Welcome to she persisted I'm your host Sadie Saxton a 19 year
old from the Bay Area studying psychology at the University of
Pennsylvania. She persisted is the Teen Mental
Health podcast made for teenagers by a team in each
episode. I'll bring you authentic
accessible and relatable conversations about every aspect
of mental Wellness. You can expect evidence-based,
Tina, proof resources, coping skills, including lots of DBT,
insights and education. In each piece of content, you
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While encouraging you to take ownership of your journey and
build your life worth living. So, let's dive in this week on.
She persisted, when we avoid things that make us anxious,
they could exponentially worse, the anxiety.
The fear of the avoidance builds over time, and then it's even
more challenging to overcome that anxiety.
If you're like, I have some anxiety, but it's not
debilitating. Go use exposure therapy right
now because you're going to avoid all of the pain and
suffering that comes We avoid our emotions, and they amplify
and intensity. Hello, hello, and welcome back
to she persisted. If you're new here, my name is
Sadie. I am a sophomore at the
University of Pennsylvania. Studying psychology, I started
she persisted after a year and a half of intensive treatment at a
residential program at a therapeutic boarding school.
And today, we're pulling from a lot of what I learned in those
early days of treatment. So we're talking about OCD and
we're talking about exposure therapy, we're talking about
anxiety, I really do see exposure therapy as the Nick, do
the solution to any type of avoidance anxiety, emotional
version, whatever you want to call it, whenever those feelings
come up for me, I'm like, okay, it's time for some exposure and
I know that that is what is going to help lessen.
Those feelings decrease, the intensity.
And it's been a long time since I've done a dedicated episode on
exposure therapy. The last time that I did an
exposure therapy episode was episode 56, guys.
That is almost 100 episodes ago. I'm sure no one was listening at
that point, that's listening now, and Feel like I discuss
exposure therapy pretty frequently on the podcast so it
felt like it was time to do a deep dive to give you a really
educational overview on what is exposure therapy.
How can you use it? How can you implement it in your
life and what I do on a routine basis to use, exposure therapy
to decrease anxiety, avoidance, Etc.
So when I first came across exposure therapy, it was in a
therapeutic group. We had group therapy all the
timer residential every single day.
And one of the groups that we had on Friday is, was called
Bossier to exposure. So you're doing exposure therapy
to the idea of exposure therapy and practicing.
This idea of exposing ourselves to things that made us anxious
or working through the hierarchy of exposure.
And then we would translate it to other things in our life.
I love the name of that group, still to this day and so we
alternated, what we would do in the exposure to exposure group,
some weeks we would learn about how exposure therapy works, what
the exposure hierarchy is, which we'll get into, don't worry some
weeks. We did something called Group
where you would share something that required vulnerability,
whether it was an emotion, you're navigating thought you
had something really personal that you wouldn't share with
most people. And that really no one in that
Therapy. Group knew about you.
So anxiety-provoking, as you can imagine, we did karaoke Group,
which was my worst nightmare to this day.
I could probably use some exposure therapy around doing
karaoke, because I am the worst singer.
I'm fully aware that I've known musical talents, I've accepted
it, I've moved on with my life singing in front of people,
gives me so much anxiety, because I No, I'm bad at.
It's not like, oh my God, I don't want to sing like, no, I'm
bad. Like your ears will bleed.
So avoiding were avoiding. I need to do exposure therapy on
that. So we would do karaoke, we do
this educational piece, we would do vulnerability group, and then
we would also do this thing where we was almost like a game
where you would draw tasks. It wasn't out of a hat, but you
would choose a task out of a bag or something.
They were cut up in little strips of paper and it would be
tasks. That would typically Some sort
of anxiety. And so we would go to the
cafeteria McClain and we would try and barter with people.
So we go to these poor people that really probably visiting a
family member or doing something on campus getting a test done
that. Can we trade?
You are food that we bought at the cafeteria for your food at
the cafeteria. These people were public, who
let these patients out, what the heck is going on, but it was
really great for social anxiety. So there was other things, like
go up and start a conversation with someone ask for someone's
phone number random, things like that.
