EP 192 – Exposure Is More Than Just Doing Things

“I’m doing things, but it doesn’t seem to be working! Why?”

If you feel like you’re doing all the exposures but nothing is changing, you may be doing “half exposures” without even knowing it. Let’s look at what full, effective exposures really require.

Exposure Recap

For those of you that have followed me for a while now, you’ve probably heard me talk about exposure so many times that the definition needs no explaining. For any new listeners or readers out there (you long-time followers may be in need of a reminder too) let’s take a quick second to define exactly what we mean when we talk about exposure.

Exposure is what we do when we intentionally do things that purposefully trigger anxiety, panic, fear, and all the things that come with them. We do this in order to learn a new way to relate to anxiety and fear so that we no longer fear it.

You read that correctly.

Exposure is when you place yourself in situations that trigger those feelings of anxiety, stress, and fear ON PURPOSE.

Right now you are likely thinking …. “Are you crazy?!”

I know, it sounds like I’ve lost the plot but that is what we must do. Exposure to the things that trigger us is really what the road to recovery looks like and what will get us out the other side.

(Side note: We’re going to be talking specifically about the two main necessary components of exposure today that allow it to be as effective as possible in the recovery process. If you’re new here and thinking that you need some background on exposure and what it is,  scroll to the search bar at the very top of theanxioustruth.com and type in EXPOSURE. There’s a ton of information ready and waiting for you)

For those of you who are already in the know, you might find that you’re now in this weird state of knowing and understanding what exposure is, feeling as though you are implementing it, but not making any progress.

Been there, my friend.

Most often, it really does boil down to the absence of one of the two important components of effective and successful exposure: willingness and acceptance.

The Role of Willingness In Effective Exposure

Let’s take a look at willingness first.  Willingness is the first thing we need to cultivate before we tackle acceptance, and it’s the easier one to deal with.

Willingness simply means that you are willing to do these difficult, scary things that will ‘trigger’ you intentionally. That’s a super important word right there. Intentionally. Willingness means exposing yourself to situations and things that evoke feelings of anxiety and discomfort in you on purpose.

Willingness comes in degrees. I like to think of it as a willingness spectrum.

Most people are initially unwilling to do this work.  I get that. This might be an entirely new concept. Anxiety may be something you’re only just beginning to understand. Your recovery journey hasn’t even begun yet and I’m telling you to go out there and face your fears head-on. If you feel completely resistant to this suggestion, I get it. There is no blame, shame, or judgment here. It is where we all begin. It’s certainly where I began. Everybody goes through the unwillingness phase.

Next, we move a little further along the spectrum.

You do start to get out and do scary things, but you might find that in this phase you are doing things only because life is making you do them. You’re willing to do the scary things, but only if you must. When you do the scary things, it’s really not intentional.  You’ve been made to do it or been told it’s what you should do, but really, you don’t want to. You do it through willpower, but you are not fully willing.

Other than doing scary things when you have no choice, you may also wait for the days when you feel good enough before doing more of them.

“Okay, it feels like a good day! Today I’ll go for a drive on the highway because I feel I can handle it today”

This is really common.

I don’t really call this exposure.  It’s more like interrupted avoidance.

You are not alone in this phase so don’t beat yourself up if you are realizing that you fall into this camp at the moment. It’s a process we all must go through. You’re not failing.  You’re just working through the process like we all do.

What Is Full Willingness?

The second slice in the willingness pie is consistency. Full willingness is indicated by the fact that you’re not only doing it, but you’re doing it consistently. 

I can’t emphasize that point enough. Inconsistency is a good indicator that you are either not fully willing or not fully accepting (more on that in a moment).

Create a schedule and work on it every day even when you don’t feel good. Especially when you don’t feel good! Those are the days that matter most. When you are fully willing, you start doing your recovery work more regularly. You make it part of your daily routine. You resist a little less and you do a little more. Over time you realize that you are capable of doing this all of the time. Once you are really ready to do it, and ready to do it each and every day, you’ve got the willingness nailed down!

The Role of Acceptance In Effective Exposure

What about acceptance… the second essential part of this concoction?

When we talk about acceptance we are talking about something that may seem obvious but often evades us when we’re in the midst of anxiety. Acceptance, in this context, means to be fully accepting of the fact that doing scary and challenging things will – in fact – be scary and challenging.

This really is the whole point.

Be accepting of the fact that you are doing a scary thing, so it will be scary.

Be accepting of the fact that you are doing an uncomfortable thing, so it will be uncomfortable.

It may seem so apparent when written down, but when we struggle with anxiety we’re most often trying to do the best we can to avoid that. Even when we’re practicing exposure, without full acceptance we may be trying to avoid the feelings of anxiety and fear. When we avoid those feelings, we aren’t really practicing exposure effectively.

Rather than trying to engineer easier or less anxious exposures, we must accept that the whole point of exposure is to navigate through the scary and challenging stuff so that we can overcome that fear. If you are immediately ending the exposure when anxious, or if you continually brace and fight your way through it just to get to the end and back to safety, then you may be finding that your exposures are not really leading to real change.

If you are ending exposures only to tell the story of how horrible they are and how scary and hellish the experience is, then you are missing the acceptance part. It was supposed to be scary. That isn’t failure.  That’s intentional, but you must embrace that and stop fighting it if this is going to work.

Acceptance, in this form, is a vital ingredient in effective exposure it.  Without it, all the willingness and resolve in the world will likely not matter and you may end of exhausted, confused, and discouraged.

Effective exposure

The most common issues that result in “I’m doing exposure but it’s not working” involves being only partially willing (inconsistency) and lacking acceptance (trying to find ways to do scary things without being scared).

A client can be willing (e.g., a person suffering from social phobia may enter a social situation on purpose) and yet not practice acceptance (i.e., the person immediately tried to suppress anxiety when it appeared). – Hayes, Strosahl, Wilson:  Acceptance and Commitment Therapy Second Edition

If you try to wiggle through exposure, try to avoid the inevitable feelings of discomfort you will face, and find some sort of loophole that means you can do it without ‘risk’ of triggering those feelings… then it’s not effective exposure.

It requires discomfort.

It requires full willingness – meaning consistency and regularity.

It requires full acceptance – meaning the acceptance of the fear, panic, and anxiety that might arise when you face scary and challenging things.

Both parts are integral to the recovery process. And if you are finding that you are trying to practice exposure but aren’t quite sure why it may not be working for you then stop for a moment. Take a breath. And be really honest with yourself, are you missing one of these vital ingredients?