FACING YOUR FEARS: EXPOSURE

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1 FACING YOUR FEARS: EXPOSURE An imprtant step in managing anxiety invlves facing feared situatins, places r bjects. It is nrmal t want t avid the things yu fear. Hwever, avidance prevents yu frm learning that the things yu fear are nt as dangerus as yu think. The prcess f facing fears is called EXPOSURE. Expsure invlves gradually and repeatedly ging int feared situatins until yu feel less anxius. Expsure is nt dangerus and will nt make the fear wrse. And after a while, yur anxiety will naturally lessen. Starting with situatins that are less scary, yu wrk yur way up t facing things that cause yu a great deal f anxiety. Over time, yu build up cnfidence in thse situatins and may even cme t enjy them. This prcess ften happens naturally. A persn wh is afraid f the water takes swimming lessns every week and practises putting their feet and legs in the water, then the whle bdy and, finally, diving underwater. Peple with a fear f water can learn t lve swimming. The same prcess ccurs when peple learn t ride a bike, skate, r drive a car. Dubts abut the helpfulness f expsure? Yu may have tried expsure in the past and fund that it did nt wrk. Hwever, yu may have tried t face smething t scary t sn, which can be verwhelming. Or, yu didn t have the chance t practise repeatedly in rder t get the benefits f expsure. If dne crrectly, expsure can be VERY effective in vercming fears. Be willing t try again! Fllw the steps belw t get the mst ut f expsure. Expsure is ne f the mst effective ways f vercming fears. Hwever, it takes sme planning and patience. AnxietyBC 1

2 Hw T D It STEP 1. Make a list Make a list f situatins, places r bjects that yu fear. Fr example, if yu are afraid f dgs, the list may include: lking at pictures f dgs; standing acrss the park frm a dg n a leash; standing in the same rm as a dg n a leash; standing a few feet frm a dg; r petting a puppy. If yu are afraid f scial situatins, the list may include: saying hi t a c-wrker; asking a stranger a questin; making small talk with a cashier; r calling a friend n the phne. HELPFUL HINT: Grup Fears Tgether. Sme peple have a lt f different fears, s it can help t grup similar fears r specific fear themes tgether. Fr example, yu may have a fear f bugs, as well as a fear f heights. Make different lists fr different fear themes. STEP 2. Build a Fear Ladder Once yu have made a list, arrange things frm the least scary t the mst scary. Yu can d this by rating hw much fear yu have fr each situatin n the list, frm 0 (N fear) t 10 (Extreme fear). Once yu have rated each situatin, use the Fear Ladder frm t make a final list. HELPFUL HINTS: When making a fear ladder, identify a specific gal (such as having a meal in a restaurant), and then list the steps needed t achieve that gal (e.g., g t a restaurant and get a cffee t g; have a cffee at the restaurant and sit near the dr; have a snack at the restaurant and sit near the dr; have a snack at the restaurant and sit at a table in the middle f the rm; have a meal at the restaurant and sit near the dr; have a meal at the restaurant and sit in the middle f the rm). See Examples f Fear Ladders fr sme ideas n building yur fear ladder. If yu have a lt f different fears, build separate ladders fr each fear theme. Each ladder shuld include a whle range f situatins. The ladder shuld include sme steps yu can d nw with mild anxiety, sme that yu can d nw with mderate anxiety and, finally, the steps yu find t difficult t d nw. It is imprtant t start really small and take gradual steps. Sme steps n the ladder can be brken dwn int smaller steps. Fr example, if yu are afraid t talk t c-wrkers, facing this situatin culd be brken up int a number f steps such as saying hi t a c-wrker, asking a quick questin, and then talking abut yur weekend. AnxietyBC 2