At that cause social anxiety, if you're socially anxious.
And so you would go into the community.
This little little campus at McLean Hospital and do these
tasks to provoke some anxiety. But then cope with it, work
through it and increase your emotional resilience to social
anxiety and anxiety in general. So that was my introduction to
exposure therapy. And we're going to do a little
mini version of those learnings that I gained during my time at
McLain. And then we're going to talk
about ways that I have applied it on my old life.
If you Like I am someone that's anxious.
I don't know where to start. Those are some good ways.
Practice, being vulnerable with someone practice doing something
like karaoke, or you have to go out of your way to do something
that's uncomfortable. Like, again, I have to go back
to how much anxiety. This gave me, like, I would,
almost refused to sing, Happy Birthday.
I mean, one of my friends stand up with me, there was a full
YouTube thing. I think I lip-sync, like, I
hated this with every ounce of my being, but you gotta overcome
that anxiety and then the other one doing things in social
situations. Chelation that you wouldn't
normally do, especially when you're never going to see those
people. Again is a really great way to
overcome that social anxiety. Okay?
So first thing we've talked about, is what you can use
exposure therapy for. I am someone that likes to do
this holistic approach to emotion.
So whenever I explaining zaidi and depression to people that
haven't experienced before, like, imagine you are fearful,
but it's on an extreme overwhelming scale that is
impacting or everyday functioning.
So that's on the same Spectrum. Like fear and anxiety, both can
be explained in terms. These basic emotions that we all
experience, like, fear and apprehension.
So the same thing is true for exposure therapy.
It has been clinically proven to be really effective for OCD
social anxiety. Generalized, anxiety disorder.
These really extreme overwhelming, versions of
rumination, intrusive, thoughts, extreme, emotional intensity.
And it also works for these smaller scale instances of
anxiety. Overwhelm apprehension, Etc.
So, it's almost spectrum and If you're like, well, I have some
anxiety, but like I definitely don't need OCD treatment.
If that is a barrier for you, trying this, whenever that kind
of emotional resistance comes up, I always like to say, all
that that means is that there's a greater chance that this will
work for you. There's a greater chance.
This will be effective because it is clinically proven to work
within populations that are debilitated by their OCD or
social anxiety. It's also going to work for that
fear. You have about giving that big
presentation coming up or making new friends.
So basically Therapy is used for phobias.
It's used for generalized anxiety, social anxiety,
avoidance OCD, all of these different things and the idea
with all of this diagnosis is that there's some amount of fear
and that fear is leading to avoidance.
And so whether that's a situation, an object and
activity, thought and emotion, Etc.
There's fear there and then there's a void ends.
And when we avoid things, that make us anxious, they could
exponentially worse, the anxiety, the fear of the
avoidance builds over time and then it's even more challenging.
Challenging to overcome that anxiety.
So again, just like I mentioned where if you're like I have some
anxiety but it's not debilitating.
Go use exposure therapy right now because you're going to
avoid all of the pain and suffering that comes when we
avoid our emotions and they amplify and intensity.
What's also really cool is that the most effective treatment for
OCD is exposure and response, prevention therapy.
So, what we're going to talk about with this, this key
principle of exposure therapy is what is used in clinical
settings to treat OCD. So we know it works, we know
it's Active for this CBT cycle of our thoughts, influence our
emotions influence, our behaviors, and then it all
repeats. And so that shows up in phobias,
that shows up in anxiety, it shows up in OCD, and so exposure
therapy works across the board. So, we do want to give the
caveat in the disclaimer, that if you are anxiety is becoming
debilitating. It's interfering with your
quality of life. It's interfering with your
relationships. Your ability to show up for work
school, Etc, and it's been going on for a long time.
It can be really emotionally unsafe to do, exposure therapy,
and that's why people. We'll go to therapy.
They get support. I did a lot of exposure therapy
with help of therapist for a long period of time.
