Every therapist says they treat anxiety. Every therapist says (and believes) they use cognitive behavioral therapy
(CBT). In fact very few do. There is only one therapy that eliminates anxiety disorders. It's called Exposure
What is exposure therapy? Exposure is the only therapy that is endorsed by all national
anxiety organizations, whether it is OCD, social anxiety, agoraphobia, panic disorder, PTSD, and phobias. If a therapist
does not use exposure as their main technique, they will not help you. It is not sufficient if they say they use CBT.
CBT is a very general term that includes dozens of techniques, including many that are not helpful to anxiety and some
which will make it worse. Exposure is a special CBT technique specifically for anxiety disorders.
you've been doing exposure your whole life and successfully overcome hundreds of fears. It's normal to be nervous or
fearful in a new situation--the first day at a new school or job, the first time you met your significant other, the first
time you did a new activity. Yet you overcame your initial fears by continuing to do the uncomfortable activity; that's
exposure! Some have even become sources of great joy---a new sport or career, a happy marriage, etc.
Exposure is the natural way people overcome fear of anything. Even the most primitive animal organisms
eventually habituate to uncomfortable stimuli through exposure. We all know people who have phobias--flying, dogs, darkness,
tall buildings. (I have a phobia of mice!) We know that people overcome these common fears just by gradually getting
closer to and spending more time in those feared situations in small baby steps. But those baby steps eventually add up to
a dramatic difference. OCD, social anxiety, and panic are no different from these phobias, except it's harder to avoid
thoughts, people, and travel. But it's the same thing and is equally treatable.
it is physiologically impossible to remain fearful of anything with continued exposure to it. Think of firefighters,
police, soldiers, doctors, and pilots. They weren't born fearless; they slowly became that way by exposure to successive
approximations of their occupations. Sadly, this is true even of people in war torn countries. We are dumbfounded
watching people go to work, school, hairdressers, and weddings while bullets fly over their heads. They've been exposed
enough times to become desensitized to it.
By contrast, we know the more we avoid uncomfortable
things, the more we become fearful of them. In fact, we could make you afraid of something simply by telling you to
avoid it, even if you never actually encountered it. Isn't it surprising how fearful people can be of others who are
different from ourselves or who live in other countries, despite never even meeting them? That's because they grew up
being told to avoid certain types of people. Yet when we are exposed to them long enough, we become more comfortable
around them. In fact people can be quite comfortable with even negative people and negative situations, for better or
worse, simply through exposure and familiarity. As long as they know what they are getting themselves into, good or
bad, they're comfortable.
We cross the street every day without thinking we could be hit by a car.
Does that guarantee we can't be a fatality? Of course not. Accidents happen all the time. We've learned
to live with these everyday risks not because we've been reassured, but because we simply are habituated to it. The
good news is that if you've overcome fears of these everyday situations--learning to ride a bicycle, learning to swim, etc.--then
you WILL also overcome the anxiety that has put your life on hold. You, and millions of people going through the same
thing, can be hopeful of overcoming this problem once and for all!