Micro Exposure In Anxiety Recovery (Ep 300)

Exposure and Micro Exposure

Let’s talk about micro-exposures. Lately I’ve been using the term “experiment” more than exposure because I think its a bit more accurate and more clearly describes now only how to face what we fear, but WHY we choose to do that to get better. If you ask an agoraphobic what exposure means to them, they will likely tell you that to learn to get back out of the house they have to start going out of the house, even though that is scary to them or might trigger panic. They will point at things like driving, walking far from home, going shopping, or attending social events as examples of exposure they might do as part of recovery.

This would be an accurate description of exposure, but it doesn’t have to be that big. It certainly doesn’t have to start that big. We can start this process with small micro-exposures designed to help you recognize what allowing the experience of anxiety looks and feels like. When we incorporate micro-exposures into recovery, we’re learning to stand up before starting to run, which is never a bad idea. This is especially helpful for anyone that is finding it very difficult to start with bigger exposures, even on the small side. And while we might be using the word “micro” in this episode, do not be fooled. Micro exposures can be a really important part of the process for you to get you moving, and throughout your recovery journey. 

Here’s an added bonus. Micro exposures often form the basis of excellent mental health and stress management habits that you may take with you long after you have overcome your anxiety. These little experiments can teach us habits that we can rely on for the rest of our lives.

Before Starting Exposures …

Of course, I have to remind you that even before I would introduce micro exposures to a therapy client, we would do some prep work. We’re always starting with an assessment of a client’s unique circumstances and how they see their anxiety issues and themselves. What you believe about anxiety, how to address it, and even what you believe about yourself and your past experiences really matter here so we always start with a solid base of psychoeducation – teaching the mechanics of anxiety disorders and recovery, and an exploration of who and where you are so we can decide together where you can best start with exposures, even micro exposures. 

 

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For more psychoeducation on the mechanics of anxiety disorders and recovery, you might refer to the first 15 episodes of this podcast even though they are 10 years old and really need updating, or you might check out my book, The Anxious Truth.

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Find Your Micro Avoidance and Rituals

If we do exposure to learn how to fully experience anxiety, fear, uncertainty, discomfort, and even panic without fighting them, it can be really helpful for us to ask ourselves how we brace against these experiences all day long. Not just when driving or shopping or being social or going to work or school.  I mean how are we fighting, resisting, and trying to control our anxiety from the moment we wake up to the time we fall asleep?  When questioned, most people struggling with anxiety can quickly identify a whole list of little micro-avoidances and safety behaviors they use all day long to try to minimize the chances of feeling things they are afraid to feel.

Take a minute or two. Think about what strategies you use all day long to try to lower the odds that you might feel anxious or get triggered.  What are you doing to try to control, prevent, or fight against those internal experiences you hate and fear so much?  What rigid rules and rituals do you insist you must live by in order to be OK?  If you find that your list is long and it surprises you, that’s OK. If you have a bunch of little rules and rituals and routines you follow, that’s fine. It’s not just you. Most of the people listening to this episode or watching this video will have a long list too.

If you look at your list of micro avoidances or safety rituals, you will likely find things you do to control how you feel, and things you refuse to do because of how you might feel if you do them. That second one is obvious for anyone that avoids big chunks of life because it triggers anxiety or panic. But its not just refusing to drive or socialize that we care about here. We also care about the idea that you cannot sit still or be idle or quiet for even a minute or two because then your thoughts and anxieties will catch you and make you feel a certain way.

Actually Feeling The Feelings With Micro Exposure

I want to focus our discussion of micro exposure on that part. The part where you can experiment – in your safe spaces – with little bursts where you stop, get quiet, and allow things to happen inside you. That means sensations in your body, thoughts in your mind, or emotions. These are micro in nature because its perfectly fine to start with 30 seconds at a time right in your living room or bedroom. You don’t have to meditate for two hours or drive 10 miles from home to do this. And the micro-ness (I just made that word up) of these little experiments means you can repeat them often, sprinkling them throughout your day.  Does the thought of stopping and being still for 60 seconds make you uncomfortable?  If it does, you’re not alone in that. When I was at my worst that was a HUGE challenge. Feeling sensations and hearing scary thoughts was something I tried so hard to not do. Most anxious people wind up in states of chronic or disordered anxiety for this very reason. The anxious feelings and thoughts themselves become threats to be avoided, resisted, and managed.  

But if we cannot allow ourselves to feel what we feel for 60 seconds at home, how do you expect that you will be able to do that when you decide to attend a family function, go to the dentist, or drive to work or school?  I’m learning as I work with more therapy clients that the first “lightbulb” moments in active recovery come when we work through little 60 second or 5 minute stillness or mindfulness exercises in session. Those are the little experiments that provide the initial glimpses of HOW ACCEPTING looks and feels

But HOW Do I Accept Anxiety?

If you’ve ever wanted to watch a movie that might trigger your OCD theme, go out to dinner with your friends, or drive yourself to a yoga class but you cannot even imagine HOW to accept anxiety to do that, starting with a 60 second experiment on your sofa is a good way to approach this.

A Few Words About Mindfulness and Meditation

A quick word about meditation and mindfulness. Well, two words really. Resistance, and expectations. 

