The only way to overcome anxiety is through exposure

[Passaggressfedup]

I recently overcome a massive anxiety of mine. I feel so liberated and proud. It has made me think of the other significant anxiety triggers I experienced in life and concluded that all have been overcome through regular, controlled exposure over time.

I read so many thread about children or young people experiencing anxiety, where the parent has opted to take the child away from the situation thinking it is what's best for them.

I appreciate that there was some specific instances where removal is the for the best, but aren't we, as a society, making things worse by not helping our children to face their fear so that they can not only gradually get over that particular fear, but also learn to build that sense of resilience, pride and positivity that comes with it?

I have already said I am?

One of my triggers is a man on the other side of a door.

I’d actually like to thank the op for this thread because it led me down the following thoughts….

Mr Jones please!

Dr Stevens waited for his ten o clock. It was a new patient, Mr Jones. Even though it was the first time he’d seen him he was pretty confident that the new psychological methods he’d learnt in his training would solve the old man’s problems.

so, Mr Jones, what seems to be the problem?

well, Dr Stevens, my GP says that you are trained in the new way of treating anxiety - graduate exposure therapy?

Dr Stevens grinned. It was a new therapy and most of this referred got the name wrong. But at least the referrals were pouring in.

“yes, Mr Jones, I am. So the aim of gradual exposure theory is that we can help cure you of your anxiety by you working through a slope of exposure - so talking about the thing you are anxious about, to looking at pictures, then as you progress going to places where it might be found and you may as one of our advanced patients even be able to be in the same room!”

that’s wonderful doctor, my life has been very difficult with all the anxieties. I hope that this therapy will finally work”.

the atmosphere in the plush consultation room changed then, as Dr Stevens looked at the referral letter from the GP.

ah he said. There may be some… logistical obstacles.

”ohh”

Dr Stevens sighed. Exposure therapy was indeed a great new advance in medicine. The problem was…
the problem was….

”you see Mr Jones, I see you have shell shock, from your time in the Army. We can arrange for graduated exposure to the First World War battlefields for you - in fact we have a great programme here in London at a very reasonable cost. The difficulty is arranging a land war in Europe. There’s also a problem with those patients who have anxiety from the Second World War - we’re trying to negotiate with the European governments to arrange a land war in Europe - and they are being remarkably helpful I must say … but the French want to re-enact world war 1 and the Germans prefer to re-enact world war 2. So you may have to wait for your exposure therapy until agreement is reached on which land war in Europe will take place.

i don’t supppse you’d consider Russian warfare on the eastern front as a substitute for the Somme?

no?

oh well I am very sorry Mr Jones.

good luck with the rest of your life.

You could try going for a walk in the countryside. At least that's what the locum doctor told me when I tried to renew my prescription. Apparently fresh air cures autism and the associated anxiety. (Thankfully the next dr wasn't so ignorant)

Well you are presuming, because your title says "the only way..."

People are not personally attacking you; they're "attacking" (or rather, criticising) your opinion. I get the narrative around "I'm just stating my opinion, we can all agree to disagree" but the reality is that actually, some opinions are worth less than others.

What are you using as your measure of what you can survive here?

“life is full of discomfort and we have to learn to accept it”

I’ll have to remember to use this in my sessions next week, when I’m telling people to grow a pair and get on with it!

Haven’t rtft, but the key with exposure is ‘less is more’. Over-exposure makes the anxiety worse.

Start with the smallest baby step. Continue the expose until the fear subsides. repeat that step until there is no anxiety. Then take the next step.

Eg if a child is afraid of water you don’t chuck them in a pool and say “see! water’s fine!” The child is going to be in panic mode the whole time and the horrible experience will make the anxiety worse.

You would start with the lowest level of anxiety the child has, eg being by a river. So you would take the child to a calm river with some sweets and a story and have a picnic. stay there long enough for the child’s low level anxiety response to subside. go there regularly, until the anxiety no longer appears. When that happens, it’s time to move up to the next step (eg picnic by a rushing river). If the anxiety doesn’t subside, you started with something to hard and need to go back a level. For some people just talking about the thing they fear is enough of a first step.

