The most problematic behavior for most people who struggle with anxiety is avoidance. Whether it takes the form of avoiding travel, social interaction, dirt and germs, or avoiding tasks through procrastination, avoidance not only interferes with moving toward your goals, it actually acts to keep worry and anxiety in your life. By avoiding the things that we fear, we deprive ourselves of the only experiences that can disprove or change our fears. To reverse this vicious cycle, it is important to engage in the opposite of avoidance exposure. This means beginning to engage in those activities that you have been avoiding. It may also mean blocking or preventing behaviors that reduce anxiety like checking and re-checking, washing or cleaning, or seeking reassurance from others. These are all forms of avoidance.
Research has consistently shown that exposure of some sort is a crucial component of successful treatment for any type of anxiety problem. There are two critical facts that many people fail to understand about exposure:
- Exposure without anxiety is not exposure. Researchers have tried to determine what it is that makes exposure successful as a treatment for anxiety problems. In repeated studies, the actual activation of the fight-or-flight response has been found to be a crucial factor. Clinical studies have found that those individuals who benefit the most show increased heart rates when beginning exposure. Those who showed less signs of reactivity during exposure benefited less from treatment. As you practice exposure, one of your goals will be to heighten and focus on your feelings of anxiety.
- Exposure is always intentional. You may be thinking "I don't need to intentionally seek out exposure. I experience anxiety and worry every day just going about my life. That's exposure enough." The problem with this statement is that it misses an essential aspect of what exposure is. Part of what makes exposure work is that it is intentional and purposeful. Exposure is something you do, not something that just happens to you. When you intentionally choose to engage in exposure, inherent in that intentionality is an increased willingness to experience anxiety. Exposure helps you to develop willingness, in part, because it is intentional.
The purpose of exposure is not to reduce your anxiety, or to take anything else away from your experience. Rather, exposure is an opportunity to add the elements of acceptance and mindfulness to your experience. By slowly exposing yourself to the very things that you have been avoiding, you have the opportunity to practice and develop acceptance of the feelings and thoughts associated with these things and to increase your willingness to have these experiences. Over time, this can change your experience of anxiety.