# Exposure Thread



## SplendidBob (May 28, 2014)

So I figured it was about time that I made this to run alongside my exposure vlog http://www.socialanxietysupport.com/forum/f16/exposure-vlog-1947218/

*1: Avoid trauma*

Do not push too far. What you want is a mild exposure that you can repeat every day or so. You will have to force yourself to do it still, but it cannot induce so much trauma that it worsens your anxiety. This is why exposure via regular life doesn't work, you are being exposed to too much anxiety and trauma and it is simply reinforcing that this is something to be avoided. *Only ever expose yourself to a 2-4* (or a 5 if you are feeling brave).

*2: This is going to take a while*

It is going to take months and months of gradual exposure. It just is. Do not try to rush things. You want to not take on instances where the anxiety is too high (because that makes the avoidance worse, much better to take on a simpler task).

*3: Score*

You need to rate your anxiety before, during and afterwards. You have to do this, and you should record it (at least at the start of each new task, so you can see it coming down, and can avoid your mind playing tricks on you). Rate out of 10.

0 = no anxiety, 
5 = moderate anxiety (difficult task you might avoid)
10= terrifying panic attack.

So in here you are looking for tasks that fit into 2-4, 5 at a push. So each task, immediately afterwards rate like:

Before: 4
During: 3
After: 2

Or whatever

*4 Your anxiety won't get worse as the time goes on*

Only perform a new task when the anxiety for the current task has dropped to a 2 or a 3 (on any measure). You are only ever exposing yourself to 2-4 (5) anxiety, ever, during the whole process.

*5 Frequency*

Anywhere between twice a week to twice a day. Depending on task and how you feel about it. It doesn't matter if you don't feel up to a difficult task, but try to get in some easy tasks most days. I would start with an easyish task, and just try to do it twice a week, then build from there.

*6 Thoughts*

Try to cut back on rumination, just trust that this will take care of itself. In my case after rumination was the first to go, I barely get that any more. Just concentrate on doing the exposures and not sweating it too much.

*7 Make it somewhere you visit regularly*

You need to be able to do these quite often, so make them somewhere you go often.

*8 Be creative with tasks.*

This doesn't necessarily need to even be social, esp if you are avoidant, anything that makes you anxious to do is a potential task.

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My own sequence of tasks (gradually done these over many months):

1. Asking for bag in Tesco (initial before anxiety 2-3ish), now 0
2. Saying "have a nice day" after going to a till in Tesco (initial before anxiety 4-5ish), now 1
3. Saying "Hi, you alright?" initially at the till, keeping the "have a nice day afterwards" (initial before anxiety 4-5), now 1
4. Work on smiling while doing the above (initial before anxiety 3-4), now 1
5. Work on body language while doing the above (more open, seem more relaxed)
6. Purchase and return an item on purpose (before 5, now 2)
7. Use changing room (before 4-5, now 1)
8. Ask someone where an item is (before 5-6, now 2-3)
9. Ask someone how their day has been / or a general question about something they are doing (currently in progress) (3ish atm)
10. Engage active listening with 9 and try to ask a follow up question or two (currently in progress).(easier than 9 if you can find a question)

Further advice, it helps to decide to do tasks on the spur of the moment, esp when considering jumping up tasks. Go in and do your regular task, then decide "**** it, lets try the more difficult" (assuming it is near the time you need to move up). This minimises anticipatory anxiety.

Further further advice, make a list of things you avoid, find the easiest, then do it and score as above, to begin.


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## SplendidBob (May 28, 2014)

Addition: 26/04/2017

Gonna dump something here about habituation. Basically the longer you are able to stay in a situation that makes you anxious, the more rapidly (and thoroughly) the anxiety around that task will diminish. It does seem to work so long as there is a reduction in anxiety to anxiety during the task, but if you can, try to find tasks that are as long as possible in duration. This frankly, is the big challenge with social anxiety I find personally. Getting tasks that are low enough anxiety and that last long enough is challenging.

One way to look at it though is the total time spend doing the tasks. You should still get a good reduction in anxiety even if the tasks are brief, if you manage to consistently repeat them over a long time period.

