Exposure Therapy: Anxiety, Panic, Phobia, &
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- čas přidán 2. 06. 2024
- Exposure and Response Prevention Therapy is a highly effective therapy for treating high anxiety, panic disorder, phobias and OCD, but very few therapists are trained to help their clients using ERP Therapy.
It is called Exposure and Response Prevention Exposure and Response Prevention Therapy rewires the brain by creating new neuropathways when confronted with anxiety-causing stimuli.
Here is a FREE PDF gift for you, to help you get started with ERP, Exposure and Response Prevention.
The Top 10 Things you Need to Know to Practice ERP: Exposure and Response Prevention for OCD, Phobias and Anxiety
www.paigepradko.com/erp
I use the example of the grocery store, but it can be anything that is triggering high levels of anxiety, like being near water, driving in a car, social situations, phobias, certain thoughts and images, body sensations and more.
Be aware, this is best done with an experienced therapist, who can guide you through the steps of setting up hierarchies and completing each exposure.
#PaigePradko, #ExposureTherapy, #Phobia, Agoraphobia, #panic, #howtodoexposuretherapy, #exposures, #Exposureforanxiety, #exposureforphobia, #exposureforAgoraphobia, #howtodoexposuresforphobia, #howtodoexposuresforagoraphovbia, #howtodoexposuresforpanic, #exposureforfears, #CalmSeriesforAnxiety
If you want to learn more about how to get the most out of your exposures, be sure to watch this video based on the latest research on making your exposures even more effective.
• 10 Ways to Maximize Ex...
Please drop a comment below to help others who might be in a similar situation. I love reading the comments and responding to them. Please feel free to follow me at the social media sites below:
/ paigepradkotherapy
/ paige.pradko.therapy
/ paigepradko
www.paigepradko.com/
I would love to hear your comments and questions below. If you would like your question considered on an upcoming Q & A video, please let me know. Thank you for helping me spread mental health help and education.
Until next time...I will see you in session,
Paige
Here is a FREE GIFT for you. A PDF to help you get started with Exposure and Response Prevention.
The Top 10 Things you Need to Know to Practice ERP: Exposure and Response Prevention for OCD, Phobias and Anxiety
www.paigepradko.com/erp
So I just let these guys be
I have developed a sound phobia, I live in a appartment and I get anxious when I hear doors slamming by my neighbours.I use noise cancelling headphones when I'm at home, but I will try not to do this all day.Thanks for this interesting video.
i was depressed at work today and planned to leave early. but i made myself stick it out, and in about 90 minutes or so i felt much better
in public i feel like some other men are staring at me. my initial reaction is to get away, but eventually my paranoia subsides, and that doesn't bother me as much
Great job! By sticking it out, and staying at work, you helped yourself learn that you can tolerate difficult emotions. Thank you for sharing. 🙌💪😊
Three years ago I was diagnosed with panic disorder and agoraphobia. I can’t leave my house without a “safety person”. I’m a single mom who can’t drive because I am terrified that I’ll have a panic attack (the car is where my panic attack after an accident happened and the event that triggered all of this) and my family doesn’t understand, they tell me to “get over It”. It’s caused a huge rift in my entire family because they feel I need so much help. I live alone with my two kiddos, work full time, but can’t grocery shop or take them to the park by myself. I’ve been in therapy for years but never heard of exposure therapy. I’m so, so hopeful and grateful to further research this and watch your other videos. I can’t live like this and my kids don’t deserve this.
Oh my gosh, Shelli. I am so sorry that you are dealing with those conditions. Yes, exposure work is exactly what you need to be working on to recover from panic and agoraphobia. I have a course that will lead you step by step through the process. It takes time due to the repetitive practice needed, but the course tells you exactly how to do it. Here are a few links to help you:
PDF: What to do when Panic Strikes: FACE Fear
paigepradko.com/facefear
Panic Attacks Quiz
www.paigepradko.com/panic-quiz
Your Panic Attacks Are NOT the Boss OnLine Course
www.paigepradko.com/panic
How are you now?
It’s so nice to see people being nice to each other in the comments. Thank you for this video! It was very informative!
Thank you. I appreciate it 🙏😊
I’ve been stuck home for close to 2 years now as I’ve been very afraid to leave, however I feel much better knowing exposing myself to those triggers is what’s going to eventually fix me thank you very much for the information.
I am sorry that you are experiencing this, but, I happy that you found the channel. I hope that you can find support here. I have a playlist for agoraphobia and I will have online classes available in a few months to help people with agoraphobia.
@@PaigePradkoTherapy Thank you very much Paige, I honestly do not know what I would have done without your channel
I just came from the agoraphobia subreddit to watch your video. Thank you so much for spreading awareness about this evidence based treatment. I hope it helps people. Personally, I am concerned because I don’t feel that I could handle the distressing symptoms I would endure. My panic attacks are better than they were years ago, but even now, a panic attack will leave me with high anxiety for the rest of the day. It doesn’t come down 50%. I have the panic attack and then feel traumatized from there bc I also have a trauma history :( idk what to do and I’m sure other people have trauma along with agoraphobia since trauma and phobias are interrelated
Your comment is so important. A trauma history can complicate every condition. I would especially concentrate on somatic techniques in your case before you ever begin gradual exposures. If you visit my playlist page, you will find a series called Calm the Body. These techniques will be important for you to practice daily. I have a restorative, meditation video going live this Wednesday that I think you will enjoy. I hope that you are able to find compassionate help to gradually guide you through trauma treatment and Exposures. Thank you for your comment.
I'm in the same boat as you are. I also most likely suffer from PTSD, becaused i witnessed a catastrophic event as a child. Pure exposion therapy is living hell for me and barely gets better with repetition. Unfortunately thats all therapists have to offer :(
Torsten Oppermann there is so much more that therapists can do! You probably need to process your trauma safely with a therapist and heal somewhat from that before the exposure. Also the advice this therapist just gave me above might be applicable to you as well! I’m in the counseling field as an intern rn and I assure you that there are options. Don’t give up 💖
@@juliejealousy Thank you. That means a lot. I probably should look more for trauma therapy. Thanks again
Hey how are you now? Are symptoms of panic or anxiety still strong?
Yesterday I reached a point where I thought I'm never gonna be cured and no one can help me or understand me. Now that I found you, I'm so thankful that you're helping me getting the right information about how I can be treated. Thank you so much for sharing. Your help makes me feel like I can do it too and the world isn't that scary for me🥺❤️
Thanks for sharing! I have lots of information that I share about exposures. You can work at this at your own pace. ❤️
"Do what you fear to do and brave the sensations." "Sensations are distressing but not dangerous". "The idea of danger can be stopped by the Will". Dr. Abraham A. Low
❤️
I cannot afford not to write this beautiful comment, your video on agarphobia is so well done, everything what your saying make so much sense and anyone who has agoraphobia can understand how deeply you understand the issue and the explanation and helping tricks is so amazing, I’m really really pleased to know your channel. Wish if I had to know it long ago.
