I'm Emma McAdam. I'm a licensed therapist. Today
we're going to talk about overcoming your fears with exposure therapy,
and I'm going to do it myself. Falling! skills. So please subscribe if you'd like to learn
more. This video is part of my 30-part series How to Break the Anxiety Cycle in 30 Days, and you can
buy the course at a link down in the description. Now, in this video I'm not going to teach you an
anxiety hack or trick. I'm going to teach you the number-one most powerful way to decrease anxiety
as backed by research. I'm going to teach you the six steps to kicking fear's butt by using exposure
therapy. Now, if you want to learn to beat anxiety, one of the most powerful things you can do is
learn the skill of facing your fears. And this is a skill that you can learn. But if when you hear
"Just face your fears" that seems both too simple and too difficult at the same time and you're like
ready to turn this video off, please stay with me for just like one more minute because I'm going to
break this skill down into bite-sized chunks that you'll work through little by little. And I'll show
you how I do it myself with my fear of falling. I have climbed off and on almost my entire life, but
I've never overcome my fear of falling. I used to climb four times a week in grad school, and I used
to do climbing trips every chance I got, but even though I was a really strong climber - I would climb
really difficult routes on top rope - I would climb like eight grades lower when I was on lead, which
is where I might fall. Um I would climb way below my capabilities in order to avoid any chance of
falling. Now, pause that for just a second. Because in order to understand how I'm going to do some
exposure therapy on myself, let me step back and explain some terms here. There's a couple
of different types of climbing. So when you top rope the rope is already fixed at the top of the
climb. So that means that when you fall you only sink a couple of inches. But when you lead climb
you have to take the rope up with you as you go and hook yourself to the wall with carabiners. So
this means that as you climb above your bolt, if you fall, you fall double the length of how high
you climbed, plus slack and rope stretch. So if I'm 5 feet above my bolt, I'm going to fall
10 feet plus rope stretch, which means maybe like 15-foot fall. Now, as long as you follow the rules - like
tying in correctly, belaying correctly, using correct gear - climbing is actually very, very safe, like
especially in the gym. So with top roping I have never been injured, and I've climbed thousands
of times. With with lead climbing, in a fall you have the potential to like twist an ankle or get a
bruise, but we aren't talking like life-threatening climbing here. That's not the type of climbing I
do. I am I'm not free soloing like Alex Honnold. I'm just scared of like that feeling of falling
on a rope. And because I am afraid of taking a lead fall, I've avoided doing really cool
routes that I was capable of. I I've missed out on the physical and mental growth that comes from
stretching myself in that way. And then I've also had to rely on other climbers to set routes for
me, which has uh limited me in a lot of ways. So um lead climbing, totally safe, feels really dangerous,
I've avoided it. This is a normal part of anxiety, right? It's normal to want to avoid things that
make you anxious. But avoidance locks your brain into this cycle of increasing anxiety, and then
it also - avoidance prevents you from learning that the things you fear aren't as dangerous
as you think. So the more that I've avoided taking lead falls, the more scared I've become.
And also back when I used to climb a lot I was a little bit more comfortable lead climbing, um
but not since having a bunch of kids. So I really haven't done any leading in about six years. So that
avoidance has made me more anxious about lead climbing. And when I got back to climbing this
fall I was even like really nervous about top roping, which is really safe. Okay so the cool
thing is science has shown us that our brains are really flexible. They they adapt and they
change depending on what we do. And psychology has developed a really effective way to naturally
decrease anxiety and fear called exposure therapy. So you you face your fears very very gradually
and by doing so your brain learns that you are actually safe, and then it turns down your
anxiety levels. Um exposure therapy is a research-backed effective treatment for phobias, which are fears of
situations; PTSD, which is fears of memories and the body sensations; um panic attacks, which I think are
essentially fears of body sensations; and OCD, which are, includes a lot of different types of fears: um
fears of thoughts, fears of contamination, fears of causing harm to others. Um but I'm going to be
using exposure therapy. I'm going to demonstrate it with my fear of falling. Um now you may have tried
exposure therapy in the past and it didn't work. Uh that might be for a couple of reasons. Um one, you
may have tried to jump into something that was too scary too soon, um which might have put you into
the panic zone and actually been retraumatizing, which reinforces that fear response in your brain.
