# CBT Exposure Hierarchy



## canusaylonely (Nov 14, 2010)

I am using self-help books to educate myself on different ways to conquer my SA. I have gone to a therapist in the past and I went so far in the sessions that there was not much else that she could do for me. She was the one that introduced me to CBT and Self Help books. I am at the point in my book where I am building an Exposure Hierarchy. I don't know how many of you know what this is. The whole idea sounds great. It sounds like it might eventually work. But, I can't even imagine doing a lot of the exposure exercises that are suggested, without wanting to cry. I didn't finish my Hierarchy yet. I am feeling quite overwhelmed by this. Am I just imagining the exposure exercises to be way worse than they are really going to be? Would love to hear from anyone who has done this or is working on this.


----------



## rambo (Nov 14, 2010)

I am working on it. I am about to start join behavioral group in person. I want to start doing the difficult ones activities. I cant wait. I do not feel like crying or whatever (I probably would If have not been taking these supplement to reduce the symptoms). In addition, it's probably because my original personally is extremely bold (i fights thru my SA alot, as result I end up doing some EXTREME activities that I cant handle.). I'm prolly saying all of this now, but when the time comes I probably have a reaction (I most likely will tense up). 

Dont worry. Just do it. Fight it. Also, I recommend to take Bio B Complex (A supplement not a pill). It strengthen your immune and nervous system. Great for reducing the symptom. I had like a wrap sheet of symptoms I used to have: watery eyes, dizziness, fast heartbeat like it's about to pop outta my chest, vomitting etc. If you have other symptoms some will go away, and some will reduce.


----------



## Black_Widow (May 23, 2008)

This is something I'm working on right now too.  I can totally appreciate how you feel. Before I attempted any kind of CBT hierachy graded exposure work, I was in two minds just like you. Thought in theory the idea sounded good and wanted to try it. But at the same time, I found actually getting started so much easier said than done. Now I've managed to get past that starting off stage and am gradually getting more confident at using this approach. But still remember how hard that first point was.

My advice to you - as someone else recently pointed out to me on this site when I was getting down on myself for doing badly with attempting a step - would be to try not to put too much pressure on yourself at first. Don't expect too much out of yourself at the beginning. Start small. ;-) And remember even a small success is still a success. You're starting from those small successes, and _gradually_ building your confidence up till you get to the harder things. ;-)There's no need to go jumping straight into trying out the toughest things right away. Instead it's much better to start with baby steps that you find the most doable.

If it helps at all, some starting baby steps I've used before to tackle agoraphobia and social anxiety fears have included:

Visiting the corner shop (2 minutes or so up the road from my house) paying for one item and then leaving.
Visiting a cafe for half an hour or so while accompanied by someone else
Visiting a cafe alone, ordering a drink, but leaving after 10 minutes
Going for a 20 minute walk alone, at a quiet time, around my local streets
Your specific anxiety tackling steps, and the order in which you decide to do them, will most likely be totally different to mine. But I thought I'd include those there just as ideas. Hope that helps!


----------



## droen (Jul 27, 2010)

I started doing exposure recently, but I've never heard of an exposure hierarchy. I'm just kinda doing my own thing. I'm curious about it now. What book(s) are you reading?

Anyway, after my first week of working on exposure, I felt a lot worse than I did before doing it. I talked to my therapist and explained how I felt and she told me it was going to get worse before it'll get better. And it's natural to feel like this when you first start out. You're facing some of your deepest fears so it makes a lot of sense for you to feel pretty bad when you start out. If you stick with it long enough and pace yourself, you'll start to see some results. My first few weeks consisted of just sitting down and eating in front of people and walking around Wal-Mart. You know, getting used to being around people. It was exhausting and very scary. And it still is a little bit. But I'm starting to not react to it like I used to. I calm down a lot faster and eventually get comfortable and I suspect the more I do it, the faster that process will happen. Later I guess I can work on actually just commenting strangers (Nice hat! or something like that)


----------

