Tackling Safety BEHaviors Part 3

Tackling Safety Behaviors: Part 3 
The Power of Exposures
​by Hayden Beach

Last week we learned about what safety behaviors are and how we can bring awareness to them. Now, it’s time to dive into challenging these behaviors through exposures. Through exposures, we learn that what we fear doesn’t come true and/or when hard things do happen, we cope better than we expect. Exposure activities help us to test our predictions or negative assumptions, and build confidence and a sense of safety. When we approach feared situations intentionally and stay in them long enough to learn, we learn that our anxiety may rise, but it eventually falls and we can navigate this without the reliance of maladaptive behaviors.

Exposures
In CBT, we use exposures and behavioral experiments to test our predictions. In our weekly social anxiety group, we've worked on gradually dropping these safety behaviors by creating a “fear hierarchy”. In this exercise, members list anxiety-producing scenarios and rank them in order from least to most anxiety-provoking.
Some exposure exercises may look like:
Calling a restaurant to order takeout rather than ordering online

• Turning off our phones during social interactions to minimize distraction/avoidance 
• Make direct eye contact during conversation
• Show up to a social event alone/without a “safe person” 
• Interrupting a conversation to share your opinion or introduce yourself 

Climbing the fear hierarchy ladder is designed to help people realize that they can navigate difficult situations without relying on these coping mechanisms.

Troubleshooting: What to do when exposures aren’t working 
Sometimes, exposures don’t always seem to work right away and we might feel stuck. When this happens, it's important to remember that the effectiveness of exposures comes down to three things: frequency, intensity and duration. 

​Common errors occur when people do exposures 
 
Too infrequent: Since exposures are uncomfortable, it's easy to fall into the habit of not practicing them enough. Only practicing exposures every once in a while makes it hard for us to truly learn and become comfortable with new situations. 
 
Too intense: Jumping head first into your most difficult exposures before gradually working your way up can feel overwhelming. In CBT, we like to work our way up that “fear hierarchy ladder” and start with something small. Try starting with something small (moderately challenging and uncomfortable) and through each activity, imagine you’re climbing this ladder – eventually tackling your highest fears. 
 
Duration: Not staying in the exposure long enough prevents us from actually experiencing the situation in its entirety. If we exit a situation before our anxiety has a chance to rise, we won’t be able to experience our anxieties eventual decline – which prevents our learning. 
            
If you come across some of your exposures not working, it's likely that the frequency, intensity and/or duration of the activity is playing a role. Taking these three factors into consideration during your next exposure can help you adjust the activity, not abandon it. 

Moving Forward
Safety behaviors are difficult to kick because they actually do work and provide us with that temporary but immediate relief. However, that relief is only short-term and contributes to our anxiety in the long-run. Understanding what they are and why they are harmful can get us moving in the right direction. The goal isn't to drop these behaviors all at once and jump into our most feared situation without a sense of safety, but rather to learn through each experience that we are capable of managing and surviving difficult situations without these maladaptive behaviors.