You are so kind. Thank you very much. You make me feel appreciated 🙏❤️
i have been struggling with agoraphobia for 14 years now (i'm only 27 years old). i spent many of my teenage years being homebound etc. now i am able to leave the house but i am still overwhelmed by fear and anxiety constantly. my comfort zone is so small and i lost all of my 'safe' people so i feel like every time i leave the house it's a battle for me and my mind. i have been on benzodiazepines for 10 years now but once i was prescribed clonazepam 8 years ago, it really helped me. i was able to do small exposure therapy on my own until i started doing flooded exposure therapies daily until i was no longer homebound! now that my comfort zone has gotten so small again and i've been so dependent on benzos for so long, i am fearful if this medication is ineffective to any exposure therapy that i try. i want nothing more than to not be afraid of being in the car and go places and live freely but i have no idea how to achieve this. i'm starting to feel helpless and lost again and like my life will never be free from this anxiety hell. :(
I am so sorry that you are in that situation and I know how lonely and hopeless it can feel. But…I hate to sound trite but there is always hope and a way out. The process is time consuming but possible. I have spent my career working with people with agoraphobia and later this year, I will begin a course and group zoom sessions to help people manage their exposures. Please feel free to sign up for my newsletter at paigepradko.com if you would like to be updated when those options begin. Sometimes benzodiazepines can be used effectively when people are just starting off with their exposures and then slowly withdraw from the medications while continuing with exposures. However, continual daily use of course may lead to more serious problems down the road. My recommendation would be to keep doing your exposures and get some good advice from your medical providers about how to manage a very slow withdrawal of benzodiazepines over the course of a year or even longer if needed. I realize that the thought of going off benzodiazepines can be scary after having them calm you for 10 years. Unfortunately, they can create even worse problems with long term use and withdrawal must be very slow and monitored closely by your physicians.
Benzos gave me agoraphobia. It is a wicked symptom of our body becoming tolerant to the effect of the drug on the brain. Many people suffer after taking benzos for anxiety. The medics are ignorant. How are you now?
Beautiful .
🙏❤️
Thank you, this was very informative!
You’re welcome. Here is a bit more information about exposures czcams.com/video/439l0c-P3lg/video.html
So soothing to hear you. Thanks for your helpful talks.
You’re welcome. And thank you for your kind words 😊
She's great 😍
loved it thank you :)
Thank you. Love your user name 😊
Yours are the first vids i started watching to learn about ERP. I'm so grateful for your presentation style and thoroughness!
Thank you. I appreciate that. ❤️
Very informative detailed very helpful very well explained...
Thank you 🙏
thanks Paige, very helpful
Thank you for watching and commenting…I appreciate it 🙏❤️
Hi Paige,i think all your videos are very helpfull in many ways,and you do well at explaining the information you bring,keep more of this kind coming thank you,love Denny😘🙏
Thank you, Denis. I appreciate it.
Massively helpful🙏🏽
That’s good to hear.🙏❤️
Hey, I really love your videos and wish I found these years ago, you’re doing great work. Liked and subscribed.
One thing I’m struggling with on exposure training...my panic triggers are a bit hard to properly expose myself too as the main ones impacting my life at the moment are underground tube trains and elevators. However it isn’t the lift or train journey itself but the fear of them getting stuck.
So i’ll be on edge a bit for the journey, but it’s only when a train comes to a stop mid tunnel that i rapidly escalate into intense panic. Then as soon as the train moves again (usually a minute or less), it subsides and huge relief fills me.
Same with elevators (was in a broken down one in the past which has really clicked my panic attacks up quite a few gears). I’m anxious but not panicking fully for the journey, but only when it lurches or takes longer than normal to open it suddenly starts overwhelming me.
I feel like these short bursts of panic followed by relief are possibly not effective in exposure? Possibly detrimental? It makes me dread and avoid them completely, and I’m fighting and forcing myself to use them whenever i can as part of the process.
Sorry for the ramble but I’m really desperate.
Thank you so much for your comment. Since we just communicated about these particular triggers, I will not leave a lengthy response here. After learning that you will be spending more time on exposures on the train, I believe you will see great results there. Elevators are more challenging because you can eliminate the panic by riding one elevator for 90 minutes up and down, over and over, but then, you have to include multiple elevators as well. If you would like more help with panic and really leaning into the feeling and welcoming the panic, I cover that on my Panic Attacks Series on my playlist page. Thank you again for your comment.
Paige Pradko LPC NCC thankyou sooo much , you are a true helpful person, I have tears in my eyes . God bless you , I have no words for your corporation with me . If you start any on line sessions , please don’t for get me .Are you in Canada ?
Shamaila Amar, I am in the US. But, if I do any online classes, I will let you know. 😊
You are amazing
Thank you for watching and supporting my channel 🙏
You explain everything so simply ❤
Thank you so much 😀
I just went outside with my dad for the first time in 8 months a few days ago! I didn’t have much of a plan other then I just try to step outside for one minute and come back home but I wanted to get into the habit of going outside everyday just to get used to it.
Im go glad I found your channel. This is the first video I saw and such good timing as now I plan to write all my fears and do a hierarchy of small steps to gradually real my goal and then move on to the next thing.
I was sick for 10 years with stomach issues, had a feeding tube for over 6 years and unfortunately has many traumas in the hospital, mistakes that happened which led me to have severe panic attacks, agoraphobia, PTSD etc. I also have a lot of deficiencies which make me feel weak and dizzy and as sometimes have vomiting all day but I’m working on my treatments to get better with my health as I feel when my stomach issues get better and I can eat more drink more water and as hydrated that will help me be more alert and actually have some energy. Sometimes I can’t walk much without help but it’s not just the anxiety but just because of my illness. So I thought of waiting to go out until I feel better but then I realized that’s not helping me.
So after 7 months of not being able to go out due to my anxiety and agoraphobia, I went out with my dad for a minute and came back home. I felt unwell and really weird like I didn’t even know where I am and I know it’s because I’m the last few years I only went out a few times.
I am on medication but slowly been weaning and right now I take one benzo very low dose now few times a week. It’s been hard weaning but I’ve made a lot of progress.
My goal for this week is to stay outside my home for 10 minutes. And work my way up with my fears.
I am so proud of you, Amira. You have been through a lot and most likely have ptsd from your trauma in addition to anxiety. We all have to start from somewhere. Just keep up the exposures every day, and you will make progress.
It's a struggle... It's like living in a prison of your own mind. It started 2014 for me, but I fought it off. I stayed anxious, but no more panic attacks. It just now started to get bad, 2 months ago. I started to have panic attacks again and can't go to the store...
@@aleksandrapopova9549 I used to have PTSD and Agoraphobia but I overcame it with a treatment called Neurofeedback or Biofeedback. I would highly recommend looking into this treatment for yourself. It helps reprogram your brain back to normal. I had agoraphobia for 7 years now I have no problems and I went on vacation recently. The struggle is real.
@@victoriavuncannon4740 Can you travel other countries ? Where did you get this treatment Neurofeedback or Biofeedback ? Thank you so much being so hopeful
You are a strong valuable person who brings a lot to the world. You deserve and good life and sending you positive thoughts.
Very helpful. I find office parties stressful.
Wow! Lots of good and interesting information.
I’ve tried exposure therapy many times but almost always have use Ativan.
Thanks Paige
I am glad it was helpful 😊
I'm studying for the NBCOT exam and this was helpful. Thanks
That’s great. Good luck on your exam.
Very informative video.. thank you!
My pleasure. Thank you 😊
Thanks for this beautiful video. You're ways of explaining things and talking is so calming. This really lift my spirit up. I learnt a lot from this. Thank you very much ma'am. More power and God bless!