I still will write exposure hierarchies with a therapist.
So if you're like, this feels really overwhelming the thought
of even thinking about this thing.
I'm avoiding is debilitating work with therapists, have them
help you out with the exposure therapy process.
And there are therapists that specialize specifically in
anxiety, OCD and exposure. So go find a clinician that
specializes in that area and they will help walk you through
this. Step by step, this is more.
Or if you are feeling anxiety avoidance Etc and you think you
can overcome it, but you're not exactly sure.
How or there are smaller levels of anxiety that you'd like to
work throughout this is for you. But if it's completely
debilitating overwhelming, impacting every aspect of your
life, definitely work with a clinician because if you are not
able to successfully cope with the emotions that come up or the
thoughts are too overwhelming or it leads you to avoid more again
the anxiety, just amplifies and then it's even more challenging
to work through. Through those emotions.
So we don't want to try it, exposure therapy, then get cold
feet back out and then we're even more anxious than we were
when we started, that would be really productive.
If you think that might happen work with a therapist that will
help you through it, they will help you make the most amazing
exposure hierarchy and support you through it.
But I feel like I think I got this.
I just need help understanding how this works.
This is for you. So the first thing going to talk
about is the CBT cycle in CBT, there is this amazing triangle
Circle. However you want to describe it
where we understand that our That's impact our feelings and
they impact our behaviors and just keeps going in a cycle.
So if you wake up and you're like, I am feeling depressed and
then you don't get out of bed and then your thoughts are, like
I have nothing going for me, I'm so unmotivated.
I hate everything about life and then you feel worse about
yourself and then you don't get out of bed for longer, then you
avoid your responsibilities. You can see how that cycle
continues to go in a loop and make the situation worse.
If you interject at one point, whether it's your behavior, your
thoughts are your feelings? You are able.
To adjust the rest of the cycle. So one skill that we've talked
about a lot in the podcast is opposite actions.
The idea is that you take the opposite of what you're feeling.
And so if you are feeling depressed and you would like to
avoid all of your friends and family members, you don't want
to do anything. You want to stay in bed, you
want to avoid your responsibilities or can do the
exact opposite. So you go to coffee with a
friend, maybe go to class, maybe you call someone and say, I'm
really not feeling great today. Can we go hang out spend time
together? I really just need to get out of
my own head, that behavior is then going to impact your
thoughts, which How they had a loop?
Like I'm nothing going for me. Everything sucks.
This is terrible. This is overwhelming.
And of course, the feelings of feeling depressed, unmotivated,
overwhelmed, Etc. So exposure therapy is building
off of that idea where when we adjust the behavior or we adjust
the thought, or we adjust the feeling and we'll get through
that. When we talk about an exposure
hierarchy, which one of those, you are kind of inserting
yourself into you, are able to break the cycle of the really
intense anxiety, the overwhelming thoughts and the
Sure, of avoidance. So, what is exposure therapy?
The basic idea of exposure therapy is that you are exposing
yourself to the thing. That is causing anxiety, fear
Etc, and a small safe doable way.
You are slowly building yourself up to the thing that makes you
so anxious. And so overwhelmed.
And as you build Mastery over those thoughts, those behaviors
those things that are making you anxious as you get more
effective with your ability to cope with the emotions that
arise. Is to shift the thoughts, you're
having, you're able to overcome the anxiety, the phobia, the
thought pattern, Etc. There are four types of exposure
therapy. I originally learned three of
what we're getting a little technologically savvy nowadays.
So, the first is in Vivo exposure.
So, you are directly immersing yourself in the thing that is
making you anxious. So if you are scared of being in
public, you are struggling with leaving your home, you are
struggling with going out socializing with others in Vivo.
Oh, exposure would be leaving your home and going outside into
the world. Imaginal exposure is when you
are mentally going through the process of doing the thing that
makes you anxious. So even though you're still in
your house, you are closing your eyes, you're almost meditating
and you are visualizing yourself leaving the front door.
