Happy Monday and welcome to your mental health mini. This week we have a solo and we are talking all things exposure therapy. I really do see exposure therapy as the anecdote to any type of avoidance, anxiety, emotional aversion, whatever you want to call it. Whenever those feelings come up for me, I'm like OK, it's time for some exposure. So what is exposure therapy?
The basic idea of exposure therapy is that you were exposing yourself to the thing that is causing anxiety, fear, etcetera, and a small safety doable way. You are slowly building yourself up to the thing that makes you so anxious and so overwhelmed. And as you get more effective with your ability to cope with the emotions that arise, to shift the thoughts you're having, you're able to overcome the anxiety, the phobia, the thought pattern, etcetera.
If you are doing exposure therapy, the way that I would approach this and the way that I've approached this in the past is I would do an exposure hierarchy. So what I would do is I would write down the thing that I am most afraid of and most scared of. So if it is public speaking, you're going to say my biggest fear that I am going to have to navigate as I have to give a speech at the end of the semester.
And I have so much anxiety. The idea of doing that makes me want to like throw up, faint, run away, drop out of college. If that's your fear, that is going to be at the top of the hierarchy. That's what we're working up towards. And you're going to work yourself backwards. You could say like what is one step below giving a speech? Maybe it is in the room watching other people give their presentations and knowing that you probably are going to be next.
And maybe below that is practicing giving a presentation to a friend or two. And then below that, maybe you're giving the presentation in an empty classroom. Before that, maybe you're prepping for the presentation, you're creating your slides, you're preparing your speaker notes. Then maybe it's watching a video of someone that is giving a presentation and like the very lowest freebie almost is mentally going through the process of giving the presentation.
Again, this will be different for everyone, it's so subjective, but you're going to make this hierarchy that feels very doable to move from one step to the next and you want to have these be things you can check off. Yes, I did this or no I didn't. We want to be really specific. Are you exposing yourself to the physiological sensation of being short of breath? Are you mentally going through the thought process that might come up when you're giving your
presentation? Are you imagining the worst possible scenario that could happen and coping through that worst case scenario in your head? So once you have your exposure hierarchy, you are going to begin process of coping ahead. So if we use the example of maybe the thought of going to the gym is like so anxiety provoking for you, but the cope ahead skill, we are planning exactly how we're going to cope with the situation. You're going to describe the situation.
You're texting your friend to make the appointment to go to the gym. You are walking to the gym with your friend. You're swiping your card in. Maybe you're filling up your water bottle. You're getting to the treadmill, you're putting the treadmill on. Are you listening to music? Are you talking to your friend and you're also going to describe what potential anxiety might come up for you? Are you anxious when you're on the treadmill? Are you anxious before you enter
the building? Like what are the pain points? You're being super specific and you're also using the check the fact skill here. So if you're like, what's going to make me most anxious is when I fall off the treadmill on my face in front of everyone and the whole gym laughs at me and kicks me out and tells me that I'm never again allowed to go to the gym. We got to check the facts there. That's probably not going to happen.
Yes, you could fall off the treadmill, but the most likely course of events, if that happens, we were like, Oh my gosh, are you OK? You're going to get back on the treadmill. You're going to keep doing your thing. No one is going to ban you from the gym for the rest of your life. So we are writing down the possible situations that might happen, but we're also being realistic. And then you're going to decide what coping skills you're going
to use when. So if I was going to the gym, I would really lean on distraction. I'd be like, OK, I know that like I really have a lot of time to be in my head and get overwhelmed once I'm on the treadmill. So I'm going to scroll on TikTok because that's super engaging and at least in the short term that will distract me. I'm also going to practice deep breathing. I don't want to be totally out of breath while I'm walking on the treadmill.
So I'm going to pace my breathing with my walking. So these are some examples of skills you would use. So go through, see what the most overwhelming things that would happen in this anxiety provoking situation are and you're going to plan what coping skills you are going to use and this you're even going to mentally go through it. So you're imagining yourself doing it. You're imagining yourself coping with the skills, you're imagining rewiring the thoughts that are coming up.
You're imagining doing your distraction, doing your deep breathing, getting through the situation effectively, and then you always want to make sure that after these really intense emotional situations, you're recharging, you are doing some self-care. You're going to be like, OK, next week is my next item on the exposure therapy hierarchy. You're not like, let me bang out all ten of these exposures right
at once. We always want to get back to our baseline after being in the situation that is making us anxious. So once we have gone through the motions, we've done the thing that makes us anxious, we've used our skills, we've overcome that anxiety in a way that is safe, that is not overwhelming, that's not causing us to avoid more. We can check that item off the
exposure therapy hierarchy. And as we keep moving up this hierarchy, over time, our level of fear, our level of avoidance, our level of anxiety will decrease. And this is the beauty of exposure therapy. Every single time you check off this thing on your hierarchy, you are getting better. Using your coping skills, you are getting better and navigating anxiety, thought patterns, avoidance, whatever it is. And it gets easier with time.