Thank you. I am happy that you liked it.
@@PaigePradkoTherapy ❤❤❤
Great video as usual!! I like how you talk about exposure therapy specifically in the context of bodily sensations. I struggle with chronic fatigue and pain, and I've been trying to use exposure therapy but it can be difficult when I can't control when or for how long I'm exposed to my symptoms. I'm looking forward to the strategic exposure therapy video :)
Yes, Exposure therapy is difficult. Chronic pain and fatigue are so challenging and you are wise to set your exposure challenges according to what you know may be difficult but achievable. Flooding yourself may be just too much for you. Using the gradual method or the strategic method may be best. Once you begin to have success, the exposures begin to get easier. I can almost see the transition my clients make when they finally feel their anxiety come down during an exposure and they understand what it is that they have to do to retrain their brain. Thank you for your comment and I sincerely hope you feel better.
@@PaigePradkoTherapy Thanks for the reply! I guess my biggest problem is not knowing how to be in control of strategy since I can't control when stressful symptoms will happen. You mention in your video that using calming techniques interrupts the process. Perhaps I can choose my "exposure" based on whether or not I use those techniques in the moment. This is so helpful!!
Great video
thank you 😊
Hi Paige,I wanted to say it”s nice to see you again,and of course I had to watch,and listen to your video again,I say was interesting to me, thank you,love Denny😘⭐️and🌙
Hi Denny. You are so kind. Hope you are well.❤️
Paige my dear you are a Wonderful person. I'm Tremendously grateful to you for making such an excellent video.
Thank you Uzma. You are so kind.🙏❤️
Thank you....just thank you
You’re welcome ☺️🙏❤️
@@PaigePradkoTherapy Hi paige please get back to me. I emailed and texted you aswell. I need you as my therapist i am struggling big time. You can really help me i know. I am ready to pay any of your fees aswell. Please get back to me. Thanks
@@findyaar I am so sorry. For some reason, I have not received your messages. Can you please leave me a message on PaigePradko.com. Then, I will have your email to respond. Thank you 🙏
Hi Precious Paige,i say good video with pertinent information that would help many others in this kind of situation not knowing much about it all,keep more videos coming as they are good choices, thank you,lovin’it,love Denny😘😊😇🦋🧩🍓⭐️and🌙❤️
Thank you so much, Denny 🙏❤️
You are Blessings maam...
Thank you 🙏
Hello, so glad that i found your channel. I deal with severe anxiety,it started from emotinally disturbing stuff in my childhood and since then i've been trying to overcome it. The problem is,about a month ago i started having intrusive thoughts. Like,bad ones. They are mostly about me harming the people i love most,without me actually wanting to do that and these thoughts and images give me such a dreadful feeling,they make me feel like i will lose my mind and my control. Although i have never lost control,and i know it and i have all the evidence in the world that i do not want to harm my loved ones and of course,that i won't do that ever,the thought that i might be wrong comes up along with all the terrible images. I have to mention that these thoughts do not come up often. And i think,after analyzing as rationally and logically as i can,that i do not have compulsions,apart from wanting the thoughts gone. I am currently seeing a therapist,but she never mentioned Exposure. I told her about what i've read,she encourages me to be informed and to never give up,but i feel like Exposure would help me.
Given the fact that most of my intrusive thoughts involve knives,should i practice exposure alone? I don't really know if what scares me more are the thoughts or being around knives when my loved ones are near me. Should i start with exposing myself to the thoughts? Or should i try to find a therapist that does exposure therapy? It will be kinda hard,because i don't live in the US and the therapists in my country are practicing more Freudian therapy (if i remember it correctly). Thank you again for your videos and your support!
I am so glad that you reached out to ask this question. (Although this does not represent a client/therapist relationship and I am not giving treatment on this channel, I will describe how I might treat a similar client in my practice. It is always advised to seek out professional help.) I know it may be hard for you to believe this, but your intrusive thoughts are very common. I have worked with many clients with exactly the same Intrusive Thoughts. This is OCD, obsessive thoughts only, some call it Pure O. And yes, Exposure Therapy is the treatment that works the best. I typically start clients with staying with their thoughts by recording themselves saying all of their triggers words and phrases and scenarios. Make the recording about 20 minutes long and keep repeating it. Listen to it everyday as often as you can until it doesn’t make you even slightly anxious. Then do exposure with getting a bunch of knives out and put them on the table. Again, do the exposures until you have no anxiety. Then do exposures with touching them. Then leave them out on the counters and do not hide any of them. Basically, we have to expose you to the knives until you have no anxiety at all. You may also want to go to my playlist and watch the video on Pure O, if you haven’t already. I hope that your question helps others as well. Thank you.
@@PaigePradkoTherapy thank you so much for answering! it really helps me,although i won't lie, I was hoping it is not OCD,as i fear that i won't be able to recover 100%,but i guess i will never know if i can fully recover if i don't try it. The timing was perfect,i just finished an exposure session with my thoughts. I didn't record them,but i tried to imagine them just like i do when they give me panic attacks. I don't feel great,but i waited until the fear went down by 50%. I am pretty confident and proud,now that i've completed this for the first time. I feel a little more powerful. Thank you again!
That is so wonderful. You did it! Keep up the good work. Repeat that exposure and continue every day this week. Once you experience the benefit of reducing the anxiety through Exposure, you will not feel so overwhelmed. Great job!
@@PaigePradkoTherapy thank you for your encouraging words! i will try my best. So in the end,there is hope of recovery :)
I have chronic fear of my physical symptoms, lightheaded, headrush, headaches and week legs and arms, I cannot stop happening so this has left me house bound.
I am exposed to these symptoms 24/7 no matter what I do.
I am so sorry, Andrew. Sometimes the physical symptoms are more difficult to endure than the exposures themselves. Those are all symptoms of anxiety. We have to mentally “downplay” the physical symptoms as much as we can, while working on exposures. I do not mean to minimize the discomfort of them. Your body will respond to exposures and you have to give yourself messages that these are “normal” anxiety symptoms and they are not dangerous. Then, monitor what you can tolerate. Some days you can tolerate longer exposures, some days you will need to rest. It is a process of training the brain and the body that you are going to do something new…and tolerate the anxiety because it is not dangerous. The physical symptoms will lag the psychological experience…but eventually will begin to calm. This is a slow process…monitor yourself as you go…but keep pushing forward.
So thankful to God for finding this amazing woman. I have been suffering from panic disorder and agoraphobia for over 3 years and just want so bad to recover but I'm a huge coward when it comes to panic attacks. I really think exposure therapy or flooding will totally help me but when the panic hits i take off and can't handle the fear and feelings, please help.
Hi Mandi. Thank you for your kind comments. It is very possible to retrain your brain to tolerate different levels of anxiety and even panic. I am going to dedicate more time this year to helping people in this area. I have seen such a large increase in people with agoraphobia and can only imagine how the pandemic has exacerbated this condition. So, stay tuned...you will see more from me to help people with agoraphobia this year.
@@PaigePradkoTherapy yes please do more on this subject. The lockdowns and then been allowed back out have affected people so much including me.
Thanks for great video again!! I have had a lot of questions regarding Exposure therapy.. thanks for clearing my doubts. Since I'm on medication.. I was always trying to figure out that How am i supposed to do exposure therapy if i feel better due to meds. I got it now for better recovery i must go through that tough time ( anxiety, panics etc) and let it calm down naturally.