Locking the door, getting in the car, driving to a coffee shop.
Placing your order talking to someone, getting your coffee,
sitting there for 30 minutes, and if you really, truly are
very anxious about something. Going through that mental
process, will bring up a Sighs. Your heart rate will probably
increase you'll be breathing a bit more rapidly.
It is an overwhelming experience to expose yourself even mentally
to that thing that is making you anxious.
This is also used with people that struggle PTSD or how to
traumatic experience, doing that imaginal exposure to the thing
that is causing all of those intense emotions is also
something that is done in a clinical setting.
The second to last one is called interoceptive exposure.
I'm sure I'm saying that wrong. But the idea here is that you
are exposing yourself to the Magical experience of anxiety.
Because if you've ever had a panic attack, you know, that one
of the most overwhelming parts of that experience is like, I
can't breathe, my thoughts, were going insanely fast.
My heart rate is going so quickly, like, am I physically,
okay, is something wrong? What's going on?
And so that can, sometimes almost become a trigger and
itself for more anxiety because you're like, I don't wanna have
another panic attack. This is my worst nightmare to be
this anxious. And so, once your heart rate
starts increasing, once your breathing is more rapid, you get
more anxious because of those physical symptoms.
We're doing at Aricept of exposure.
You are kind of getting yourself in the physiological space of a
panic attack. So maybe you're doing some, some
Sprints, and you are sitting with the increased heart rate,
increased breathing rate that similar to what you experience
when you have anxiety. Maybe you're breathing through a
straw. So, you know what?
It feels like to have shallow breaths and not fully be able to
catch your breath. Maybe you are going through the
similar thought, patterns, that sometimes come up when you are
having social anxiety or worried about leaving the house, right?
So that's of exposure. You're exposing yourself to the
experience of being anxious. And as we talked about how an
exposure hierarchy and going through that exposure process
works, you are again building Mastery over your ability to
cope with the situation. The last, I think this is the
newest version of exposure therapy is.
You can use Virtual Reality, so you're like fancy-schmancy.
You have a whole VR headset. Maybe you're like, okay, I'm
scared of leaving the house. I'm going to have someone else
film a VR experience in me, leaving the house and then I'm
going to watch that. Of course it's going to make you
anxious because it feels like you're really going through that
experience. But a great example here is if
you're afraid of flying, maybe you are going to watch a vlog of
someone going to the airport and going through security and
boarding the plane. And on the plane, that will
probably bring up some anxiety. So, to work through that, in
that safe environment and that less intense version of anxiety
can be super effective. So those are the four types of
exposure therapy. And, again, underlying theme.
There is that you are exposing yourself to the thing that's
making you anxious. Us in a small manageable way,
that is still slightly, pushing you outside of your comfort
zone. You are effectively coping with
the emotions and thoughts that arise.
And you are working your way through it, and you were doing
the opposite of what you want to do, which is a void and run
away. Today's episode is brought to
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persisted. The link will be in the show
notes and start therapy or continue on your therapy Journey
today. So if you are doing exposure
therapy, the way that I would approach this in 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 or
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'm absolutely terrified.
If I dive so much anxiety. The idea of doing that makes me
want to like throw up faint runaway, 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 being in the room, watching
other people, give their presentations and knowing that
you probably are going to be next.
So maybe you go and sit in on another lecture where people are
giving presentations and you mental are like, okay, I'm ready
to give my presentation. And let me pull up my slides.
Let me emotionally deal with this overwhelming experience and
maybe below that is practicing giving a presentation to a
friend or two, you're going through the process.
You are saying everything that needs to happen, Etc.
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 before that,
maybe you are watching someone else's presentation.
You are not mentally. Ali.
Like okay, my presentation is next but even just watching
someone else do it, can kind of bring up that anxiety.
So you're doing that in person then maybe it's watching a video
of someone that is giving a presentation.
And the Very lowest freebie, almost if you will 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.
You don't want to be like, okay, one day I'm imagining I'm giving
a presentation, the next one. I am.
