What Is Exposure Therapy For Social Anxiety?

In a nutshell, the rationale behind exposure therapy is “short-term pain, long-term gain.”

It is meant to have the opposite effect of avoidance, which provides short-term gain but long-term pain by reinforcing anxious thinking patterns.

Fear is in the unknown

There could be ANYTHING down there. Werewolves, vampires, HUMANS.
Photo by Lucas Pezeta from Pexels

Think of it like watching a scary movie over and over. The movie gets less scary the more you watch it. But why does it get less scary?

  1. You’ve watched it before, so you know what’s coming.
  2. You know you’ve gotten through it before, so you have more confidence about your chance of making it through this time.
  3. You get to start noticing things you couldn’t notice when you were too scared and hyper-alert, and that opens you up to new and fascinating observations.

Fear is also in the memory of the unknown

By which I mean, I find it scarier to think back on a scary movie than to actually re-watch the thing.

Avoiding anxiety triggers gives them power. Facing them takes that power back.

(even though it might feel like
teeth-gritting,
butt-clenching,
vomit-tempting
mortification in the moment)

(Para)sympathy for the devil

In my CBT program, our group leaders told us that our bodies can only sustain a high level of anxiety for so long until our parasympathetic system kicks in and brings down our anxiety naturally. If you flee the situation too soon, you’ll never get to that lower-anxiety place.

Basically, if you’re willing to have a standoff with your anxiety, it will eventually fall asleep, unlike the kindergartner who tries to engage me in deep, convoluted conversation at bedtime every night.

But what do you actually DO for exposure activities?

Here are some examples we were encouraged to consider:

  • Make a telephone call
  • Read in front of others
  • Refuse an unreasonable request
  • Offer an opinion that is different from someone else’s
  • Buy one Timbit from Tim Horton’s
  • Ask for the time in a location where the clock is clearly visible
  • Buy, and five minutes later, return, the same book
  • Engage a stranger in conversation while trying to be as boring as possible
  • Order something that is clearly not on the menu, like pizza at a coffeeshop
  • Intentionally make a grammatical mistake online

Just looking at this list makes me a little anxious. (Sadly, just looking at the list probably doesn’t count as exposure therapy.)

Hospital parades and other shenanigans

Wherein tail feathers are shaken.
Photo by Pixabay from Pexels

I did many of the items on the list during therapy, and since.

One notable activity that’s not on the list was the day our group leaders presented us with a trunk full of ridiculous costumes and announced we were going to get dressed up and do a parade through the whole hospital, each taking 2 turns as leader of the crazy-parade.

It was a fuchsia feather boa and garish CANADA DAY headband for me, by the way.

No, I don’t have photos.

We did a bunch of other silly stuff too. But I shall regale you with those tales another day.

Trite and true

In closing, I will say that two cliches are certainly true for anxiety and exposure therapy:

  1. You can’t have courage without fear.
  2. Sometimes the only way out is through.
Or you could make yourself a hair-shield like I attempted to do in summer 2018, but your mileage may vary on this strategy.

22 thoughts on “What Is Exposure Therapy For Social Anxiety?

  1. “Intentionally make a grammatical mistake online”. I know you. That would be the most anxiety-inducing one of all. Or at least the most difficult one to pull off.

    It is interesting to learn that if you stay in a situation long enough, the anxiety will lessen. It always seems to be to increase as time goes on. I guess I haven’t been hanging around long enough.

    And I would LOVE to see those photos from parade day. Seriously.

    Liked by 2 people

    1. We talked about how it feels like anxiety gets worse in the moment. They said anxiety “peaks and passes.” If you escape during the peak, you don’t get the relief.

      That said, if an exercise is TOO triggering, then you need to dial it back. Otherwise it’s not good exposure practice.

      Photos? What photos? 😇 😉

      Like

  2. Do you still have the fuchsia feather boa? It would go well with the hair over face look.

    I think the next time I’m near a Timmy’s I’ll have to go in and order a single Timbit. At a job I had a number of years ago, I would sometimes pop over to A&W to get hashbrowns as breakfast for everybody. I always got odd looks when I ordered a dozen hashbrowns.

    Liked by 2 people

    1. Hahaha sadly (*ahem* happily) I was not allowed to take the feather boa home. Aside from the many feathers it shed upon me.

      If you order a single Timbit, let me know!!! The only time I’ve come close to that is when I had to go BACK through the drive-thru when the kids began wailing that I didn’t get them the Timbits they insisted repeatedly and savagely that they did not want me to order for them.

      For today you shall be known as She-Ra McDozenHashbrowns.

      Liked by 1 person

  3. You look affectionately like Captain Caveman in the photo, if that reference rings a bell. Sadie, we were a copywriter and an editor and an English teacher in our lives: a preposition is a part of speech it is safe to end a sentence with

    Liked by 1 person

  4. I did some exposure therapy for social anxiety last summer. It helped a bit, but afterwards it has been easy to fall into bad habits. It is possible that I didn’t push myself far enough, although with only so many sessions it is hard. One thing I did was having my therapist film me on her phone while I talked to other people. It was useful to see that I didn’t look as nervous as I felt. Since then I’ve led services in my synagogue (shaking with anxiety), which I had done in the past, but not for five years, but unfortunately someone said I looked anxious (his actual words were that I “looked like you were about to have a coronary”), which has only increased my anxiety there.

    Liked by 1 person

    1. Thank you for sharing 🙂

      Filming you talking to show you don’t look anxious: what a great idea!!!

      Talking in the synagogue again: Can we take a moment to acknowledge how AMAZINGLY brave that is?! Go you. Your hard work helped soften some of the anxiety barrier — even if you were still anxious, you still did it. 👏👏👏

      Person who said you looked anxious: That is unfortunate and was probably very deflating 😦 If possible, I would say try not to let one person’s (possibly wrong) perception take the power away from your progress. You did it. You got up there. That makes you strong. (But I totally know how deflating comments like that can be, truuuust me.)

      In terms of falling back into bad habits, maybe try not to be too hard on yourself. You never really go back to square 1. Even if you backslide a little, that’s normal. It happens to me too. But you’ve clearly put in the work and made great progress — and you’re writing about it in a comment to stranger!

      All signs point to courage and progress. 💙💙💙💙💙💪💪💪💪💪

      Liked by 1 person

  5. If I intentionally made a grammatical mistake, my friends would think I had been kidnapped and was sending a secret message saying I was in trouble and needed help.

    And can you explain to this American who does not live near a Tim Horton’s what a Timbit is? I could google it, but after reading this, I think it would be healthier for me to face my fear and ask a question.

    Liked by 1 person

    1. Your grammar comment made me smile. I feel the same way. And you can’t tell people you’re making the mistake on purpose or it takes away from the exposure. Gaaah!

      I wondered if the Timbit reference would cause any head scratching! Thank you for asking! A timbit is basically a little round ball made of the same stuff a donut is made of. Some people call them donut holes but that doesn’t compute in my brain because how can you eat a hole? …does that make sense?

      Liked by 1 person

  6. Interesting and informative read! very helpful in facing anxiety. I love the quote “you can’t have courage without fear” I think ill steal that one for myself. I acknowledge your bravery in posting that pic of your hair! cheers

    Liked by 1 person

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