Using sadness and anger to overcome anxiety.

Expressing and releasing anger and loss.

Overview

Sentence Exposures

Sadness and Anger Exposures

Cathartic Letters

Real-Life Exposures

Exposure Hierarchy Examples

I refer to Gradual Exposures as the “Berserker” Style because they are the most forceful of the cognitive behavioral techniques.

Overview

Gradual Exposures are the treatment you would use for a phobia of spiders. You would start by looking at a picture of a spider, then holding a rubber spider, then looking at a spider in a cage... and so on until you worked your way up to holding a small spider in your hand.

There are three keys to exposures: They must be voluntary, they must be sustained, and they must be mild.

Let’s say I misguidedly try to treat your phobia of spiders by locking you into a room full of spiders against your will. It won’t help at all! In fact, it will only traumatize you and make you more afraid of spiders. Similarly, if a friend forces you to go to a party or forces you to socialize against your will, it won’t help your social phobia. Exposures must be voluntary in order to be helpful.

In particular, it's not just the activity that has to be voluntary, it's the anxiety itself that has to be voluntary. An exposure is a very strange activity. You have to actually try to feel anxious in order for it to work.  For example, in college I went to dozens of parties to try to get comfortable, but it never worked. Parties still made me just as anxious at the end of college as they did in the beginning. But that's because when I went to the parties, I would try to keep calm. That's not an exposure. That was me practicing relaxation techniques.  Later in my twenties, when I did parties as exposures, I would go in trying to feel anxious.  I would talk to whoever seemed the most intimidating, I would purposely repeat negative sentences in my head, and I would push myself to be the last one to leave (I actually started with much easier exposures than parties).  As a result, parties eventually started inducing much less anxiety.

Let’s say you agree to hold a spider, but within two seconds you throw it down because it creeps you out. Well, even though that exposure was voluntary, it was be too brief to be helpful. Exposures only work if they are sustained long enough for your anxiety to at least starts to go down. Ideally, you should sustain an exposure until the anxiety is completely gone.

The optimal exposure is always a low-intensity exposure. The problem with doing an exposure that is too intense is that it can backfire. If the anxiety is too high, then it becomes involuntary is no longer useful. There were some times when I would go to a party thinking that it would be a mild exposure, but once I got there I felt so out of it that I realized that the exposure is too intense for me that day. When that happened, I would leave. If an exposure is too intense, it won't help you. Low intensity exposures, in contrast, can help you expand your comfort zone.

Whenever you do an exposure that is voluntary, sustained, and mild it's like taking a stick and poking out your comfort zone in this direction and that direction, gradually expanding your comfort zone.