Apologies I didn’t see that comment.

This is absolutely true.

Its basically the heart of CBT.

And to agree with a pp the title of the thread is

The only way to overcome anxiety is through exposure

and that is frankly bullshit. Unless you want to expose people like me to our trauma events over and over?

I’ll remember that when I’m talking to my therapist about my rape

I had a severe phobia and it was quite easy to avoid. In the end I had hypnotherapy done by someone with a background in neuroscience. He explained the fear response and gave me a few exercises to do to try and retrain the brain. Then I had the exposure and I was exhilarated not afraid.

So exposure is good but you need support which for me was hypnotherapy. I think EDMR has a similar approach to hypnotherapy and this is used for people who experienced trauma. I knew someone who was in the place a terrorist attack happened and you can imagine he was traumatised. EDMR helped him enormously.

I think a lot of people have anxiety about something but you wouldn't know because they hide it well or exposure is easily avoided. Also some anxieties are socially acceptable and some are not. I have a friend who won't walk home late at night in London and it doesn't bother me much. For whatever reason that's not my anxiety but society accepts my friend's anxiety as reasonable.

Anxiety can be pervasive with multiple triggers, from social to sensory and cognitive. Children absolutely can have a physiological fight, flight or feeeze response - particularly during autistic shutdown/ burnout. I don't think you know what you're talking about if you don't understand this. Those things you've listed? My reply would be 'all of the above'. Here's my list of her triggers, let's see what you suggest:

• Cooking smells (dinner hall) and other smells
• Unexpected loud noises (assembly, dinner hall, classroom)
• Group dynamics (all)
• Fear of pain
• Fear of being sick, or around others who are sick
• Loud, overbearing teachers
• Being too hot and unable to control it
• Being too cold and unable to control it
• Having personal space invaded/ unexpected touch
• Fear of blood
• Vegetables that are not broccoli or peas
• Mess and clutter
• Germs
• Slow verbal processing speed and comprehension
• Fear of making mistakes
• Test pressure/ perfectionistic tendencies

Now, she's held it together for long periods and fallen apart for long periods. But when you look at this list and apply it to a primary school environment, it's not hard to see why she's fallen apart, why it takes so long for her to recover and why repeated episodes cannot be avoided - no matter how much you 'control' exposure (you can't in a school environment).

Gradual reintroduction to school will happen. So too will more episodes of burnout. People talk about 'resilience' - ND people are actually some of the most resilient people you'll meet precisely because they're repeatedly exposed to the things that cause them the most difficulty. But at great cost.

YANBU and any decent parent would be encouraging their child out of it instead of indulging and feeding into this ‘oh they can’t possibly because they have anxiety’ narrative.

Parents like this aren’t doing them any favours. You’re setting them up for a lifetime of claiming benefits and hiding away when they could have a chance with real support and encouragement.

@Taztoy - you have taken over OP's thread to the point it isn't what she was talking about any more. I wonder what you want to achieve here? No one here is comparing general, treatable anxiety with severe sexual abuse and PTSD.

With trauma events the exposure wouldn’t be to the trauma event obviously. But if the trauma related anxiety is impairing somebody’s access to something then exposure to that might help their brain feel safe again. So if somebody was attacked in a park, they may become agoraphobic. Very slow exposure to the outdoors and open spaces could potentially help them overcome their fear of being outdoors.

Nobody is suggesting that they be attacked repeatedly!

The Baz Lurman song Everybody's Free (To Wear Sunscreen) has the line 'Do one thing everyday that scares you'. When I'm having a moment or procrastinating about doing something anxiety inducing I remember that line and think 'This is that one thing today' and do it.

Often, that's the catalyst for doing other scary things because I'm geared up but I tell myself I only have to do the one thing and then I don't have to do anything else. It works for me.

