The Exposure Hierarchy: How to do Exposure Therapy for Anxiety: Anxiety Skills #20

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In this video, I'm not going to teach you  an anxiety hack or a trick. I'm going to   teach you the number one most powerful way to  decrease anxiety fears and phobias As backed by   research. I'm going to teach you the six steps to  kicking fears butt by using an exposure hierarchy. If you want to learn to beat your anxiety, one  of the most powerful things you can do is develop   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   about ready to turn this off like stay with me for  just a second. Because I'm gonna break this skill   down into bite-sized chunks, that you work through  little by little. Now it's normal to want to avoid   things that make you anxious, but avoidance locks  your brain into a cycle of increasing anxiety.   And avoidance prevents you from learning that the  things you fear aren't as dangerous as you think.   So check out my video on the anxiety cycle to  learn more about that topic. But the gradual   process of facing fears is called exposure. It's  a safe and effective process that has been shown   to naturally decrease anxiety. Through exposure,  you basically rewire your brain to help it know   when you're actually safe. Now you may have  tried exposure in the past and it didn't work,   and that might be for a couple of reasons. You  may have tried to jump into something too scary   too soon, which might have put you into the  panic zone, and actually been retruamatizing,   only reinforcing that fear. Or perhaps you only  faced your fear once or twice but when it still   bothered you, you didn't continue. When exposure  is done correctly, it can be very effective at   overcoming fears and anxiety. Try again, work with  an experienced therapist who can help you stay in   the sweet spot of the growth zone, and help you  stick with it long enough to get lasting results.   Facing your fears is often most effective when  you start with things that are less scary, and you   work your way up to facing things that come with a  lot of anxiety. 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 you   once feared. This process happens naturally  when we let go of our addiction to avoidance.   So for example someone who's afraid of water take  swimming lessons every week. But starts slowly, by   putting his feet in the water, and then his legs,  and then his whole body. And finally is diving   underwater. And after a few weeks he may learn  that he loves swimming with his children. So,   how to do it. Step one, make a list of your fears.  Write down all of your fears, and pick the first   one that you want to work on. So if you're afraid  of dogs, write down all the situations with dogs   that you would feel anxious about. For example,  thinking about dogs, looking at pictures of dogs,   being in a park with dogs, petting a dog, being  in a house with dogs, etc. Step 2. Make a personal   goal. For example, visit my grandchildren who  own a dog in their home. Step 3. Build a fear   ladder for one fear area. Psychologists like big  words to make them feel special so they call this   an exposure hierarchy. So put your fears in order  of the things that are least scary to most scary,   and you can start by rating the situation's from  a zero to ten and then organize those into a list.   So write down as many tiny steps as you can think  of that will help you reach that goal. 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 retruamatized, and  then they escape, and their brain reinforces that   anxiety. Actually increasing the anxiety response.  If you want to successfully kick fears butt then   you need to get really creative at imagining and  coming up with these tiny steps. Now let me give   you some examples. If you're afraid of dogs,  you could start by watching movies about dogs,   looking at pictures of dogs, or looking at  a dog through a window. If you're afraid of   getting a vaccine, you could watch a video of  a needle, or watch an Apple being injected,   or touch a needle. And you would practice this  over and over again until it was no longer as   anxiety-provoking. If you have social anxiety, you  can record yourself talking through an imaginary   social situation and listen to that recording, or  you could set the goal to say hi to a co-worker,   and then eventually move up to things like asking  a co-worker how their weekend was. It's important   to have a mix of tasks that are mildly anxiety  provoking, somewhat anxiety provoking, and some   steps that seem out of reach right now. So break  down tasks into tiny steps whenever possible. I'm   including a link in the description to a site  which has a bunch of examples of this. Anxiety   it often seems as if it's all or nothing there's  no middle ground. Either something is comfortable,   or it makes me panic. But like I said in the  introduction, with the right skills you really can   do this. So there's some other ways to make some  of these practice exercises easier or harder. And   this is called scaffolding. Providing yourself  some extra support while you're building your   abilities. So here's a few ways to do that. You  can adapt the length of time that you're doing   an activity. So for example, talking to someone  for 30 seconds is easier than for five minutes.   You can add some support, doing some tasks alone  might be easier, but having a friend or spouse go   with you could be a big help for others. Changing  the time of day. So if you're afraid of driving   over bridges, you could choose to drive over  bridge during the middle of the afternoon while   you practice, instead of during rush hour.  