The term “exposure” gets tossed around quite a bit in therapy and could sound quite scary at first so,

here are the nuts and bolts for any of you who are a bit worried and unsure of what it means….

 

Therapeutic exposure is about paying attention to or doing something that you typically try to avoid because it evokes a strong anxiety or fear response. Over time you condition yourself to believe that the only reason your anxiety has gone down is because you didn’t do it and therefore you are likely to continue to avoid it and if for some reason you HAD to do it, you would attribute it to some fluke like “beginners luck”.

 

Anxiety is a natural mental and physiological response to something that can or ‘might’ be able to harm you. We cannot get rid of anxiety because it is a natural mechanism that is very necessary to keep us safe. Ever look over the edge of somewhere really high up and get that anxious feeling at the pit of your stomach? That’s your body and mind saying “hey you, don’t go any closer or you’re gonna die” and that is quite important. 

 

So when does it become harmful? Unfortunately for human beings, we have really latched onto the ‘might’ component. Our highly evolved brains could conjure up several scenarios at any given time that may (or may not) negatively effect us and cause us emotional or physical harm. The difficulty is when we begin to avoid things that trigger anxiety and then still have anxiety and the only thing we know to do to cope with the anxiety is avoid it more - your world can become very small. 

 

Take someone with PTSD who was in a car accident, one day as they are driving around they start to come close to the place where the car crash took place and their overly helpful mind starts saying “HEY! This is where we were hurt before and could be hurt again, we should stay away from this intersection because it is a dangerous place”. So we stay away from the intersection but then at a similar, but different intersection, the anxiety comes back again - “HEY!” Your mind says to you. “This looks a lot like the other intersection, these types of intersections aren’t safe - we should stay away from them” and so on, until eventually you could conclude it would be better to just not drive to stay safe. 

 

In comes exposure, to assist you in understanding and connecting to the bodies natural anti anxiety medication - habituation. You and your therapist will discuss and understand better the things you do NOT do because anxiety is at the wheel. Together you build a hierarchy of actions that produce anxiety and that you want to avoid… from the little things that make you uncomfortable to the top of the totem pole items that “ain’t ever gonna happen” we will start to list them all. 

 

We begin with mid to low range items, planning the practice in your agenda, deciding on a time for the practice and ensuring that you have opportunities in the week to repeat. Therapeutic exposure must be planned, predictable and frequent! 

In short, we aren’t going to throw you into whatever it is you are fearful of, rather slowly and steadily build up to doing things that elicit a stronger response while at the same time developing mastery. The increased confidence in your body and minds ability to ‘get used to it’ will allow you to continue to work up the hierarchy and get back to doing things YOU want to do!

Elder woman and her caretaker

What it Exposure?