Thank you so much! 🙏
So glad that you are feeling better. Exposure Therapy may be a bit easier for you now. Thank you for your comment, I appreciate it. 😊
At last, a video thst actually breaks down what exposure therapy really is. We all get that its the gradual exposure to your fears, but this is the first video i have found that explains in depth, how it actually works and needs to be done in order to be effective. Thank you 🙏🏼 I have a terrible phobia of heights and open spaces, i have spent the last 2 years pushing my boundaries with the gradual exposure to this environment, the problem i have is that in order for me to feel that anxiety and trigger the amygdala, i have to be fairly high up a mountain or hill. Although i am not in imminent danger of falling because the mountains i chose to climb or of a gradual assent and its actually impossible to fall off, it could still be dangerous if i have a panic attack and my fear response kicks in and makes me decent rapidly and irrationally. This means i often go to a point where i am triggered but i cant stay fir very long in that exposed state, it just becomes too much, and plus, it could be a long time coming down. 2 years ago i couldn't walk across an open space the size of about a footbal park. Now, i can almost reach the summits of many mountains in England, but after all this time i cant walk along the ridges, even the fairly low ones because of the fear of how long it would take to turn back if things go wrong 🤦🏼♂️ I run my own youtube channel (under a different account) so i appreciate it gets very busy to answer these questions, but lol 😁, could you offer any advice as to jow i can tackle this phase that i cant seem to break. In short, when i hit the point where the amygdala is triggered i could be in a fairly dangerous environment which makes doing the treatment very difficult, a panic attack in a shopping centre although is awful its not too dangerous, a panic attack on the side of a mountain or a bridge potentially could be. I hope that makes sense, im sure it does to you 😊 Like i say i would appreciate any little advice and would be happy to pay or donate some money or something for your time 🙏🏼 Thank you so much, and thank you for this video. Much love ❤️
I want to commend you for working on this phobia. I also have a fear of heights and mountain roads and any place involving heights. I refuse to back down or avoid heights. But, it is difficult to get enough practice to extinguish the fear unless you were practicing virtually. But hiking and climbing are both wonderful ways to practice. A panic attack is not going to hurt you no matter where it occurs. But, I would advise you against retreating or heading back if you feel one coming on or if you have just panicked. As soon as your brain knows you are heading back, the panic will reside. That trains your brain that heights are dangerous. Instead, you will want to stay where you are. You can sit, stand or walk around the area where you are panicking. Then, when it has passed, usually 10-15 minutes later, I suggest going a little higher. This is the perfect time to teach your brain that you are unafraid of panic symptoms. I am sending out a newsletter that talks about this in 2 weeks with a photo of me climbing. You can join the newsletter at paigepradko.com. But, keep doing what you are doing. Your job is not to eliminate anxiety or panic. Your job is to tolerate whatever shows up and to not let it stop you from doing what you want to do. I still get anxious on mountain roads…but it doesn’t stop me. ❤️
I have health anxiety and I usually run from it. Try to calm it. This taught me to lean into my body and the anxiety. By learning a new neuropathway, it’s control and affect on me will diminish. Takes practice.
Yes, it takes practice. Move towards the anxiety. If you need help, I have resources for health anxiety at paigepradko.com
Looking Forward to your videos regularly Madam .. Thank You .. Arjun..
Thank you, Arjun. I appreciate your comments and I am glad you find benefit in the videos. 🙏😊
Hi! I just found your channel, and these OCD videos have been so helpful! Please keep posting similar videos about OCD. Much love and appreciation! One question: I experience a lot of groinal responses which trouble me and that is the hardest part about my ocd. They Aways make me go wash myself to feel relief. Should I do exposure the same way you explained it when i experience groinal responses? To just stay with the troubling feelings until I calm down, and continuing doing so until i eventually recover from ocd? Will it be effective and make the groinal responses stop when I have overcome ocd?. Would appreciate an answer so much, thanks for your work.
Thank you for your comment and question. The groinal response is very common with OCD and intrusive thoughts. But, it can be very confusing for people experiencing the symptoms. The treatment is to, as you suggested, stay with the confusion and uncertainty of the body sensations and do not do any compulsive behaviors. I liked this article particular article. www.intrusivethoughts.org/blog/whats-going-ocd-arousal/. Thank you again for your comment and asking such an important question that so many experience.
Thank you mam for you free videos. I come from a country where mental health is not taken seriously. I am suffering from ocd from last three years. And I am currently on ssris luvox but i know that will not change my thoughts pattern so I am practicing erp. By seeing your video. Thanks a lot mam.
Love and respect from India
I am so glad that you are finding help through my videos. I have a few more coming out in the next several weeks that address exposures for unwanted, intrusive thoughts, or obsessive thoughts. I wish you the best.
This is new to me. And a greT challenge on my part to do it alone. Help me God. Thanks a lot for the information.
Exposures are difficult, but, you do not have to be perfect at them. You learn as you go. Here is a video that I cover some ways to make exposures more effective. Do not worry about doing everything perfect. Just being committed to doing them as often as possible is the key. If you are able to find a therapist with experience in exposures, that would be wonderful, but, you can do them on your own if help is unavailable. I wish you the best.
Thank you for this information! I’ve been wondering in what “state” my daughter should be in when we work on exposures. This is so helpful! ❤
Here is an updated video on more current research on making exposures even more effective:
czcams.com/video/439l0c-P3lg/video.html
I also have pdf’s to help your daughter move through difficult exposures and activities:
paigepradko.com/facefear
@@PaigePradkoTherapy Thank you so much for your response and the links. My daughter has been battling a severe vomiting fear with OCD for over a year and we are beyond grateful for any help/information. 😍
I learned something new. I’m not going out as much, and might apply this as a challenge. Might even record myself so you can see what I do
Good luck to you, Mark.
I wish you were my doctor 😓
I freeze so I can’t move because I will faint, the medications do not help anymore
I take clonazepam
Seriqiuol
Remeron
And some ssri
Was given these all at once for panic disorder and agoraphobia
I am physically sick from all the meds and worse off now
I have been on a benzo for my phobia for about 6 years but never this much meds
It got worse when I lost my mom and dad a while ago
I did have a bit of a break because losing my mom to cancer really just made me kind of disconnected with reality
I am going to try a suds lists tonight
I did not see this message before I read and answered your last message. I am so sorry that you are struggling and that you are on all of these medications. The one I am most concerned about is the clonazepam. Unfortunately, there is not much success with exposure therapy when one is taking benzodiazepine medications . You will most likely need to work with your physician and a therapist to see what your best options are. Please do not make any changes on your own without guidance from your physician. I wish you the very best in your healing.
Nice
🙏😊
Your acc the 🐐 I relapsed the other day, my agoraphobia musta started in late 2019 but the virus helped me to heal from it as all I needed was time and then last week I musta drank alcohol, it wasn’t my first time but I was eating something sugary with it and made me feel a bit sick had a panic attack and rushed to the toilet and Yhh that’s how I relapsed
I’m sorry that you had a setback, but, you likely did not lose your progress. Keep working on your exposures….one day at a time. 🙏❤️
I like the way you explain how exposure works on the brain and the way it’s processed (or not).
I am long term Xanax user. I’m stuck between know whether to start doing exposure or reducing my dosage first, as I know it take a while to stop them completely but want to get out there.