Or the other most common reason is that um you only faced your fear once or twice, but then when
it still bothered you um you didn't continue. so my problem with fear of falling is I just haven't
practiced it enough, and it's been a long time since I did fall. Jeez! The way our brain works,
it's naturally plastic. It's naturally adaptable. And the more we avoid something, the more scared we
become of it. So during COVID a lot of people avoided being around people, and a lot of people developed
greater social anxiety. Or a lot of people avoided germs more, so they developed greater health
anxiety. The more you avoid something, the more scared you are of it. And the more you face
something, the more your brain dials down that anxiety. So when exposure is done correctly it's
actually really effective at overcoming fears and anxieties. Exposure therapy is often most effective
when you start with the very smallest things, the things that are less scary, and then you just
gradually work your way up. And the the cool thing about this is as you work the process, you build
up a belief in your ability to do hard things. And you might even learn that you enjoy the things
that you once feared. So let's test it out. Here's how you do it. Step one: choose a fear to work on.
Um I'm going to pick my fear of falling on lead. Okay. Step two: make a personal goal. So remember
why you care about this. Focus on why it matters to you more than avoiding your fears, more than
just living a comfortable life, um whether it's, you know, so that you can function at your job or
so you can spend more time with your loved ones or so that you can build up your sense of self. Like
there's something out there that you care about more than you care about just feeling comfortable
and avoiding your anxiety. So your motivation here is really essential to your progress. Make it super
clear. Make a vision board or write your goal down in a place where you can see it every day. Tell
others about your goals so that they can support you and hold you accountable. Um imagine if you
overcame this fear, how will your life improve? So like let's say if you're afraid of dogs you might
say like, "I want to visit my grandchildren who have a dog in their home. It's going to be wonderful
when I am able to spend time with them in their home." And and visualize how great that'll be. So my
goal: I want to get really good at falling so that I can lead climb up really cool routes. So here are
some of the routes I'd like to do: um Babe-a-licious is this amazing route in my home canyon. It's
totally within my ability, but I've never led it because I didn't want to feel scared. Like I want
to be able to climb at my potential and not waste so much energy like over-gripping while I'm
scared. I don't want to have to rely on someone else to lead up the routes that I want to climb.
And I want to watch as my fear levels decrease and my confidence increases. Okay. So the next one
is step three. We're going to break this down and make it happen. So step three is building a ladder
for your fear. Now, psychologists like big words because it makes them feel special, so they call
this an exposure hierarchy. So I'm going to make a list of all of the aspects of this this fear, and
I'm going to start with the the simplest ones and move up to the bigger ones. So um on a on a scale
from 0 to 10, how scary are the following things? Uh falling on top rope is like a one. Uh resting
on the rope at the top of uh top rope is like a two. Uh watching people, like videos of people
taking falls on lead and and studying how to learn to fall correctly is like a 1.5. Climbing a
lead route that's well with my capabilities is a three. Um taking a one-foot fall on lead, taking
a three-foot fall on lead, taking a two-foot fall on lead on a really vertical route. Um taking a
5- to 10-foot fall, like a really long fall on lead on a vertical route. That's pretty scary for me. Um
taking a long fall while clipping on a vertical route. I have literally never done that. So that's a
nine. Um falling unexpectedly outdoors on poor gear. taking a whipper, that's like a really long climb.
Getting really run out on gear and falling. Those are things I'm quite scared of but I'm maybe
not quite ready to do um this this thing. So go ahead and write um each situation down and then
scale it from zero to 10, with 10 being the most frightening for you, zero being not frightening
for you. Now, this is the hard part of exposure therapy, I think. The hardest part is figuring
out the tiny steps that are at like a level one, two, or three. This is this is the part that most
people get wrong. They just try to jump into the deep end of their fears, and they get freaked out
and re-traumatized, and then they escape. They run away. They they avoid that situation, and their
brain reinforces that anxiety, which, you know, increases the anxiety response. So when I first
started thinking about this goal, I could only imagine facing my fears by taking those long,
scary falls. So I wasn't like super motivated to make this video because I thought, "Well, the first
thing I have to do is just take big, scary falls, big, scary falls, and I don't want to do that." But
when when I started to write down my exposure hierarchy I felt a lot more confident because I
realized I can I can totally start by like resting on top rope, watching other people fall, and taking
like one- to two-foot falls. That's that's awesome. And um so the very first time I went back to the
lead wall I climbed on lead without falling. And that was fine, but it didn't really make me feel
less anxious about falling because I was still avoiding falling. So the next time I went back to
the gym I started taking one- to two-foot falls. And honestly, I was dreading it. I didn't want to do
it. I was like, "Maybe I shouldn't make this video. I don't feel like making this video. I don't want to
do this anymore." I made myself do it. And I got up there, and I took that first fall, and I was like so
scared to let go. I was - like I was very scared. I was feeling like intense anxiety in my body. I was
