.
Don’t do what’s comfortable right here and now –
and you might very well get lovely long-term results that’ll increase your quality of life.
That way, you might very well get rid of the dread that contributes to nothing but a decreased quality of life by restricting what you can and will do.
By doing what’s really scary, challenge it and poke the fear you might get rid of the handicap your anxiety gives you, regardless of if it’s from
Fear of the dark
Fear of needles
Fear of water
Fear of social situations
Fear of driving
Fear of snakes, spiders, rats, or any other tiny creepy crawly.
Fear of your own thoughts, like ruminating and brooding might be.
Fear of… practically everything and anything, as with Generalized Anxiety Disorder.
Fear of what has happened before and thoughts of that horrible thing, like PTSD.
Fear of your own emotions, sensations, or of having a panic attack.
I tend to use the word fear and anxiety quite synonymously. Anxiety is, in my opinion, practically to fear something. Add the emotions, sensations, and thoughts on top, and you’ve created anxiety.
Emotions are what makes us human and perhaps what makes life worth living.
But they might also do just the opposite. Haunt, cripple and plague our minds – and if that’s the case, you’re screwed. Life simply isn’t worth living if it’s bad enough. I get that. That’s why you might need to do what’s even more uncomfortable.
The choices are among these three.
- One. Pick the previous you just read about, mostly just… misery and anguish – stuck, no action, no progress, and without any change whatsoever. Forever haunted by the suffering of that anxiety and despair.
- Two. Be completely super-human, fear nothing, and be the equivalent of some sort of god. Do the right thing and be a sage, a story and something godlike like this Youtube video is an example of (just a couple of minutes long – click it!):
… I wouldn’t say I’m quite sure how to turn into a Stoic sage and role model at that level just yet. Sure, I’m doing my best, but I’ll use other methods until it’s apparent how to do so. The misery part where I’ll have to endure lifelong misery as the first example, where without getting ahead and fear and dread is what controls life sounds… dull – and I don’t know how to turn into someone with the courage of a BALROG as in number two.
- So… there’s number three, the human, pragmatic way of doing this. Work for the progress. Like we all do, generally. In these cases, with exposure therapy, you’ll bathe in your fear and dread – helplessly – and you will fear no more.
Fear of the dark
Remember Batman, where we learn that Bane knows this all too well? “Oh, you think darkness is your ally. But you merely adopted the dark; I was born in it, molded by it. I didn’t see the light until I was already a man; by then, it was nothing to me but BLINDING! The shadows betray you because they belong to me!”
Bathe in what ought to scare you and induce nothing but fear, and you’ll get used to it.
I tend to use cognitive behavioral therapy with those I help if necessary since it seems to work really well to extinguish irrational feelings.
Since that’s what I do… What do you think happened on the night of Halloween?
Graveyard at midnight with someone afraid of the dark… Bathe and embrace.
Fear of needles.
No difference. There’s a specific strategy to avoid getting the opposite result – you’ll have to do it with some finesse to avoid overextending. But it’s not rocket science. Treating the fear of needles makes quite the difference for those who get panic attacks from vaccines and anxiety from the thought or from accidentally seeing something related to needles on TV.
A few days ago, when I wrote this, I met a client of mine again who started being uncomfortable when we spoke about needles. She actually shivered from fear when she was close to them. And there were panic attacks when she was in contact with them.
That was the start.
The last time we met, she casually stabbed herself in the arm while looking at it sloooowly get in further as she’s poking it more and more with barely any reaction. I stabbed her in the arm, shoulders, legs, and abdomen. The insertions with the shoulders and the leg were supposed to hurt. That was the point.
Not at all. Going from panicking from needles to mastering watching the needle penetrate things that are supposed to hurt is kind of as close to heroism as we get in everyday life today. That was achieved through the pragmatic and quite human approach previously mentioned. When I said the point was for the spots to hurt I mean that I was going for trigger points, the sorest part of a muscle, which is penetrated to treat pain and dysfunction in muscles. That is worth an applaud.
When people progress like this, it’s impossible to be anything but incredibly proud as a therapist.
There’s a lot of work and plenty of emotions, in some cases tears, behind the progress. But the results and the difference can be huge. And I’m nothing but proud and amazed.
Fear of water
The fear of water is possible to combat similarly. My point is that most irrational fears are.
I’ve been doing a little intervention myself to do something about an uncomfortable relationship to water. In”never really liked water”. As a kid, I never really liked swimming or just playing in the water, unlike most kids. Avoided swimming and avoided, well, most unnecessary contact with water.
I never really connected it to any fear or actual discomfort, but closer to 30, I got thinking. I really couldn’t say I LIKED water, and there seems to be a scale between love and hate, where dislike is somewhere closer to hate than love – and there’s often some sort of feeling in addition to how well something is appreciated. It could very well be uncertainty and a portion of fear.
The reason? Not entirely clear. Left by the edge of the water by the age of 2 and found at the bottom could explain something. Though, that was a pretty undramatic event. I’m told.
Something caused the emotions that kept me from water anyway – and here’s the beautiful part about the CBT – it doesn’t matter why I didn’t like it. We don’t need to know why to treat it.
Solution? I got a year-long membership at the closest place with decent enough swimming pools and started learning the front crawl with the help of a friend. While doing so, I just implemented the usual things I keep in mind when I expose people to things.
I showed up somewhere between one and three times a week for a year and that was more than enough to expose those emotions into submission. By now, I’m just not particularly fond of swimming. I don’t dislike it irrationally. I’m not great, but that was never really the plan or the goal. I was mainly there to do things in the water, which worked out great. By now, I’ll survive decently in water without particular discomfort. It practically bores me – and that ought to point to great results since boredom seems to be a very clear indicator of an absence of fear.