My general advice would be to start your exposures now and then if you decide to slowly taper, you may have more anxiety, but you will be somewhat used to your exposures. Be sure to have plenty of support and knowledge about how to taper off of benzodiazepines. I refer people to benzoinfo.com for information.
Hello Paige , thank you so much for this video, I'm 56 and retired, and have vacation anxiety (agoraphobia) anything that is 4 or more hours away from my home. not on any medication, but planing to head out for a one month road trip to Florida (I'm in Canada) with my wife. Your video is really helping me to understand my fear, and tackle it head first. No money in the world can buy happiness , but I'm on my way Lol.
That’s wonderful. I think that is wonderful that you have decided to go. I will be there too but not until January. I hope you have a wonderful trip. Remember that “uncomfortable” does not equal dangerous. There is nothing dangerous or harmful about anxiety symptoms. If anxiety shows up, just invite it to ride in the back seat while you keep steering the bus! 😊
Thank you so much !
@@PaigePradkoTherapy
Hi, Paige, I love your videos! I'm also psychologist and it's great to find this kind of information. I have a little question/petition, could you recommend an specific paper about flooding? I recently have a discussion with an another psychologist and he is very "sure" that using flooding exposure is unethical. If you have a link to refuse that comment, I will appreciate it so much. THANKS.
P.S. I apologize if my english is not exactly great, but I'm Mexican and my english it's not perfect, haha.
When comparing systematic desensitization and flooding in exposure therapy, flooding has been shown to be more rapid and effective than gradual learning (Cain, Blouin, and Barad 2003). But, in practice, it is very difficult for an anxious person to be willing to flood themselves in an exposure. When treating clients, I explain both methods, and the client is in control of what exposures they choose and when the are going to increase their anxiety by increasing the intensity of the exposure. Most clients will begin gradually, but soon gain confidence to flood themselves after having several weeks of gradual exposures. Forcing a client to do something against their will would be unethical in my opinion. But, many clients choose to flood themselves once they gain some experience in what to expect during an exposure. I find Michelle Craske’s work on exposures very informative and I have changed the way I do exposure therapy to incorporate her findings as well. Thanks for your question.
Hi Paige - hopefully my question will make sense. I'm wondering what advice you would have for someone who has panic attacks regarding *doing* something, rather than just being exposed to something - like reading, public speaking, or in my case, writing.
The exposure is always difficult (so there's no way to really vary it) and at times, the fear feels too intense to actually *do* the thing. Sitting there stalling will calm me down, but I think that's because I'm stalling, not because I'm getting used to the exposure, if that makes sense. I'm guessing I should just try to push through it for the exposure to be successful?
First, let me say that I am sorry that you are experiencing this, and exposures are very difficult because we are activating your fear center, which is why you are having panic attacks. Even if you do panic during the exposures, there is evidence that has been duplicated in research, that your exposures will be more effective and lasting. Try your best to stay in the exposure until your anxiety drops by half. If I were working with someone that just could not get themselves to do an exposure, I would find some easier exposures to build up their confidence. For example, I might have them describe the exposure on a video tape, giving every detail they could, to activate the fear center. We might find videos or photos of people doing the activity and do exposures on those resources first. I hope this gives you a few ideas. You have a creative license here to do what ever you can to create anxiety in your mind, and then stay in that exposure until the anxiety goes down. Your brain does the rest. Thank you for your question.
I will definitly try all of this. Although my intrusive thoughts are really intense I dont really know if im doing the right exposure...
If you are having obsessive, intrusive thoughts, you can do an exposure on the thought itself. You can either keep yourself having the thought by repeating triggering words, or you can record yourself saying the fearful thought, image or scenario. Then stay in the anxiety, really lean into the anxiety that the thought brings up in you. Your job here is to welcome and want the anxious thought. Accept the uncertainty and doubt and anxiety that it bring. The anxiety level will drop on it’s own. I am working on another video on Strategic Exposure Therapy for OCD that I think will be helpful for you as well.
@@PaigePradkoTherapy thank you for the tips I will try them for sure!! I'll be sure to watch it when I get the notification. Thank you so much for what you do!!
Great video, I have a question.
How does exposure work with social anxiety? I was nervous and anxious about a one day festival recently that I attended and yet even though I’ve been to many parties I still get anxiety about socializing, I had a blast but still get anxiety.
I think it’s relating to how I look, I’m self conscious about myself and whenever I’m around people my age (parties ,club etc) I get affected.
Because I’m self conscious I also avoid talking to girls.
What can I do?
Thank you for asking such a great question. Exposure Therapy works the same for social anxiety as it does for phobias or other environments that trigger anxiety or panic. You commit to a social challenge, like a social gathering, and then you stay long enough for your anxiety to go down. It is a little more difficult because you have to complete many exposures in all different kinds of social situations. I highly recommend that you watch my video on social anxiety. Taking on a personal commitment to continue to challenge yourself socially, even small steps will help to build your confidence. Think of every single social opportunity as a challenge and a way to practice your exposure to being in social situations. Every effort and experience can help. Thank you again for your comment and question.
Yes....its very helpful to me...am strugling this problem since 6 yrs back.....thanks for yr support...God bless you.....Love from India,Manipur, churachandpur
Thank you for watching and commenting 🙏❤️
How are you now? Am also from india?
I am on fluoxetine and risperidone.my psychiatrist mentioned cognitive behavioural therapy but there was no one to teach me that.I want to thank you that atleast through your video i get the idea.i am from india and i still think psychiatrist here do not train much about therapy .Thank you for uploading this
Here is a playlist that may help you further with Exposure Therapy. It is a exposure therapy is a process that takes time, commitment and flexibility. Exposures are not expected to be perfect. Just doing them is what is helpful. I wish you the best.
Hi again. Paige. I've been diagnosed with ocd, major depressive disorder and generalized anxiety disorder. I feel I've got these anxiety's your taking about as well. I get so overwhelmed I don't know what to tackle next because it's so depressing that I feel I have them all so I feel like "oh heck I better work on one so I can get it taken care of and then on to the next one". It's so old doing all this. I just wanna cry
I am so sorry you are feeling so overwhelmed. Start with a plan to seek support. Are there therapists and/or physicians available to consult with? Sometimes there are resources available and sometimes not. If you have no resources available for support, make a list of what you are missing in your life and what you want in life. If someone has depression and anxiety and ocd, we decide together what we want to work on first. I typically work on depression first. For example, I might have a person give themselves 3 behavior goals a day. They might be: take a shower and get dressed, go grocery shopping, make dinner. That might be impossible for someone else and they might have 3 different goals. Start with 3 behavior goals that you feel good about accomplishing.
@@PaigePradkoTherapy thanks Paige for your response. I kind of feel like after I messaged you earlier today that I've kind of had a win today. At least I'm going to say that. I feel a little empowered. So what happened was I got to work and had anxiety like I normally do. I started off like normal; sweats, pounding heart, shaking so bad I spilled my soda and this dark cloud like I wanted to die. I tried my hardest to sit with it all. It lasted hours. No lie. Almost all day. But towards the end of the day I noticed I still had the shakes but I wasn't bothered by it as much. 😋. I hope I can keep on keeping on. PLEASE know you are loved. You have been a blessing to me.