Also worth noting that if you avoid the task, you effectively deny yourself any possibly chance to habituate (i.e. your body and brain to get used to the fear and let it diminish). Even short duration tasks are beneficial then.

https://www.psychologytoday.com/blo...9/overcoming-fear-the-only-way-out-is-through


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## SplendidBob (May 28, 2014)

Wasn't expecting any takers for this  - still will leave the thread up here in case anyone changes their mind at some point.


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## Humesday (Mar 6, 2016)

These are some great threads, Bob. Thank you for adding some constructive threads to a primarily destructive forum.


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## 629753 (Apr 7, 2015)

You cant lose your anxiety by doing exposure therapy. Most the time, it only gets worse. The real change is internal


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## SplendidBob (May 28, 2014)

Humesday said:


> These are some great threads, Bob. Thank you for adding some constructive threads to a primarily destructive forum.


That's alright mate 



impedido10 said:


> You cant lose your anxiety by doing exposure therapy. Most the time, it only gets worse. The real change is internal


Lose it entirely? Well everyone has anxiety so expecting to lose it entirely is a bit unrealistic. I have made significant improvements doing it over the last few months. It all depends how you do the exposure. Flooding is horrible, gradual exposure works. It isn't particularly fun to do, and you have to push yourself to do it, but yeh it helps.

Have you tried it?


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## 629753 (Apr 7, 2015)

splendidbob said:


> That's alright mate
> 
> Lose it entirely? Well everyone has anxiety so expecting to lose it entirely is a bit unrealistic. I have made significant improvements doing it over the last few months. It all depends how you do the exposure. Flooding is horrible, gradual exposure works. It isn't particularly fun to do, and you have to push yourself to do it, but yeh it helps.
> 
> Have you tried it?


Yes, I got even more anxious.

It is possible to lose all your anxiety, if you live in the moment (no anxiety because no thoughts pop off).

Im tryna get there, slowly, just playing the waiting game.


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## I Beethoven (Mar 11, 2017)

I haven't left the house in 7 years today I decided to just do it and walk to a busy area away from my house I was scared but I'd say it wasnt as scary as I thought it would be. I felt better after I think exposure is the best method for me personally


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## SplendidBob (May 28, 2014)

impedido10 said:


> Yes, I got even more anxious.
> 
> It is possible to lose all your anxiety, if you live in the moment (no anxiety because no thoughts pop off).
> 
> Im tryna get there, slowly, just playing the waiting game.


How many months did you try exposure for? And no, everyone has some level of anxiety.



I Beethoven said:


> I haven't left the house in 7 years today I decided to just do it and walk to a busy area away from my house I was scared but I'd say it wasnt as scary as I thought it would be. I felt better after I think exposure is the best method for me personally


Just take it slow, very slow, you don't want to induce more trauma


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## harrison (Apr 14, 2012)

splendidbob said:


> So I figured it was about time that I made this to run alongside my exposure vlog http://www.socialanxietysupport.com/forum/f16/exposure-vlog-1947218/
> 
> *1: Avoid trauma*
> 
> ...


Nice work Bob - a psychologist I have been seeing for a while says pretty much the same as what you've advised. ( This guy was a scientist then did psychology as a mature age student - he loved it and went on to do a Phd. I have a great deal more faith in what he says than in my psychiatrist. He's the best one I've come across. )

That doesn't (of course) mean I do what he says. I have a problem with recording things - as in the rating part. I do see the point in it but I get lazy, I chicken out and I think I also have some sort of weird obsessive thing about doing it. (or not in my case)

Also have been battling with my bipolar crap lately - mania mostly - so I'm using that as an excuse too. 

It really is great to see you playing such an active role on here.


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## I Beethoven (Mar 11, 2017)

splendidbob said:


> How many months did you try exposure for? And no, everyone has some level of anxiety.
> 
> Just take it slow, very slow, you don't want to induce more trauma


Thats a good point i just need to get to know how to talk to people thats my biggest fear


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## SparklingWater (Jan 16, 2013)

I'm in. I wasn't necessarily going to post, but I may to help keep myself accountable. Great thread Bob.


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## Kayvy (Jan 13, 2017)

Ahhh this sounds really good! Thanks for sharing!!!


