Anxiety and Exposures- How Long Does it Take?
Exposures and Response Prevention for Anxiety
I’ve Done Exposures-Why am I Still Anxious?
Doing an exposure, a behavior that deliberately ignites the anxious response, feels counterintuitive. You are expected to invite the feared stimulus, bring on the anxiety, to make it dissipate? That can be confusing and feels wrong. Aren’t we supposed to avoid danger? But you decide to do it (whatever that feared thing is, going outside of your house, driving, going to a grocery store or a party). You get scared, feel the symptoms (increased heart rate, sweating, shaking, dizziness, derealization, etc.), get through it (yay!) and feel great, only to feel anxious again the next time you set out to do it. You then ask yourself why you are still experiencing all of the symptoms? Why do you continue to feel fear? How many times do you need to do this? Will you ever not feel anxious?
When I was teaching my teen to drive, I felt the physical and emotional symptoms of anxiety every time I got into the car with her. We agreed that she would drive to and from school (approximately 5 miles each way) every day for a few months to gain the practice and hours required to pass her driver’s test. She felt good about it; I dreaded it.
For the record, I did not start out driving the 5 miles. I began with the exposure of being a passenger in the car sitting in the back seat while my husband sat in the front passenger seat as my daughter drove to a local restaurant. My anxiety symptoms were present. I then did short trips without my husband sitting in the front seat as my daughter drove to a local store before doing the more challenging exposure of driving with her to school.
It was not easy to subject myself to the experience each time. There were many a day I was looking for excuses not to let her drive. If it was raining, I took the wheel. If she was late, in a hurry, not feeling well or tired she asked if I could drive and I of course said yes. When this happened, I was so relieved and happy. But these respites from hell for me were less frequent than the days she actually drove, so in spite of excuses we had plenty of time to do the driving exposures.
Being an anxiety specialist did not give me a pass on the experience of anxiety. I was scared to drive with my daughter every time I got into the car with her. There were plenty of times I did not face my fear and drove instead of having her drive. I am human and failed at persevering through the fear at those times. And that is the land of exposures. The process is not linear. There were plenty of ups and downs, times when I felt good and not so good. My anxiety symptoms did not decrease overnight. I had to drive over and over and over with her and expect every time I would be anxious.
I noticed over time that I was most anxious during the first 10 minutes of driving. After that, my anxiety decreased a bit and I actually remember telling myself, “This isn’t so bad.” After the 2 months passed and she attained her driver’s license, I still was anxious when driving with her, but it had decreased significantly. Now (years later) when I drive with her, my anxiety is a 1 on a scale of 1-10.
How long did it take me? The time is different for everyone, but I remember feeling less stressed after a few days of the exposures. I don’t remember exactly when there was a major decrease in symptoms, but I did stop looking for them, and just acknowledge that I was going to be anxious for a while, and that those feelings and thoughts were temporary. I knew once we were home, I would feel safe and comfortable, and content that it was one more successful driving experience that my daughter completed.
This was the mindset shift that my being an anxiety specialist was beneficial for me. I knew I had to acknowledge that I would feel the symptoms each time, instead of focusing on the presence of them. I had to remind my brain and body I was ok and driving with my daughter was not necessarily dangerous. During these times I did some cognitive reframes like reminding myself I was 99 percent confident we would make it to school without getting in an accident. I thought about the other teens going with their parents on drives and them also getting to and from school safely. What I did behaviorally was tolerate the unease I had every time I got in the car, and not do the automatic response (well most of the time) I wanted to do which was to drive myself. I believe my attitude of what anxiety specialist Joshua Fletcher refers to as “willfully tolerate” the anxiety was the key to the “how long” question. When I accepted the fact that I would be anxious instead of putting all my attention on the fear of the anxiety, I made the eventual progress.
Doing exposure work is difficult. You are having to behaviorally demonstrate that there is nothing to fear when your anxious brain tells you that there is danger and you should avoid this exposure to keep safe. If you let the anxious brain get its way, you live a life that is very compromised. It takes bravery and courage to challenge your anxious thoughts and perseverance to keep doing it again and again. And it is the way out. Stay with it. Use self-compassion when you are or aren’t consistent. View the exposures like experiments, dialing it down if it was way too much, adding more when it seems too easy or you are not experiencing the anxiety symptoms. And when you do an exposure, congratulate yourself! You did something very hard and deserve reward. Contact me for help on conducting exposures with your individual experience and I’m happy to guide you so that you can overcome the limiting effects of anxiety in your life.