I am so proud of you. How we respond to anxiety is so important. The more we learn to tolerate it and just let it run it’s course, the better we do. Maybe you already heard my recent video where I explain how to not react to anxiety....because today, you did just exactly what I recommend...nothing. Here is the video if you haven’t seen it. czcams.com/video/A_ND_Vwdvj8/video.html
Wonderful help for those people who don't have access to psychologist.thanks a lot.plese make some vdos on in VIVO EXPOSURE.
I will be working on new videos soon. I will put this on my list. Thank you.
@@PaigePradkoTherapy thanks for your selfless service to humanity.dr rk.jai Osho
Quite interesting I'm really expose 😊😊😊.
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I have had checking ocd behaviour for 8 years or more and I often use my husband to close the door for me. Because my fear is that something bad will happen to my dogs if I don’t check the house well enough but of course there isn’t a good enough feeling when you have ocd and for years I didn’t know what it was and had the rituals and only enforced this. My behaviour is from trauma as a child loosing lots of pets to freak accidents. I am just now trying erp I have done gradual for the last year and some days it’s stronger then me and I can’t leave the house. I will physically vomit while challenging the feelings. I do want to get better with my ocd.
Hi Meighen. I am so sorry that you were traumatized as a child and that it seemed to activate your ocd. It sounds like you are working very hard. I believe I left you a link for my course and my support group. I am on the support group daily that accompanies the course. I do cover ERP for checking in detail. Please reach out if I can be of further help. Paigepradko.com
Thanks for the great and concise video. Just a quick comment: I have the fear (and actually this one is really based on evidence so not an obsession I think! ) that when I let these thoughts to come for ERP, the anxiety makes it virtually impossible for me to go about my studies outside the Exposure time without significantly distracting my focus. Is there any way to have both ERP running and the demanded focus for our daily routines at the same time without rendering the mental compulsions to take over?
I think almost everyone can relate to your question. It is true that when the fear center of our brain is activated, by having the fearful thoughts on purpose, we will often have lingering anxiety and fear after the exposure. Research on Exposures, even our most difficult exposures, show us that the fear center in the brain calms significantly after 90 minutes. However, my experience, working with clients has been that some clients seem to be anxious for quite a while, where as others notice a drop in anxiety within a few minutes. When working with people that report their anxiety and fear staying active for quite a while, I have them track their level of fear and anxiety every 15 minutes. I want them to notice, even a slight difference of intensity. You will notice it too. After you get through the first few exposures on those fearful thoughts, the exposures will become easier and shorter. My advice would be to challenge yourself to do the first exposures when you have a break in your studies. You do not want to end the exposure until your level of initial anxiety (SUDS score 0-100) has dropped by half. Exposures are challenging, but they work. Make sure you watch my video on Maximizing Exposures to make them as effective as possible. Thank you for your question, because it will help many people.
@@PaigePradkoTherapy Lovely, thank you so much, I'll try doing it anyway. God bless you for making these technics available to the public.
Hello, you are amazing! Your videos are so helpful. I want to see if i am understanding this, what is the goal of an exposure? Is it to have the experience of not fleeing from the trigger/situation and letting your anxiety naturally burn off? Or is it to not have significant anxiety or a panic attack when exposed to that trigger at all? So as someone with agoraphobia/the fear of getting "stuck", I came to associate certain areas/activities as "danger zones" because I panicked in them. Then I let my avoidant associations spread and generalize until I was very limited in what I was comfortable doing (everything started seeming like a scenario where I am at the risk of being stuck). But the origin was repeatedly panicking in similar situations. So I am assuming having a panic attack continually in the same situation/location isn't itself the way to build a new neural pathway, right? So is it the intention that makes the exposure effective? The way you frame it afterwards? Or is the difference just that you don't flee, which eventually allows you to be desensitized in a way that is different than just continuing the pattern of panicking in certain locations/situations/etc. Hopefully this question makes sense! Thank you
Thank you for leaving such a detailed question. Several things are happening during exposures. You are correct that you have associated certain environments with high anxiety and panic. And your avoidance of those environments have reinforced the panic and agoraphobia. When you do an exposure to environments you have avoided, your brain forms new neuropathways. You may occasionally have high anxiety and panic symptoms, but, that does not matter. The more exposures you have, the more neuropathways will be formed. Eventually, the old association with the fearful neuropathway will be taken over by the new neuropathways. We have learned that the more exposures in a variety of situations works the best. You can change up how challenging the exposures are, and how long you stay in the exposures. The fear and panic reaction comes down, because your brain jumps onto one of the new neuropathways you have created during the exposures. Here is a video that I go into the details a little more: czcams.com/video/439l0c-P3lg/video.html.
@@PaigePradkoTherapy That makes sense, thanks for your reply
hi Paige! thank you so much for your videos, you are doing some amazing work + we are super grateful 💕 I wanted to ask, what your opinion on doing Hypnosis between exposure therapy experiences is? I suffer with panic attacks and agoraphobia which are bought on by stomach pains (from the panic symptoms) it’s a viscous cycle. I’m using hypnosis to get through to my subconscious and relax my body most mornings + evenings as I spend most of my time in fight or flight. could this be making exposure less effective or is it harmless?
This is such an interesting question and one that I have never seen in research. I am not a hypnotherapist, but I support anything that works as long as it is healthy. My best guess is that it does not help exposure therapy, because it most likely decreases the activity in the fear center of your brain. But, if hypnotherapy helps you get through the exposures that you otherwise could not get through, I would suggest doing the hypnotherapy at first. You can always give up the hypnotherapy as a safety behavior and continue on with the exposures afterwards. I am going to take a look and see if I can find any research on your question. My overall opinion is do what ever you need to do to do your exposures daily. Good, bad or ugly....all exposures help. Thanks for your great question.
Paige Pradko LPC NCC thank you for getting back to me! I look forward to hearing your findings! 💕
Hi Paige, my 14 year old suffers with similar agoraphobia which has been brought on by stomach nausea (similar to Jessica's comment). It started about 8 weeks ago. We were also looking into hypnosis...along with encouraging exposures ..were you ever able to find out if hypnosis was detrimental to exposure therapy? Thank you🙏
Thanks for this video. I hope you don't mind me asking some questions. If an agoraphobia sufferer was working on exposure, travelling further and further from his house, but occasionally having panic attacks whilst doing so, are you saying that it is better for him to 'tough out' those panic attacks (activate the amygdala) instead of practising breathing exercises and trying to fight off the panic? By the same token, would you then say that it's better to not take SSRI medications, but rather to expose one's self to the panic 'raw' if that makes sense? Thanks in advance.
What a great question. Yes, it is better to stay in the Exposure, even if having high anxiety and panic, and then letting the anxiety level come down by at least 50% before going home. The new neuropathways in the brain cannot form without being highly anxious. Doing an exposure and practicing relaxation skills at the same time to get through the exposure makes the exposure less effective. Practicing an exposure where there is no anxiety does not do anything. When working with an agoraphobic client, I first have them do interoceptive Exposures (Exposures that teach them to better tolerate their own body sensations like a rapid heart beat). Then we practice imaginal Exposures. They also learn to practice daily techniques to calm down their amygdala. You can find these techniques in the Calm the Body series on my playlist page. They practice these daily...but not during an exposure. And finally, we work on gradual Exposures (challenges that they set and complete). I loved your question and hope I answered it adequately.