And changing the environment. For example,   visiting a dog in home versus being at an  off-leash dog park. So get creative and find   ways to break down these big scary tasks into  smaller doses, and to build up the support that   you need. Now I do like the idea of physiological  self-regulation I mean I use grounding techniques,   and I use these pair of sympathy techniques all  the time in my life, and they are really helpful   as well at at limiting the amount of anxiety and  and sending that sense of security to your body   that you need while you're doing an intense task.  But you can't ever use them as avoidance otherwise   it's gonna backfire so that's the one caveat  with using self-regulation techniques. Okay,   so once you've broken these tasks down, and you've  found ways to scaffold them, the next step is   facing your fears. So starting with the bottom  rung on your ladder, begin to repeatedly engage   in that activity. So for example, if you're afraid  of dogs, you start by just walking by the dog park   every day. The repetition is important and as  soon as you're able, you want to try to lengthen   out the time you're there, or loop the activity.  So you might walk by the dog park three times in   a row, or you might stand and look at the dog park  for ten minutes, and it's really important for you   to stay with that situation long enough for your  anxiety to lessen. Or at the very least that you   set a goal based around the number, so how long  you'll be there, or how many times you'll do   something. Never set a goal like I'll stay there  until or unless I get too anxious. Because that's   just an invitation to your brain to increase your  anxiety levels through avoidance. If you stay in a   situation long enough, or you do it enough times,  your anxiety will go down. This is a fundamental   aspect of neuroplasticity. Our brain adapts to  situations and when you keep doing something   that feels dangerous, but it is actually safe,  your brain has to adapt to that and relabel the   situation as safe. Practice willingness during the  exposure. It's normal to feel anxious or afraid   during exposure and this is where your unwritten  rules are going to try to take over. People have   anxiety disorders almost always have the rule of  if it makes me anxious, it must be bad. It must   be dangerous or I can't handle it. These are  rules that you made up, and you believe them,   but they just aren't true. Anxiety is not  bad, it's uncomfortable, it's unpleasant,   but it serves a function keeping us safe from  real dangers like cliffs and rattlesnakes. But   with disordered anxiety, we feel like we're in  danger, but we're actually safe. So you have   to challenge those thoughts that say that anxiety  is dangerous. It's not bad, or harmful, it's just   hard. You can do hard things. Keep breathing. Just  breathe through it. One way you can do this is by   tracking your anxiety in the situation. So keep a  record of the exposures that you do and write down   your anxiety on a scale from zero to ten. Zero  being no fear and ten being extreme fear. And then   stay with the situation until your anxiety goes  down by half. It can also be helpful to keep track   of your progress by writing down your fear levels  and what you learn each time you face a fear. Step   5 repeat. Repeat repeat repeat. Keep practicing.  You are building neural pathways in your brain.   These are like muscles. The more you use them,  the bigger and stronger they get. And with time,   it gets easier and easier to do the things that  were once difficult. Practice as frequently as   possible. The more you do it, the faster the fear  will fade. Step 6 reinforce courage. Give yourself   some credit. You are doing something hard for  you. Don't compare yourself, with others or put   yourself down. Each time you face a fear say out  loud or write down I did something hard today,   I can do hard things, or I'm proud of myself. And  allow yourself to feel a sense of accomplishment.   When you do, your brain basically releases  more dopamine. This is the reward chemical,   but it's also the motivation chemical. This helps  you feel more motivated than next time to do it   again. And if you want, you can set some specific  reward for yourself like plan a fun outing,   or buy yourself a book, or a movie after you  reach one of your goals. Make sure to keep   track of your progress so you can look back and  see how far you've come. When you intentionally   allow yourself to feel the fear, and do it anyway,  you're gonna learn that anxiety doesn't have to   control you. You're going to build up your  self-efficacy, which is your belief in your   ability to do hard things. And you're going to be  able to live the life that you value. Like I love   this stuff. So if you want more of this please  hit the subscribe button, and please share this   video because you never know who could benefit  from it, thank you for watching, and take care.
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Channel: Therapy in a Nutshell
Views: 192,169
Rating: undefined out of 5
Keywords: exposure hierarchy, how to overcome fear, overcoming fear, exposure therapy, Phobias, OCD, exposure therapy for anxiety, exposure therapy for phobias, exposure therapy for ptsd, exposure therapy for social anxiety, exposure hierarchy for ocd, social anxiety, exposure hierarchy example, how to overcome fear of public speaking, Exposure and response prevention, Erp therapy, Graded exposure therapy, How to face your fears, overcoming fear and anxiety
Id: n2rKVj75P3M
Channel Id: undefined
Length: 11min 34sec (694 seconds)
Published: Thu Apr 11 2019
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