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## SplendidBob (May 28, 2014)

I swear I already replied to this.. damn.



don said:


> Nice work Bob - a psychologist I have been seeing for a while says pretty much the same as what you've advised. ( This guy was a scientist then did psychology as a mature age student - he loved it and went on to do a Phd. I have a great deal more faith in what he says than in my psychiatrist. He's the best one I've come across. )
> 
> That doesn't (of course) mean I do what he says. I have a problem with recording things - as in the rating part. I do see the point in it but I get lazy, I chicken out and I think I also have some sort of weird obsessive thing about doing it. (or not in my case)
> 
> ...


Thanks Don, trying to help a little ya know 

This stuff has been helping me, so I figure I have to share it.



I Beethoven said:


> Thats a good point i just need to get to know how to talk to people thats my biggest fear


The key point in your case I think is to take things very gradually. You don't ever want to go beyond what you feel only slightly anxious about, because that will just worsen the anxiety (how you got where you are).

Basically

1. a minor amount of manageable anxiety = overridden by feeling good about accomplishing something difficult

2. a major amount of anxiety = worsening the avoidance response

So in your case you need to break it down into very small steps (just step outside your door for a a few seconds if you need to to begin), or hell, just open and close the door. Then do it daily and gradually increase things but only when anxiety has gone down (which is why you have to record).

Doing this you _never_ want to be outside the range where you feel you can comfortably do it.



realisticandhopeful said:


> I'm in. I wasn't necessarily going to post, but I may to help keep myself accountable. Great thread Bob.


 thanks.



Kayvy said:


> Ahhh this sounds really good! Thanks for sharing!!!


Ty, hope some people manage to give it a go, its helping me a lot.


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## sad1231234 (Jul 10, 2016)

This is similar to what my therapist told me to do to overcome social anxiety. He also said to use a sort of step plan, where you rank different social situations on a scale of 1-10, with 10 being the most terrifying, and 5 being challenging but possible. And you just keep aiming for the social situations that are 5 on the scale, and practicing to be comfortable and confident in those situations helps a lot. Then when you are adjusted to being in that situation, it wont be as anxious as 5 anymore, but maybe a 3. And then you can go on to more challenging social situations. Eventually, in only a matter of time(anywhere from a few months to a year) and effort, your social anxiety is almost completely cured. You will have to experience a little discomfort but hey, its worth it to have a life isnt it?


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## SplendidBob (May 28, 2014)

@sad1231234 yup basically  - though 5 for me is a bit much as I have AvPD so I would avoid if I aimed that high, but yep, essentially its how it works.


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## I Beethoven (Mar 11, 2017)

splendidbob said:


> I swear I already replied to this.. damn.
> 
> Thanks Don, trying to help a little ya know
> 
> ...


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## SplendidBob (May 28, 2014)

I Beethoven said:


> I totally agree with you, and if I was younger like 18 I would totally do that but time is running out I am 23 now I have the urge to do this now I never cared about being alone until now. but if I don't just get a job and force myself I will end up wasting my youth, I already have.
> 
> Again I understand your point and you are right but I don't have time.


No other way though man. You rush it, you end up with worse anxiety. You have to take it slow or it wont work imo. You have tonnes of time. If you do it too fast and **** up thats x amount of time that you wasted and you will have worse anxiety as a result .

Taking it slow is the only way, there is no other option.


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## I Beethoven (Mar 11, 2017)

splendidbob said:


> No other way though man. You rush it, you end up with worse anxiety. You have to take it slow or it wont work imo. You have tonnes of time. If you do it too fast and **** up thats x amount of time that you wasted and you will have worse anxiety as a result .
> 
> Taking it slow is the only way, there is no other option.


You are right but I worry that im just making excuses


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## SplendidBob (May 28, 2014)

I Beethoven said:


> You are right but I worry that im just making excuses


What happens if you take it all too quickly is that you spend months (if not years) like you have likely _already_ done, saying you need to act quickly or it is too late, and you end up doing nothing, because the task is too difficult so you avoid it. Start tomorrow, start very slowly, and in a few months you will have made amazing progress. You have to just place some faith in the progress and _keep scores_. It only takes a week or two to see the scores coming down and then you know it will work in the end.