Live podcast. Like that would be the worst way
to structure your exposure hierarchy, because you're going
to get too anxious about the idea of giving a whole life
podcasts to an audience. You're going to avoid the
situation and the anxiety is going to amplify.
So what I would do is make this really comprehensive list and
you want to have these three things you can check off.
Yes, I did this or no, I didn't. We don't want to be vague.
Like I'm going to expose myself to the feeling of being anxious.
Do you want to be really specific?
Are you exposing yourself to the physiological sensation of being
like, 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?
We're being very specific and we again, it's a comprehensive list
of like freebie. I can do that.
It'll make me a little bit anxious, but I got this to, oh
my gosh, this is the end goal and I'm very anxious about
navigating this experience. So once you have your exposure,
hierarchy is what Halt. You are going to begin the
process of doing these small exposure therapy steps.
And this is why it's great to work with a therapist because I
full accountability here. I've made multiple exposure
therapies for myself this year, whether it's like making new
friends or talking to people are doing things that make me
anxious. There are my bullet journal.
They're written down. Have I done them?
Nope, I go back home and I see my therapist.
She's like house exposed to. There we go.
I'm like have a really dumb so this is why it's great to work
with the clinician or someone that can hold you accountable
and also be there to support you throughout the process.
But it's totally possible to do by yourself.
Especially if it feels emotionally safe to do so, and
you can do things like having a friend hold you accountable.
So, maybe the thought of going to the gym is like, so
anxiety-provoking for you. So you asked a friend.
Hey, do you want to go walk on the treadmill with me?
It's a pretty low ball, like easier item or more like oh can
you go to the gym with me and get a smoothie, don't even work
out. Just go and get a smoothie or
maybe you're walking past the gym and you're like to a friend.
Hi. Do you want to go on a walk?
We can go. However, and then you
strategically walk past the gym, but you're going with a friend.
So they're there to hold you accountable and you're not
backing out, and avoiding the situation.
So, there's some ways to hold yourself accountable, but it can
be very personal thing. You almost need, like, expose
yourself to the idea of being vulnerable and telling people
that you're anxious and you're trying to overcome this anxiety
that itself. You're exposing yourself to
those anxiety, shame. Whatever emotions.
Come up, can be intense. And so that also you're doing a
little bit of exposure therapy there, but now getting in to the
details. So we have our exposure therapy.
We have our first item. What you're going to do before
is we're going to really go above and beyond with coping
ahead. This is a DBT scale within the
ABC scale. So it's from the emotion
regulation, module. We're working to long-term
overcome and maintain our emotional stability.
So with the Copa head scale, we are planning exactly how we're
going to cope with the situation.
When you're coping ahead, you are describing the situation and
as much detail as possible, we're not even doing the
imaginal part of it, but on a piece of paper.
Like I'm going to be imagining what?
It's like to expose myself to this anxiety.
So if we use the example of going to the gym with a friend,
that's what's making you anxious but you're like big long-term
goal is to work out three days a week.
So like going to the gym with a friend is maybe you in the
middle of the hierarchy like maybe first third.
So it's not quite like I'm just walking by the gym or I'm just
getting a smoothie. We've already done those things.
We've conquered them. We've overcome the anxiety.
We didn't avoid them. We did it.
Amazing. Saying this is maybe a third or
fourth on the list. So you're like my friend and I
are going to go to the gym. I have someone there to support
me. We're just walking on the
treadmill. We're not going to do anything
crazy. We're not going to try to
navigate lifting weights or asking someone what workout are
you doing? Like none of that.
You're just gonna walk on the treadmill for 30 minutes and
then you're leaving. So 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 probably feeling some anxiety,
you then, get to the gem pan. We have to swipe our cards and
so, 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.
What are you going to do on the treadmill?
Are you listening to music? Are you watching a show or you
talking to your friend? What are you doing?
And you're also going to describe what potential anxiety
might come up for you. Are you interests while 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
facts scale 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 gotta check the facts are,
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 won't.