3 Because it is smetimes difficult t cme up with steps n the fear ladder that cause nly mderate anxiety (that is, smewhere between a little and very scary), yu can cnsider ther factrs that might make it easier r harder fr yu t d. Sme examples include: Length f time: fr example, talking t smene fr 30 secnds is prbably less scary than talking fr five minutes. Time f day: fr example, driving ver a bridge in the middle f the afternn versus evening rush hur. Envirnment: fr example, swimming at a lcal pl versus swimming in a lake. Wh is with yu: fr example, ging t the mall with yur spuse versus alne. See Examples f Fear Ladders fr sme ideas abut building yur fear ladder. STEP 3. Facing fears (expsure) Starting with the situatin that causes the least anxiety, repeatedly engage in that activity (e.g., saying hi t the bus driver everyday) until yu start t feel less anxius ding it. If the situatin is ne that yu can remain in fr a prlnged perid f time (such as standing n a balcny), stay in the situatin lng enugh fr yur anxiety t lessen (e.g., standing n the balcny fr minutes). If the situatin is shrt in duratin, try lping it, which invlves ding the same thing ver and ver again fr a set number f times (e.g., repeatedly driving back and frth ver a bridge until yu start t feel less anxius r making cnsecutive phne calls until yu feel mre cmfrtable ding it). If yu stay in a situatin lng enugh (r cntinue engaging in a specific activity), yur anxiety will start t reduce. This is because anxiety takes a lt f energy and at sme pint it runs ut f gas. The lnger yu face smething, the mre yu get used t it and the less anxius yu will feel when yu face it again. AnxietyBC 3

4 HELPFUL HINT: It can help t track yur fear level during expsure exercises and t try and remain in thse situatins (r cntinue engaging in a specific activity) until yur fear level drps by abut 50%. Fr example, if yu rated hlding a needle as a 6/10 n the fear scale (remember that 0 = n fear and 10 = extreme fear) then yu want t cntinue hlding the needle until yur fear level drps t a 3/10. It is imprtant t plan expsure exercises in advance; that way yu feel mre in cntrl f the situatin. Identify what yu are ging t d and when yu plan t d it. Remember - Expsures shuld be planned, prlnged, and repeated! Make sure t track yur prgress. See the Facing Fears frm, which will help yu identify hw anxius yu were befre and after facing the feared situatin, and what yu learned. Make cpies and fill ne ut each time yu face a fear. Once yu are able t enter a specific situatin n several separate ccasins withut experiencing much anxiety yu can mve n t the next thing n the list. KEY: Dn t Rush! It can be very scary facing the things yu fear. Be patient and take yur time. G at a pace that yu can manage! Step 5. Practise It is imprtant t practise n a regular basis. Sme steps can be practised daily (e.g., driving ver a bridge, taking an elevatr, saying hi t a stranger, tuching drknbs), while ther steps can nly be dne nce in a while (e.g., giving a frmal presentatin t a large grup r taking a plane trip). Hwever, the mre ften yu practise the faster the fear will fade. Dn t frget t maintain the gains that yu have made. Even if yu have becme cmfrtable ding smething, it s imprtant t keep expsing yurself t it frm time t time, s yur fears dn t creep back. Fr example, if yu have vercme a fear f needles, yu shuld schedule rutine bld tests r dnate bld every six mnths s that yur fear f needles des nt return. Re-rate yur entire fear ladder every nce in a while; that way, yu can see the prgress yu have made, and identify the steps n the ladder yu still need t tackle. AnxietyBC 4

5 Remember, yu will experience anxiety when facing fears - this is nrmal. Step 6. Reward brave behaviur It s nt easy facing fears. Reward yurself when yu d it! It may be helpful t use specific rewards as a mtivatin t achieve a gal. Fr example, plan t purchase a special gift fr yurself (DVD, CD, bk, treat) r engage in a fun activity (rent a mvie, g t the mvies, g ut fr lunch r dinner, plan a relaxing evening) after yu reach a gal. Dn t frget the pwer f psitive self-talk (e.g., I did it! ). TIP: Dn't be discuraged if yur fears start creeping back. This can happen frm time t time, especially during stressful perids r transitins (fr example, starting a new jb r mving). This is nrmal. It just means that yu need t start practising using the tls plan sme expsures! Remember, cping with anxiety is a lifelng prcess. Fr mre infrmatin n hw t maintain yur prgress and hw t cpe with relapses in symptms, see Hw t Prevent a Relapse. AnxietyBC 5

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