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Exposure Therapy... Oi

Excessive February 23rd, 2016

Hey there fellow social anxiety fighters! I have had SA since I was very young, I have been noticably scared of people since I was 5. It has been a debilitating issue in my life. I am now 24 and cannot hold down a job due to how anxious I get in a work environment. I actually recently quit my dream job because I woke up and just couldn't go. I am now in therapy which involves CBT and exposure therapy. Basically I am really struggling with the exposure therapy part. I try to make small goals and do them but it all seems so slow and draining.

For example my goal is to go to the library and get a library card. Yesterday I walk right into the library and then directly out and got very upset at myself for not being able to do it. Then it is just one guilt train after another and I get very depressed. And of course I feel that added pressure that I need to be able to handle a job to... you know... live...

So after all that exposition I was wondering if anyone here is doing or has done exposure therapy and maybe had some tips or stories to tell....

Also some more ideas for little exposures to do would be great, so far I have braved the bottle depot and am going to get my library card.... after that I have no ideas!

Thanks everyone and have a good day!

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tranquilVision80 February 24th, 2016

I've had a bit of exposure therapy for OCD (though my therapist thinks it's just my social anxiety acting up) and honestly it made it worse for me. My issue was/is I have this rewriting compulsion in response to the obsession of fearing of being publicly humiliated and laughed at and people thinking I'm incompetent and such if my handwriting isn't "perfect". The therapy was basically me writing my name down and her taking my pencil away and not letting me erase it for a set amount of time, gradually getting longer. It just made it worse for me and made me almost have an anxiety or panic attack.

As for social anxiety, I haven't had much luck there either. A tip my old therapist told me was to act the opposite of what your anxiety made you feel like doing. For instance, if you get anxious walking down the street and start speeding up because of it, you're supposed to take slow, deliberate steps. Maybe you could start out with littler things like that? Then you don't need to actually interact with anyone yet and could gradually build up to that over time. It didn't really work for me, but I've heard others say it worked for them so maybe it'll work for you?

1 reply
Excessive OP February 24th, 2016

@tranquilVision80

Doing the opposite sounds like a good idea. It reminds me of George on Seinfeld! I often tend to walk really fast and avoid looking up. Those are smaller things I can work on. As for exposure making the anxiety worse, I definitely understand that. Especially if it is too much at once or just not the type of therapy you need. Some exposure therapy got me used to the grocery store, but has never gotten me used to family gatherings! It's really hard to find the right balance of what works, but I guess it is just trial and error.

Thanks for the helpful reply!

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Daydreamer47 March 2nd, 2016

Hmm I think your social anxiety is slightly different from mine/maybe more severe but I definitely got some exposure therapy to work for me. Mine mainly revolved around class participation, calling friends and going on dates. Parties/family gatherings are definitely still high anxiety for me so I understand that! ugh

I think I started with making calls to slighlt easier people like my mom or a close friend and then the harder ones for dates came later.

I also highly recommend volunteering at an animal shelter or being outdoors, basically naming environments that make you comfortable and then interacting slowly with the people who enter your "safer" place.

SaturdaysChild March 13th, 2016

Hi Excessive,
I've been through CBT and Exposure therapy and although I can do pretty much anything now I still have some social ineptitude and awkwardness so I am still doing exposure... From my personal experience I can say that exposure is starting to work when you notice little details that you missed before, couple days ago I asked librarian for something and I noticed his hair, his face expression, I read his name tag, I noticed his clothes. That wouldn't happen in the past, I would barely remember the guy's appereance and details of what happened. The key to overcoming social anxiety is in focusing your attention out, away from the self plus dropping all safety behaviors (plus optional cognitive interventions). Social anxiety persists only because you avoid situations - which in turn reinforces your negative/distorted beliefs about yourself or the world or when you do exposure you are not focused externally and you don't drop safety behaviors - then you cannot learn that "the environment is safe". What is going to happen over time (if you do good exposure) is Pavlovian extinction, you "unlearn" to feel anxious in social situations, your anxiety will die out.
http://www.homepage.psy.utexas.edu/HomePage/Class/Psy394U/Bower/12%20Anxiety%20Disorders%20/CLARK-SOCIAL%20PHOBIA.pdf

Cheeney March 13th, 2016

I've done CBT and exposure exercises for social anxiety. These are the exercises I found most helpful:

- Asking a stranger for directions
- Going to the supermarket when it's super busy
- Acting confident (e.g holding your head up high, back straight)
- Drinking coffee by myself in a cafe

It took a long time for these exercises to actually make a difference, and I absolutely hated them. But that's the point. By doing what makes you anxious you show your mind that you can do it, and that there's nothing to be anxious about. This will take time, and it'll be hard. I've still got SA and am still struggling. But CBT and exposure have made me a stronger person and because of it I am able to deal with my anxiety better. My advice: continue doing the exercises and give it some time. It will be worth it.