@Passaggressfedup I suspect you won't return to this thread

But I feel like you're working with some Disney version of anxiety

I've had such dreadful anxiety over the years, I've had to go to work to pay the bills but the anxiety is still debilitating - I got off the bus to work because I was so anxious I thought I was gonna throw up, I got back on the bus because how else do the bills get paid? It's exhausting. And in many periods of life, it happened every day.

Anxiety isn't necessarily a fear of something in particular - some of us are just anxious.

Therefore, you can't use exposure therapy to get better from it

You don't really understand what it is in a clinical sense

And I don't think you understand that some of us are stuck with it permanently

I am still able to go out and work, but they are a huge number of things that I can't do because I have to recover from all the effort trying to manage the anxiety to go to work

Does that make sense? So I end up living a very small life.

If someone tells me to get over my anxiety over something that I don't have to do - fuck no. There aren't enough hours in the day to manage that.

By the way, I don't have help from the state or anything. No benefits or anything like that I mean although yes, I have had medication from the NHS for decades. They're putting the lid on that I can tell you that now.

So me being anxious doesn't affect anyone except me

I don't really know where you were going with this thread - if you don't know anything about it, that's fine. I don't bother learning about medical conditions that I don't currently have. Again, that would take all bloody day.

But why did you feel the need to start a thread? I don't get it.

i'm a big fan of not commenting when I don't know anything about a subject.

Or else questions in order to learn more

I don't start mad threads that are bound to upset people. You can see from the responses you've had here, there are many many types of anxiety that are not going to respond to "exposure"therapy

I was the victim of a similar crime 25 years ago (very violent stranger rape, tried to kill me and would have succeeded had he not been disturbed).

I had months of therapy at the Maudsley trauma unit, and it did indeed consist of going over what had happened very slowly and in detail, stopping immediately I felt any panic, working up to visiting the site (which happened 4 months into treatment and took several attempts - passing through the nearest station, getting off at the station, going outside the station entrance, going to the end of the road it happened on, etc etc). So, gradual, managed exposure. My starting position was being unable to leave the house unaccompanied (this was over a year after the rape), and having a panic attack if I had to think about it (I couldn’t even complete the pre-therapy assessment forms myself because I was crying too much).

Of course I still find discussions about rape triggering, depictions of rape on tv triggering, etc. and I don’t exactly hang around the place it happened. But I no longer have severe PTSD.

Incidentally the rape crisis counselling was worse than useless - the Maudsley therapy was specifically focused on treating PTSD symptoms not rape in particular. It would obviously not be sensible to DIY it, but I don’t think OP was talking about people with severe PTSD so much as mild anxiety.

Not anxiety. Why have some people got this stupid idea? People used to know what anxiety was in a medical sense.

And the reason for that is MH provision is broken. Children and young people are not getting the treatment and care they need so treatable conditions become severe and hard to treat conditions. Hence the bottle neck from CAMHs to CMHT. It’s madness and a false economy.

There is a sense in the thread that people should just white knuckle it and get on with whatever they are anxious about. Phobias or anxiety can feel huge and not just a little fear they need to talk themselves out of. The key is support and understanding and if more people were open about their phobia or anxiety I suspect we might be surprised by how many people are anxious about something.

This is really interesting thank you. I was pondering this when thinking about the mismatch between the requirement people are talking about for dedicated long term professional intervention and the incredibly long CAHMS waiting times. And also the fact that with both adult and child services being so underfunded that absolutely have to triage and address the most extreme and life threatening cases first. (I have had experience of trying to get help over a number of years for an adult with severe mental health issues so I have long term exposure to the limits of what is available)

Especially for those that can’t afford private care an investment in your own skills and education in supporting your child seems essential. Young Minds has some good online resource and I’m sure there are many other routes.

I think confronting your fears is fine in principle but it's very simplistic to think that solves things for everybody.

I am mentally danaged from chidhood emotional neglect, have very low self esteem and self worth, bad life experiences and I am Autistic. I've had social anxiety all my life but living alone during COVId isolation has set me back to a place I can't recover from. I've had CBT and seen a Clinical Psychologist and honestly now feel my problems stem from my essential being and no amount of trying to face my fears is going to alter me..