sweating, I was over-gripping, I was breathing heavy, my voice was shaky. And I took a fall. And I was
scared. And it felt really scary. And then I took a second one, and that one was pretty scary. I
took a third one, and I was like, "Oh, okay. Maybe this isn't that bad." And I my goal was to take 10
one- to two-foot falls. So then I did four, five, and pretty soon I was like, "Wow, nothing's happening." I'm
falling. This is fine." Fall number six, fall number seven. And it became like no big deal. Like my
anxiety literally went away. Like I wasn't feeling scared anymore. And if I had stopped after taking
one or two falls I would have felt just as scared, but by seven, eight, nine, by 10 I was like, "Oh, okay, I
can do this. I got this. I got this." So taking those teeny little steps made a huge, huge difference for
me. And I even found myself like sitting in the car the next day just feeling like kind of proud of
myself. Like, "Yeah, I did that! And I don't feel so scared. And I can go back to the gym next time
and totally do like one-foot, two-foot falls, and I won't even feel that scared again." So I would say
after doing that first round of exposures I felt like significantly less anxiety. Okay. So if you
want to successfully overcome your fears, then you need to get really good at making these tiny, tiny
steps. Um a couple examples of this: you can watch other people doing the skill you want to do. Um you
could pretend with play characters facing their fears. Uh you could do imaginal exposure, where you
imagine yourself facing your fear and imagining yourself not feeling so scared afterwards. Um I'll
I'll give a bunch more examples uh later on. But um so so your goal is, you've written down your fear,
you've identified why it's important to you, now write down as many tiny steps as you can think of
that are going to help you reach that goal. So let me give you some more examples. Um if you're afraid
of dogs, that might include watching movies about dogs, looking at pictures of dogs, looking at a dog
through a window, um being in a house with a very small dog on a leash, being in a house with a very
small dog in the other room - things like that, right? Like very gradual steps that are one, two, or three
on your fear levels. Um if you're afraid of getting a vaccine, you could watch videos of a needle. You
could watch a video of an apple being injected. You could practice touching um a needle or carrying a
needle around with you or putting a needle on your phone screen so that you see it frequently. And the
more you're exposed to it, the less scared you'll get of it. Uh if you have social anxiety you could
record yourself uh talking through an imaginary situation and then just like listen to that
recording. Uh you could practice saying hi to a coworker, and then move up to the next
level, like asking a coworker how their weekend was. In addition to like breaking tasks down like
I just described, you can also add in support. So in the beginning stages, facing our fears can be a
lot easier with a friend or a family member or a therapist to support us. And then over time we
can do things with more Independence. And this is really important because safety behaviors
can keep us trapped in avoidance. So like let's say you're afraid of flying but you always take
valium when you fly. You're not overcoming your fear of flying because you still believe you
need valium to do it. Or you have social anxiety and you always have to um take a friend with you
to be okay. You're not really overcoming your fear of social anxiety, but it can help in the early
stages. That's what I'm trying to say. As we're building up our skills and our abilities, it's
okay to have support. But later on you want to make sure that you do things on your own, and
that shows your brain that you can handle it. Okay. So as you make your ladder it's important to
just have this mix of tasks that are very mildly anxiety-provoking, somewhat anxiety-provoking, and
then some steps that just feel out of reach right now. Okay. And then step four, which is facing your
fears. Okay. So let's do this. We're going to start on the bottom rung of our ladder, and we're
going to begin to repeatedly engage in that activity. So I've already started top roping
twice a week with friends. Um the first few times when I rested on the top of that rope I was
um pretty nervous about it, but now I'm calm about that. So now I'm going to lead climb for the
first time in six years, um but I'm choosing a route that I most likely won't fall on. Okay.
So I I led this route. I led climbed for the first time. I was quite scared. And honestly, I don't
think my fear went down much because I I was really gripping and avoiding falling as much
as possible. So I I don't feel any less scared of falling. But this next session I'm going to
start taking very short lead falls over and over again. So today my goal is to take 10 two-foot lead
falls. And just to explain, counterintuitively, falling over an overhang or like a a a route
that's past vertical is actually safer than falling on a vertical area. So one takeaway is that
repetition is super important. So as soon as you're able to, we want to lengthen out the amount of
time you're doing that activity or loop the activity. Do it over and over and over again. So
if you're afraid of dogs you might walk by the dog park every day. And you might start spending 30
minutes walking by the dog park, or you might walk by it three times in a row. And it's just really
important that you stay with the situation long enough for your anxiety to go down, or at the
very least that you set a goal based on around a number, like how many times you'll do it or
how long you'll do it. Because the last thing you want to do - don't do this. Do not set a goal
based on like, "I'll do this until I feel scared" because basically that's just an invitation
to your brain to increase your anxiety levels. Like that is literally telling your brain, "Make
me really anxious so I can get out of this." Okay. Here's the last key. We're almost done. Um after
repetition, the other key is you've got to allow yourself to do something while you feel anxious.