Many people in the community surrounding this podcast look sideways when I suggest things like 60 second mindfulness or meditation experiments because they feel they just can’t do it because it makes them anxious. Correct. This episode is about micro exposures. Exposures are things we do to intentionally feel uncomfortable because there are lessons there. I do not suggest mindfulness or meditation to learn to not be anxious or afraid. I suggest them because they are ways to learn how to get better at being anxious or afraid, and they can be done in small bursts anywhere, anytime. 

Additionally, when I talk about mindfulness or meditation no matter how often I say that these are not calming exercises or anxiety shields, its expected and common for anxious people to try to do them to calm down anyway. Then I hear that these things “don’t work” because expectations were a bit skewed going into the exercise. 

Please keep these things in mind. You can choose to bail on this episode right now and I would respect that, but if what you are hearing has you thinking about how you might use micro exposures in your recovery work, please keep resistance and expectations in mind as you go forward. You cannot use these concepts to advance in recovery while also insisting that you must steer clear of difficult inner experiences. Those two goals are in direct opposition to each other.

The Start of Lifelong Habits

Remember when I said that micro exposures can form the foundation of lifelong wellness habits?  Well, you may find that if you continue to practice things like sitting quietly to accept your reality without resistance for a few minutes at a time, you will ultimately begin to find the activity to be calming or relaxing in some way. That would be great, right?  But if you are terrified of your own heart, or your own thoughts, accessing calmness and serenity through mindfulness or meditation practice is not your immediate goal because at first those will be exposures for you.

I’m thinking that in episode 301 of The Anxious Truth we should do a five minute mindfulness meditation practice together so you can really see what that is supposed to look like. If you’d like that, either leave a comment on YouTube or click this link to send me a comment via text.

Other Forms of Micro Exposure

If sitting quietly and mindfully to allow your internal experiences without resistance is one form of micro exposure, are there others?  There sure are.. There is likely an unlimited number of micro exposures you can do to help yourself learn recovery lessons, but in general most of  the other micro exposures are going to fall under the umbrella of removing safety rituals or routines. 

If you insist that you must use your magnesium powder every morning to stay calm that day (I was that guy), a micro exposure might be skipping that tomorrow morning.  If you are terrified that going to bed and getting even a minute less than 8 hours sleep means you will be crushed tomorrow, then a micro exposure might be pushing bedtime back 30 minutes to get only 7 ½ hours of sleep.  If you miss your morning coffee or tea but avoid it because “caffeine and anxiety”, what about trying a small shot of coffee when you wake up?  That would be a micro exposure.

If you have any of my books on your bookshelf but you stopped reading when you got to the parts where you face what you fear, reading a few more pages into the scary parts might be a micro exposure. If you can’t talk to your friends because being trapped in a conversation might make you panic, how about texting a friend to see if they can chat for five minutes as a micro exposure?  See how this works?  Micro exposures can be done by removing micro avoidances and small safety/resistance devices or rituals to see what happens at a small scale. 

These Are Supposed To Be Small!

Remember … micro. I am not suggesting that you guzzle a pint of espresso as an exposure tomorrow morning. There’s a reason why I suggested a one or two ounce shot of coffee as a start. Maybe delay your anxiety supplements for an hour before you take them. Or push bedtime even 15 minutes later. These count. You can learn lessons from them if you understand and accept that when you do these micro exposures you will likely feel a certain way to some degree … and you’re choosing to do that as practice.

The Response Prevention Part

Regardless of what form of micro exposure you want to explore, always remember that the key in any exposure of any magnitude is the response prevention. ERP – exposure and response prevention – is not just for OCD.  ALL EXPOSURE IS ERP. If you choose to play with micro exposures, the point of the exposure is to refrain from saving yourself from the feelings you intentionally trigger. If you choose to sit in the sofa quietly for 3 minutes, go be uncomfortable for 3 minutes, then you’re done. If holding off on your magnesium powder for 30 minutes makes you nervous, then be nervous for 30 minutes, then you’re done. This is really the most important part because when the experience ends naturally as scheduled even though you didn’t bail out or fix your feelings, you can learn from that.

Tolerating uncomfortable feelings is a big ask for everyone, which is what makes micro-exposures so useful to start. Shorter duration with lower perceived “risk”. Even so, if you find all this challenging, be kind to yourself. Its supposed to be challenging.

Wrapping It Up

If you’ve been struggling to come to grips with the concept of facing your fear as part of recovery, maybe micro exposures will offer you a way to dip your toe in the water to see what it feels like.  I cannot stress enough that alongside good psychoeducation and the cognitive part of cognitive behavioral therapy, even little experiments or exposures can have a significant impact on the way you view anxiety, recovery, and your belief about your ability to engage in the recovery process. 

Give it a shot if you’re so inclined. See what happens. Who knows what you might learn?

Links Of Interest

Putting the Response Prevention Into Your Exposures

How Does Exposure Work In Recovery?

Recovery Without Exposures?

• My Panic Attacks Explained Workshop
• My Agoraphobia Explained Workshop
• My Panic and Agoraphobia Recovery Guidebook
• Follow me on Instagram
• My YouTube Channel
• Disordered – With Josh Fletcher

 

Disclaimer: The Anxious Truth is not therapy or a replacement for therapy. Listening to The Anxious Truth does not create a therapeutic relationship between you and the host or guests of the podcast. Information here is provided for psychoeducational purposes. As always, when you have questions about your own well-being, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.