Anxiety and Exposure Therapy

Anxiety is a normal emotional response to a threat. In the ancient past, our ancestors likely escaped being a wild animal’s lunch through the use of this emotion! Today, if you are walking down a dark alley alone at night, anxiety can help you look for and evade any potential danger. Anxiety is healthy when it is proportionate to the threat and resolves after the threat disappears.

Anxiety can be unhealthy when it persists after the threat is gone, when it is disproportionate to the danger, and when it interferes with our daily life. For example, having a fear of poisonous snakes while walking through an amazon jungle may be healthy, but fearing a snake attack while walking in a Toronto field may interfere with daily life.

First, we should know how this powerful emotion called anxiety affects our body. Anxiety increases our heart rate, speeds up our breathing, increases oxygen in our body, tenses our muscles, reduces blood flow, and makes us hypervigilant. These physiological responses are incredibly helpful when we need to quickly respond and fight off a predator or run away from an attack. These symptoms may not be helpful when we are faced with emotional or social threats such as a critical remark, being stuck in traffic, or needing to write your next essay.

What treatments are available if I have unhealthy anxiety? There are variety of treatment options and likely cognitive behavioural therapy (CBT), a type of talk therapy which focuses on thoughts, and can help resolve many types of anxiety. CBT is an evidence-based treatment that has been proven to be effective in many different populations.

Some types of anxiety disorders such as panic attacks, obsessive compulsive disorder, and specific phobias may benefit from exposure therapy. Although exposure therapy may sound horrifying to sufferers who spend their lives avoiding their fears, it is an evidence-based therapy that does work. Coping and de-escalation tools are taught, cognitive therapy is introduced, and exposure is paced to each individual in a controlled environment. You would not be asked to hold a snake on your first day of therapy! Exposure to fears is gradual, tools are employed, and fear levels should never escalate out of control in therapy.

Anxiety, unfortunately, can become feedback loops or cycles that repeat themselves. Our avoidance of our fears can actually strengthen the fear response! We may have a phobia of riding in elevators. Every time we ride in elevators, we feel our body’s anxiety response, and want to avoid these uncomfortable sensations. Our leaving the elevator ride prematurely before our anxiety has peaked, and exiting early will give us a feeling of instant relief. This relief signals to our body that the elevator threat was real and has been successfully averted. This fear cycle has been reinforced and our phobia strengthened through our avoidance response. If we were to stay on the elevator, despite anxiety symptoms, we would realize that our anxiety will eventually peak and slowly subside on its own. Once this anxiety has come back down on its own, we realize that nothing catastrophic happened and there is no real threat to riding on an elevator. Through repetition, we learn that elevators are perfectly safe and overcome our avoidance and phobia of elevators. Although this staying on the elevator is the crude example of exposure therapy, there are many nuances and steps before ever getting into an elevator.

In therapy, you can learn relaxation and de-escalation exercises to calm the body down from anxiety. These tools will be practiced and mastered by clients, first. Second, you will also learn to identify your negative fear cycles, their triggers, your emotions, and what keeps them in place. Cognitive behavioural therapy (CBT) can be used to examine thoughts and to retrain our thoughts to become more accurate and helpful to us. These fear cycles should weaken and your body’s calmness should return during this phase of treatment. Only after these important preparatory steps are accomplished do we begin exposure therapy. Exposure therapy can begin with as little as a one second visualization of the fear in your mind. These exposures will continue to increase in the length of time exposed and in the quality of its’ realness. Eventually, a person with a phobia of riding on elevators will build up to riding on elevators without highly elevated fear levels. Exposure therapy is a process and clients reserve the right to refuse therapy at any point in time.

If you are struggling with unhealthy anxiety, please reach out for help. Counselling can help you interrupt these negative anxiety cycles, relearn healthier thought patterns, and can help you experience greater freedom in your life. If you dealing with panic attacks, phobias, or OCD, ask if exposure therapy combined with CBT is right for you. Ask for a paced intervention, if you feel nervous about therapy, and work with a therapist who creates a safe environment for you.

If you have been struggling with these anxiety issues and it interferes with your life, you do not need to suffer alone. You can overcome these issues with the help of a psychotherapist trained in CBT and exposure therapy. Feel free to contact a Fancy Therapist to discuss this issue further.

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