We oh my gosh. Are you okay?
Like, can I help you? You're going to get back on the
treadmill. You're going to keep doing your
thing. No one is gonna ban you from the
gym for the rest of your life. We're checking the facts.
We are writing down the possible situations that might happen but
we're also being realistic. You Also, again, listing the
emotions and the thoughts that might come up, that would lead
to the anxiety and that typically cause avoidance or you
having like a thought pattern about not feeling like you are
active enough to be at the gym or is not going to the gym for
you associated with maybe body image like what body image,
thoughts are coming up for you and how do you cope with those?
So we're describing the situation, we're naming, the
events were naming, the emotions were naming the thoughts, 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 okay I know that 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 Tech talk because that's super
engaging and it's really hard to ruminate in your head when
you're watching Tech talks and people are dancing.
The sounds are going. The trend is happening.
So I know the second I get on the treadmill.
I'm going to scroll on Tick-Tock and that's what I'm going to do
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.
Can the treadmill. So I'm going to paste 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, again, this is a little bit more challenging with imaginal
exposure because you're planning it, and then the anxiety
provoking situation is imagining it.
But if you're doing something in person, you're physically going
somewhere, and doing this activity that provokes, Anxiety.
You're going to imagine yourself doing it again.
Even exposure therapy is built into the DPT skill, cope ahead.
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 pick, okay?
Next week is my next item on the exposure therapy hierarchy or
not. Let me bang out all 10 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 that's an example of how we
would use the Copa had scale and then we actually go through the
motions. We actually do the thing.
So we do the skills that we plan, we were going to use, we
problem solve in the moment if we need to we're going to lean
on distress tolerance skills. If this is something that makes
you super anxious, but if you really do take the time to
properly, do a cope ahead and plan how you're going to cope
with this situation. Ation, what might come up?
What, exact coping skills? I'm going to use even write
yourself a list put on your notes app.
If I have a thought spiral about body image, I am going to
distract with this thought instead of and say these
affirmations, if I start breathing really quickly because
I'm getting anxious, I'm going to paste my breathing to my
walking. If my thoughts are just going
crazy, I'm an open Tick Tock and scroll 45 minutes.
So if you truly do that process of outlining what skills, you're
going to use and what triggers might come up, I don't
necessarily think you will have to do.
As much problem solving in the moment.
Because you've done that in advance, you've made it pretty
easy for yourself. You just have to do the thing.
We can't avoid avoidance is easy but again it amplifies the
anxiety long-term. 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, G over time, our level of fear or level of
avoidance, our level of anxiety will decrease.
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. Yes, you are continuing to
expose yourself to things that make you more anxious, but you
also have more practice using your skills in the moment and
coping with the That's making you anxious.
And so we just went through like an extreme really comprehensive
way to cope with something that makes you super anxious will
probably be like a big phobia, or a big sense of avoidance, but
you can also do this for smaller things.
So if you're like, I get super-anxious being in a new
situation, I never am the first one introduced myself.
I'm always like kind of hanging back and letting other people do
the talking, you're like, it's a long-term goal for me to become
more comfortable in those situations.
Maybe that doesn't have a lot of anxiety for you, but you know,
that easy. Our option is to avoid.
So you've just always done that in the past.
So maybe you would have like two or three items on your exposure
hierarchy, like I'm going to go ahead and make conversation when
I order my coffee at the coffee shop.
Next time, I'm going to pretend to ask someone for a phone
charger. Pretend like, oh my gosh, my
phone just died. What time is it something like
that? And then you work yourself up to
being like, oh, hi, I'm Sadie. Nice to meet you.
So you don't have to do this, like, 12-step plan.
You're just doing that. When there's extreme avoidance,
there is a pattern of extreme anxiety and Avoidance.
So that is exposure therapy. And again, if you are feeling
the urge to avoid, if you are feeling anxiety, your little
like mental signals to be like, okay we gotta do some exposure
here because the more you lean into that anxiety and the more
you avoid, the more it will build with time.
