Exhausted and frustrated, clients come to me hopeful that freedom from anxiety is still somehow possible. As an anxiety specialist, I offer them something quite simple. I am an outside observer who can see all of their strengths and potential. I can call out from the sidelines, "You can do this," and "Just because your anxious brain says you can't handle it or something really bad is going to happen does not make it true."
Something remarkable happens when you make contact with your fears: When you allow yourself to experience your deepest darkest thoughts, they immediately become less ominous. They become something you can observe and experience and move through. The key to making contact with feared material, and then becoming free from it, is to create a realistic plan of attack. We call this an exposure hierarchy, which is simply a list of stimuli that cause increasing amounts of anxiety.
The point of creating this exposure hierarchy is to make facing your fears less overwhelming. If you have a fear of heights, you need not jump out of an airplane to move past this issue. If you have a blood phobia, you need not volunteer to work at a blood bank... at least not as a first step. Yes, you are determined to work on your anxiety, but no, you have no intention on licking toilets to get over contamination fears or immersing yourself in a bin of spiders to get over a spider phobia.
No step forward is too small when facing your fears. It is more powerful to take teeny-tiny baby steps forward on a daily basis than to take a gigantic step forward and get stuck and overwhelmed. Movement and flexibility are key, not Herculean feats of bravery.
It is critical to set realistic daily anxiety-fighting goals. When my clients review their weekly homework assignments, I ask what might get in the way of their achieving these goals. I always encourage smaller and more realistic assignments that are likely to be met instead of large sweeping goals, which just set you up for feelings of failure. Nothing takes the wind out of an anxiety-treatment plan more than self-blame and criticism. A dash of, "What is wrong with me, that I could not accomplish X?" and you quickly find yourself at "What is the point... I should just give up... this is hopeless."
To reduce the role that anxiety plays in your life, first ask yourself, "What is one thing I can do today to face a fear?" Rate your ideas on a scale of 1 to 10 (1 being the easiest) of how anxiety-provoking they would be to engage in exposure exercises. Try to identify an exercise that would not be too easy yet not too hard; shoot for an anxiety level of 4 to 6. Make a commitment to go for it today, tomorrow, and forever more. Every day is a good day to face a fear in a small, bite-size serving.
For assistance in creating your exposure hierarchy, contact a mental health professional trained in cognitive-behavioral therapy (CBT) or pharmacotherapies, or both. You can search for a therapist in your area on the ADAA website to help you with this challenging, but very important work. Consider taking a look at the self-help materials on the ADAA website, including Facing Panic: Self-Help for People with Panic Attacks.
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