You also don't know _how_ fast you will progress either, but atm I would guess you are standing still not making _any_, and slow but steady progress will get you there, so long as you commit to it long term . You can do this twice daily to speed things up (hell even 3x daily).

You are still young, you have plenty of time, the sooner you start on this slow road to recovery the sooner it will be over with and you will have your life back.

That's my opinion.

Good luck


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## Persephone The Dread (Aug 28, 2010)

Cool thread. I wouldn't have seen it if it wasn't in your sig btw, I never go into the positive thinking type subsections since I haven't tried to use this as a support forum of any kind since 2014.

@I Beethoven I don't go into detail often here but when I was your age - literally 23 - I started cbt and did too much to soon (she basically started me in the deep end with mock job interviews with other people working in the building too.) and I really pushed myself with some progress in the short term. However when my therapy finished due to my general avoidance (which is always worse after the first time I do anything, also why I went to a meetup group once that I haven't been to since and once went to one anime club meeting in Sixth form, and never returned because I didn't know as much about anime as the others) I didn't seek out therapy again on the NHS.

My motivational anhedonia and ADHD type symptoms I always had spiraled increasingly out of control so now almost three years on, I'm incredibly depressed, sleeping pattern is entirely broken (always is aside from the odd couple of weeks here and there,) feel like a disabled child around my family. My younger brother is increasingly taking on the role of carer for me as of the last few months (making sure I wake up and stuff,) though I don't want him to, and I've never been more dysfunctional. I struggle to carry out basic everyday tasks like cooking so I'll repeatedly make pasta with pasta sauce type meals and washing up takes a gigantic amount of effort for me. I barely leave the house alone anymore and struggle to deal with being alone with myself and my thoughts without some kind of distraction from everyone else and my thoughts. The only time I go out alone now is a couple of times a year or so to go to concerts, only because music is the only thing that reaches through my depression, and even then being out and about by myself (without music,) is awful until the end of the night where I feel a little better but then don't go out alone again for ages and struggle being outside alone in the daylight - not just because of social anxiety - I've actually built up a negative association with it now because my positive nightime experiences outweigh the daytime ones.

So I would take things gradually.


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## I Beethoven (Mar 11, 2017)

Persephone The Dread said:


> Cool thread. I wouldn't have seen it if it wasn't in your sig btw, I never go into the positive thinking type subsections since I haven't tried to use this as a support forum of any kind since 2014.
> 
> @I Beethoven I don't go into detail often here but when I was your age - literally 23 - I started cbt and did too much to soon (she basically started me in the deep end with mock job interviews with other people working in the building too.) and I really pushed myself with some progress in the short term. However when my therapy finished due to my general avoidance (which is always worse after the first time I do anything, also why I went to a meetup group once that I haven't been to since and once went to one anime club meeting in Sixth form, and never returned because I didn't know as much about anime as the others) I didn't seek out therapy again on the NHS.
> 
> ...


I agree, I went on my second walk today! I feel great making progress its not much but I feel good there was tons of people too.


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## Cassoulet94 (Apr 3, 2014)

Do you think telling a girl I find attractive but that I have meticulously ignored after speaking to her a lot at a party (drunk) that about my blocage is a good exposure exercice ? I feel it would look more brave than just keeping being avoidant and rude. She's starting to laugh about me with her friends and I can't stand being mocked by people who do not understand how frustrating and limiting SA is. I won't weap or anything I just want to explain honnestly. Is it a bad idea ?


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## Cassoulet94 (Apr 3, 2014)

She tried to be nice but now I think she s just getting fed up with it and just indulging in mockery which I find deeply frustrating even if I can t blame her. When for whatever reason I have this kind of blocage with someone a few casual conversations are not enough to make a change.


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## SplendidBob (May 28, 2014)

@Cassoulet94 not sure what this would have to do with exposure therapy tbh . Exposure has to be gradual so you could gradually work up to talking to women or whatever, but a single instance of anything is just a single instance of something and could either be beneficial or trauma inducing.


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## MysteryWhiteGirl (Mar 18, 2017)

Thank you for writing this up, I think it's very helpful. 

Back in Oct 2016 to Dec 2015 I was going out almost everyday (my sis was helping me) and although it was a huge struggle, I pulled through. But I think there were times when I pushed too hard and ended up relapsing into my old self by being housebound again. In Jan 2016 to now (March 2017) I haven't been outside at all. 