It's normal to feel anxious or afraid during an exposure. Um this is where your unwritten rules are
going to take over, um or going to try to take over. People with anxiety disorders often have a rule
that's like, "Oh, if it makes me anxious, it must be bad. If I feel anxious, it must be dangerous. If I
feel anxious, it means I can't handle it." These are stories. These are rules that you made up. You you
might believe them, but they are not true. Anxiety is not bad. It is uncomfortable. It's unpleasant.
But it serves a function. So you have to challenge those thoughts that say, "Anxiety is dangerous." It
is not bad. It is not harmful. It's not evidence that something's dangerous. Anxiety is simply
uncomfortable. You can do hard things. It's hard. Like this skill is called willingness. Other really
cool thing is that when you feel nervous, that emotional energy primes your brain to learn. So as
you face your fears and you feel anxious and you survive, your anxiety is going to go down and your
confidence will go up. So thanks to neuroplasticity our brain actually adapts to situations and
relabels them as being actually safe. So it's okay if you feel anxious. Do it anyway, right? And
and this is going to decrease your anxiety over time. Okay. So now I'm coming back to the gym
and I'm going to do 10 five-foot falls. I feel a lot more confident um taking these falls after
falling last week. Like I'm a lot less scared. But I still feel really anxious the first couple
times I do it. And um now that I've done them, after about, again, about the third fall I'm
like, "Oh, this is no big deal. I'm okay. I can do this. So next time I come to the gym I'm going
to keep repeating. I'm going to keep taking 10 falls every time I come to the gym. And I'm just
going to gradually increase um the length of those falls or the difficulty of those falls. And I'm
going to start doing some things that I've never done before, which is falling while I'm clipping
and falling off to the side of my bolts. The more that I have practiced falling, the more falls I've
taken, the less scared I feel. I actually like feel really proud of myself every time I've done an
exposure session cuz it was scary every time. And every time by the end of it I'm not as scared and
my confidence has gone way up. So um I don't think by the time I have to publish this video I'm
going to get a chance to climb Babe-a-licious, but I am definitely going to check back in on the
channel when I do, and I'll send you a video of that. Okay. The last step that's really important
with exposure therapy is step five: repeat. So I've been taking big falls, I've been feeling
really confident about it; I'm not just gonna assume that I'm cured here. So for this to
work I just need to keep practice falling over and over again um frequently for a long period
of time. Uh I'm planning on coming to the gym all winter and uh practicing leading and falling
at least once a week for six months. I'm going to try to take 10 falls every week for six months.
For exposure therapy to work you've got to face your fears over and over, um daily if possible,
and have longer exposures, like 60 to 90 minutes, multiple times each week. Uh it can also be really
helpful to just track your fear levels. And as your numbers begin to drop you'll feel more confidence,
and you'll gradually just kind of move up to the next scary item on your ladder, uh even if you're
not afraid anymore. Like at some point I'm going to get to where I'm not afraid of falling anymore.
Um it's important to set something up regularly so that you keep facing your fear. So let's say,
for example, you're afraid of needles and you get really good at getting your shots or getting
your IVs or whatever it is and it doesn't scare you anymore. You could consider changing the
photo on your phone home screen to a picture of a syringe. And that's just going to make it so
that every day you just do exposures throughout the day. No big deal. Um and it's just like staying
physically fit. So consistently facing your fears is mental fitness. It's it's just like building
muscles. You build confidence in your ability to do hard things. Okay. Step six: give yourself
some credit. You are doing something that's hard for you. Don't compare yourself with others or put
yourself down. So each time you face a fear say out loud or write down, "I did something hard today. I'm
proud of myself. I can do hard things" or something like that. Right? And allow yourself to feel that
sense of accomplishment. And when you do, your your brain basically releases more dopamine, which is
the reward chemical, but it's also the motivation chemical. And that helps you feel more motivated
the next time to do it again. And then also just notice, like was it as dangerous as you thought it
was? Or did you learn anything new? Like I learned that like after three or four falls I don't feel
so scared anymore, and and that makes me feel a lot more comfortable taking more falls. And then the
last thing is just just make sure to keep track of your progress so that you can look back and see
how far you've come. So now as I look at my list, things that used to be like a four, five, six, now
they're like a one or a two. Like I'm getting much better at falling. Definitely made progress. I'm
proud of myself for doing that. I'm proud of all of you for the work that you're doing. I'm definitely
going to check back in on the channel when I've accomplished my goal to climb Babe-a-licious, and
I hope, i hope to be able to send you guys a video of me climbing that route. when you intentionally
allow yourself to feel the fear and do it anyway, you're going to learn that your anxiety doesn't
have to control you. You're going to build up your belief in your ability to do hard things. And
you're going to be able to live the life that you value. So pretty cool stuff. I love it.
Thank you so much for watching, and take care.