So whether that is anxiety, let's go back to the beginning
of this episode, where we talked about being vulnerable, maybe
it's social anxiety, maybe two things like doing karaoke in
front of other people. Maybe it's a phobia you have,
maybe it's a general, something you want to.
Oh, improve on. But you've been avoiding because
it does bring up some anxiety. There's this whole spectrum of
things that cause anxiety and intense emotions, and you can
use exposure therapy across the board.
Just like a quick little recap exposure therapy in a nutshell.
You are identifying the thing that makes you anxious, whether
it's an activity, an interaction, a behavior,
whatever it is you're identifying that thing.
We were deciding whether you're going to do in Vivo just when
you're actually going and doing an action related to the thing
that's make you anxious. Whether you're Imagining
yourself doing that thing. Or when you are doing
interceptive, which is when you are exposing yourself to the
feelings of anxiety, you're going to make a hierarchy of
each. Stop is like, okay, a little bit
out of my comfort zone, but I can do this.
You're starting with an easy item.
Let's make things easy for yourself.
Give yourself a freebie that you're like.
Yeah, I can do that. Let's get some momentum going.
And the last thing is the thing that you are most anxious about
and again when you're choosing your biggest thing, check the
facts. Like, if we go to the gym
example, you're like I am most anxious.
I have the biggest phobia falling off the I'd nail your
biggest thing that you're working up to is not going to be
falling off the treadmill. Dealing with that anxiety.
It's probably not going to happen.
Sure. We like to be prepared for every
worst-case scenario, but you don't really have to fall off
the treadmill that I'm so glad I have the coping skills to deal
with this, in case this ever actually happens in my life, but
like, going to the gym consistently and using the
treadmill would probably be your highest item on the exposure
hierarchy. So, writing down the exposure
hierarchy, it's manageable it pushes outside of our comfort
zone but Still doable. We're checking things off with
each action, item, with each part of the exposure therapy,
hierarchy, or coping ahead. We're planning with coping
skills. We're going to use.
We're building Mastery over the thoughts, emotions and
behaviors. We are beginning to trust
ourselves because we know I can cope with this.
I got this. I've done this before and I can
get through this anxiety. And then you keep building
yourself all the way up to the thing that makes you most
anxious, you overcome that anxiety, you stop avoiding and
it's amazing. It really just is so effective
in. So many areas of life because
when we're not doing something a lot of the times, it's emotional
resistance, or anxiety, and exposure therapy is a great way
to combat that. So I know that was so much
information. I truly hope that made sense
because it can be a little bit overwhelming, it can be a lot.
Probably gives too much detail at some points and skeet over
some things at other points. But I'll leave links in the show
notes about what is exposure therapy, how it works, all of
the things, but it's been one of the greatest Tools in my tool
kit for me Mental Health. Eyes.
And so I hope it helps you now as well.
And again, if this feels really overwhelming and like too much,
make sure to Loop in a clinician, go to therapy, get
support, that is totally 100%. Okay, if you enjoyed this
episode of, she persisted, as always, make sure to leave a
review share with a friend or family member.
I can share on social media tag me.
I'll make sure we post give you a little shout-out.
I really, really hope this was helpful and I'll see you next
week. Thank you so much for listening
to this week's episode of jeepers.
Today if you enjoyed make sure to share with a friend or family
member, it really helps out the podcast and if you haven't
already leave a review on Apple podcasts or Spotify, you can
also make sure to follow along at at she persisted podcast on
both Instagram and Tick-Tock and check out all the bonus
resources content and information on my website.
She persisted podcast.com, thanks for supporting, keep
persisting and I'll see you next week.
Today if you enjoyed make sure to share with a friend or family
member, it really helps out the podcast and if you haven't
already leave a review on Apple podcasts or Spotify, you can
also make sure to follow along at at she persisted podcast on
both Instagram and Tick-Tock and check out all the bonus
resources content and information on my website.
She persisted podcast.com, thanks for supporting, keep
persisting and I'll see you next week.