@@PaigePradkoTherapy Thank you for your detailed answer Paige, and for putting all of this information out there for free. I feel bad for asking more questions, almost like I ought to pay you for your help! For the longest time, I have been practising exposure whilst trying to minimise anxiety, and perhaps therein lies the problem. The reason I do this is because every time I have a panic attack, my heart starts skipping beats, I feel breathless and I genuinely fear that I'm having a heart attack or I'm going to die. It sounds crazy, but I've been trying to avoid it. So perhaps I need to learn to tolerate the body sensations, thank you so much for pointing this out to me. I'm only 33, I used to be so confident, I travelled the world and was really quite fearless. Then something happened and I started getting these panic attacks, it has ruined so much from me, taken away my relationship and even my career. I need to fight back, and you've given me a new angle on things. Thank you again.
Thank you for your acknowledgment. I actually enjoy answering questions. Many people unknowingly make the same mistake by trying to practice relaxation to not have panic symptoms during exposures. I know the symptoms feel horrible, but you have to stay in that high anxiety feeling, do nothing to calm or avoid it, your brain will bring down the anxiety on it’s own. This is necessary to Rewire the brain. Think of it as trying to teach your brain that nothing bad happens during panic symptoms. Your brain has to learn that you are not in danger. If you try to calm down to avoid panic, your brain is still getting the message that panic is something to fear. I will be working on more videos specifically for people suffering with agoraphobia. It can absolutely be completely reversed.
This is making me realize I should start titrating down my Klonopin. I'm afraid to be without it even if it's just available if I need it. I guess that's a safety behavior. Learning that panic attacks aren't dangerous is important it would seem.
Great video what should I do if I afraid of sweat seen by people
Hi. I have dealt with that myself and made a video addressing it: czcams.com/video/6I8MXoEZTBE/video.html
Re agoraphobia - How can we face our fears without distraction / safety behaviours especially in a crowded busy store or mall ? What is allowed to do to make the habituation work especially when flodded with extreme dizziness and hyperventilation ? Do we need to stand still in one spot and pay attention to what's going on internally or keep on moving while feeling them ? Sitting down not always available which is a big issue when feeling dizzy .
I understand and you’re absolutely right. Sometimes we have to work up to these exposures. We have to set challenges that we are willing to do. Sometimes there are safety behaviors when we start, and slowly over time, we challenge ourselves to let go of the safety behaviors, one at a time. You should really feel very proud of yourself for every step forward and every challenge. This is very difficult work and every exposure is helpful.
This video makes me feel better. Im a filipino mam im not good in english but when i watch your video i fell more stronger i think i have a agoraphobia because im always avoiding when my friends or family inviting me to travel far because im scared it might my panic attack attack me 😔😔😔 i want to overcome it 😔
I am so sorry that you are struggling with agoraphobia. Here is a playlist to help you. czcams.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html
@@PaigePradkoTherapy thankyou and godbless😊😊😊
Hi Paige,
I appreciate your work so much! I’m a social worker who often works with adults who experience very distressing auditory hallucinations. Some of them realize the “voices” are created by the illness (and are not real), but their amygdala gets activated nonetheless. Do you know if exposure therapy has been attempted with individuals experiencing this? If they were not so frightened by these symptoms, their quality of life would be vastly improved.
Kevin
That is such an interesting question, Kevin. What great work you are doing to help your clients. I have found that almost anything including real or imagined sensations inside our body, outside our body, thoughts, images, absolutely anything can be associated with fear. And thankfully our brains have plasticity and can create new neuropathways to override the fearful associations. Exposures are what creates the new neuropathways. We have to get creative when developing exposures with our clients. Joining with your clients to create different exposures to activate their fear center is the key. My clients and I almost feel like we are conducting little experiments. What can they try this week to active that anxiety, how long and when will they do the exposures. They have to be willing to be uncomfortable and practice the exposures daily if possible. I have made the mistake of setting exposures too high...they were not yet willing. You and your clients will learn together as you go. Every client is different in what they are willing to do in their exposures. Thank you for your message and I wish you success with your clients. This is very difficult work and I am so thankful that you are doing it. ❤️
wooah! for someone like me who has a panic attack disorder for 4yrs. and agoraphobia like symptoms (can't leave the house w/out someone with) for 2yrs. now, the flooding sound so extreme. imagine having an extreme fear that you feel dizzy and fainting yet standing on a grocery store or any trigger areas w/out anyone you know. I'm only curios have you had your own experiences of panic attack disorders and agoraphobia in the past? How did you manage the flooding? I really wanted to recover from this but I always cower everytime I attempted to went outside on my own.
Yes, I have also experienced panic when I was younger and ended up in the ER. I know it is an awful experience. I wouldn’t suggest that you begin your exposures by flooding yourself. If going someplace with someone makes an exposure doable for you, then begin with that. We want you to be able to make it through the exposure, so it will be best for you to start off gradually. Here is a playlist that may help you. czcams.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html
thanks so much, i am currently on vacation after having my first panic attack 3 weeks ago, i have been exposing myself to scary situations (dinner at a restaurant, shopping at a mall) but i was never alone, because i am travelling with my brother - do you think once i get home i will have to start all over again? the thought of going grocery shopping on my own doesn't necessarily scare me, but i know i had problems with that right after my panic attack and because i didn't know about exposure, i always asked my roommate to for example come to the hairdresser with me, i am feeling a progress as my anxiety has gone down to almost zero when i'm in situations i was afraid of just days ago, but i'm a little worried that i'll have to do it all again without a safety person and my progress will be gone again
You are making great progress. Exposure therapy is challenging and every effort you make to challenge yourself helps. You will not have to start all over again when you return home. Going places without a safety person will just be one more challenge. Just keep adding new challenges, new exposures and you will continue to make progress. Thank you so much for your comment. Hope you continue to enjoy your vacation.
@@PaigePradkoTherapy thanks a lot for taking the time to answer people's comments, your videos have really helped me to understand, accept and challenge my anxiety! :)
Hello!
Thank you so much!
I need to be courageous. I'd like to go back to all those grocery stores and I'd like to cycle again but I'm so scared to feel dizzy. Even though it's apparently not dangerous. I need to be bold. I don't know if I should start with a small step or if I should go far from home and see what happens. Both are difficult.
If I'm outside and feel dizzy, I'm going to go back home immediately. But I know it's not the right thing to do.
Hi Nicolas. I know it is difficult, but your brain has to be taught that it is not dangerous. Your brain is trying to keep you safe from something that it got wrong. You have to take time every day to retrain your brain that you are safe to go out. My advice would be to start small. Perhaps a short walk every day. Then add to it as you push out your boundaries. You will most likely feel anxious but it won’t hurt you. You can tolerate it. Little by little…retrain your brain as if it were a toddler learning to walk. Be compassionate…yet determined. Build up your boundaries and confidence and then you can do more.
@@PaigePradkoTherapy
Okay. Thank you so much!
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I would like to try exposure for my driving anxiety which has evolved to the point where I can barely leave the house. I think I get the concept however, stoplights are a huge trigger for me but I can’t sit at a stoplight for a extended time or long enough for the anxiety to subside on it’s own... I get to a stoplight start having a panic attack, light changes and I start to calm down then get to another light and the situation repeats. Which keeps me in this viscous cycle. Because I drove to work and home for several years like this and I thought why are my symptoms not subsiding as I am literally exposing myself to a stoplight multiple times a day everyday? Well now I work from home and my lack of daily driving or even walking down the street has put me in a bad spot not sure where to go from here especially since driving used to be a huge stress relief and so enjoyable now everyday life just seems like a prison.