But I think if I did tiny steps then maybe I can improve. I always thought I had to reach one place (like a shop) to say I actually tried. But I'm trying to change my mindset. 

It's hard, though. I feel lazy and I feel like it's too late.. I'm so used to being an insider that I've kind of accepted my future being this way forever, it's unhealthy but hopefully I'll get out again.

Thanks again for this advice


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## MysteryWhiteGirl (Mar 18, 2017)

Oops, I meant Oct 2015, not 2016 *facepalm*


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## Cassoulet94 (Apr 3, 2014)

splendidbob said:


> @*Cassoulet94* not sure what this would have to do with exposure therapy tbh . Exposure has to be gradual so you could gradually work up to talking to women or whatever, but a single instance of anything is just a single instance of something and could either be beneficial or trauma inducing.


I think I was drunk when I wrote that. Sorry to have polluted your thread! Too much alcohol these last few days. Well in theory you could ask a girl everyday but it would be rather hard haha.

ps: trauma inducing I don't think so. Even if it's once, I think as long as you do something that you would not do usually, you should be proud.


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## SplendidBob (May 28, 2014)

Cassoulet94 said:


> I think I was drunk when I wrote that. Sorry to have polluted your thread! Too much alcohol these last few days. Well in theory you could ask a girl everyday but it would be rather hard haha.
> 
> ps: trauma inducing I don't think so. Even if it's once, I think as long as you do something that you would not do usually, you should be proud.


Np 

Ah well it depends on the anxiety levels and duration. A sustained 9/10 out of 10 that you are stuck in for a good while can seriously **** me up for a while and make me never want to do that thing again (where, if it had been gradually worked up to, probably would be fine). Not that I have managed to work up to these things yet.

Have probably gotten original 7/10's down to 3's tho (some of my exposure tasks).


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## sadness (May 9, 2006)

I'll join in the exposure. Going to work on my list of stuff.


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## sadness (May 9, 2006)

Cassoulet94 said:


> She tried to be nice but now I think she s just getting fed up with it and just indulging in mockery which I find deeply frustrating even if I can t blame her. When for whatever reason I have this kind of blocage with someone a few casual conversations are not enough to make a change.


You need to start making "failures" successes. Every failure you make is one step towards becoming desensitized to it. Re-frame. ie: She was laughing because she's a *****, most women don't do that, she's immature. (this is actually true)

Reframe the failure to: I'm making progress! I actually did it despite the fear. This is a great learning experience.


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## SplendidBob (May 28, 2014)

sadness said:


> You need to start making "failures" successes. Every failure you make is one step towards becoming desensitized to it. Re-frame. ie: She was laughing because she's a *****, most women don't do that, she's immature. (this is actually true)
> 
> Reframe the failure to: I'm making progress! I actually did it despite the fear. This is a great learning experience.


Good advice there. Gotta constantly reframe stuff in my own head. Whatever it takes to cut the post and pre event rumination and force myself into action.

I totally accidentally said the wrong thing today in an exposure. Reframe as "get used to saying the wrong thing sometimes, as its gonna happen".


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## sadness (May 9, 2006)

splendidbob said:


> Good advice there. Gotta constantly reframe stuff in my own head. Whatever it takes to cut the post and pre event rumination and force myself into action.
> 
> I totally accidentally said the wrong thing today in an exposure. Reframe as "get used to saying the wrong thing sometimes, as its gonna happen".


 On your reframe, don't always think its your fault, other people may be having a bad day, they might be the problem, they have their own issues as well. But that is a good reframe nonetheless. I recently listened to a video on reframing. He can explain it better than me. He talks about the reframing at about 7:14 in the video on youtube. Youtube video is " watch?v=qb1Y06iqasM " (i don't like it putting in a huge video on my post when i paste the whole URL.)

He calls it 're-framing', which is pretty much what Cognitive Behavior Therapy is, but I find his strategy more simple.

I like his idea of not making it about identity, instead strategy. Say you have the thought "I'm horrible at talking to people." Reframe that to "I'm acting like I'm horrible at talking to people". He explains how it works subconsciously.


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