Yes...I have a client that has exactly this same experience with traffic lights. And this pandemic has set back so many people that suffer from anxiety, panic and agoraphobia. The key thing to remember is that we always have the ability to create new neuropathways in our brains and this is what you will need to do with driving. You can experiment with all kinds of exposures. Maybe you can even start with watching driving videos and lots of stop light videos. Watch videos with the longest, most frustrating stop lights ever. Then set daily driving challenges for yourself. It is okay if you panic and have anxiety, we invite that into our exposures. You will have positive and negative experiences doing exposures....they are all good and all necessary. Every exposure is helpful and will move you forward. This video will help you as well. czcams.com/video/439l0c-P3lg/video.html
I have the same experience when driving. My anxiety hits the roof when I'm stopped at a red light, especially if its a busy intersection and there's cars behind me and besides me. It's of feeling of intense fear and claustrophobia. Once the light turns green, I feel better.
My panic disorder caused agoraphobia about 3 years ago, during these times I was struggling , not staying home and doing exposures, I mean trying to walk , travel by public transportation in my city, once I also managed to leave the city and visit nearby city. Though during this period there were times when I had no problems but in some cases I still have problems with panic attack, so it seemed like I overcame it , but it still returned , can you explain how it's possible that during this time I managed to walk far places but now I have problems again ? Actually I am taking anti-depressant escitalopram, I didn't take Xanax after I listened to you , though I was prescribed. Can you please advise what else should I do to finally fully recovering from this condition ? Yours Sincerely thank you so much for doing such great job
Hi Rusudan. You are working very had at your exposures and I want to congratulate you on your progress and help you get over some hurdles. Exposure therapy is not a perfect science and our brains also do not always cooperate in every exposure. It is quite common to have exposures go very well, and then have panic come from out of the blue. What we have discovered in neuroscience research is that the brain can occasionally jump to an old neuropathway that is associated with a fear response. Please do not let this discourage you. It happens to everyone and I like people to expect it to happen on occasion. You should always continue your exposures and not stop them if this occurs. The next day, your exposures will most likely be right on track again. Here is a video that I explain it a little more czcams.com/video/0xpDmuIe53E/video.html. Send me a message through PaigePradko.com if you need more help.
Hi miss Paige. My name is John ,and I suffer from somataform health related OCD, specifically the fear of schizophrenia. I have had this fear for the past two weeks straight , and although I know most of my symptoms arose after researching them, I can't help but feel that Im starting to believe them. Ive already been told by my therapist that she doesn't think I have it, but I can't help to think that I didn't stress myself enough her, for her to take me seriously. Is doubting professional advice a symptom of OCD?
Hi John. I cannot diagnosis over CZcams of course, but, it does sound like you care very much about having a sound mind, and therefore any thoughts about having schizophrenia or other possibilities create intense anxiety for you. This anxiety causes you to seek out reassurance through googling symptoms and asking therapists for reassurance. No one piece of reassurance seems to calm the anxiety and therefore, you reinforce the anxiety by looking for more reassurance. John, if you want to treat the obsessive thoughts, you must learn to not react to them. Tolerate the anxiety and do not reinforce the anxiety by seeking constant reassurance. Accept the thoughts, float through the anxiety without trying to calm yourself. I hope this helps.
Hi! This is very helpfully How would I do exposures if I have Pure “O”? I have horrible thoughts of doing horrible things , with the most troubling being “what if I never stop thinking these thoughts?” Would I just think these thoughts until my anxiety goes down OR would I have to think about the action that I’m scared of doing? For example If I have Pure O about what if I punch someone, would I think about “what if I punch someone” or would I think instead about the action of punching someone?
Great question. I treat clients with Pure O, obsessive, intrusive thoughts using a variety of techniques. I discuss these techniques on the video titled, “Pure O”. But, to answer your question, I either have clients repeat key phrases and words to stay with what exactly they fear. Or, I have them make 20 minute recordings of their most feared scenarios. In your example, you would talk about punching someone in the face and everything that you fear would happen because of that action. Describe your worse scene in detail. The more you do this, and listen to the worse things you can imagine, the more you will train your brain that this is not reality and is nothing to fear. It is actually the opposite of anything you would ever do. Check out my video on Pure O. I really appreciate your comment.
OCDs should never control thoughts or try to "calm down" There is hope: Google "Bergen 4 day treatment" Exposure therapy is the way to go, its science based - Paige have a video about that too. Feel free to contact me for more info.
Hey Paige, regarding my issue with agoraphobia its about being too far from the house. i can only get 10-15 minutes or so. My question though is how would exposure therapy help this? since it isn't like a specific place/item, and its everywhere within a distance? cheers
Yes...great question. When I work with a client with agoraphobia, we work on pushing out the limits of their safe zone. For example, you would create a list of exposures that would challenge you to go places further than 10-15 minutes away from your house. Your goal would be to stay there (outside of your safe zone) until your anxiety comes down by at least half of what it was at the height of your anxiety. Then, you want to change the exposures by going different places outside of your safe zone, different distances, sometimes stay longer, sometimes shorter times, sometimes during the day, other times at night, occasionally with people, other times alone. You have to change up the exposure constantly. Your goal is to stay away from your safe zone until the anxiety comes down, then you may turn to go home. You do not want to go home during the height of your anxiety, or you may actually teach your brain that it is correct to be anxious. The reason we stay in the exposures until our anxiety comes down, is that our brain then learns that we are safe, and it does not need to attach anxiety to being away from home. Do not worry if you occasionally have a bad exposure experience. Overall, that is part of the process and helps to teach your brain that you can tolerate anxiety. Be sure to watch my video on 10 Ways to Maximize Exposures...use as many of those suggestions as possible. Let me know how you are doing.
I feel disoriented everyday like my vision is not good I feel worse when I'm in the house
As uncomfortable as this condition is, it seems that in many people, their brain has become fearful of these symptoms themselves. And that fear seems to perpetuate the condition. Sometimes these symptoms go away on their own. But there are recommended therapies. The brain learns to not fear the bodily sensations and symptoms through interoceptive exposures. It is difficult because in those exposures you have to create the symptoms you fear and then not do anything to calm or comfort yourself. I am sorry that you are having to deal with this.
hi um want to ask like for exmaple, when you are doing exposure by trying to have disagreement and argument with someone
(which I'm terrified of) if staying in the argument is too stressful and distressing to the extent that I cannot argue back with the person and just stand there and listen... should you just finish the exposure by standing there, looking at the other person until the anxiety drops to half?
Hi ZiYu.
I enjoyed talking with you last week. I bet many people can relate to being uncomfortable in conflict and even avoiding conflict at all cost. This is a difficult question, because conflict is uncomfortable for most of us. Sometimes it is necessary to verbalize our viewpoint, even if it makes us uncomfortable. Yet, other times, it may be best to let it go. If you find that you simply cannot verbalize your feelings or view in a conflict, I suggest practicing using your voice when there is not a conflict and gaining confidence in your ability to speak up. Thank you for sharing such a great question.
My question as well I thought am the only one in such dilemmas
@@PaigePradkoTherapy do you have news letters sent personal emails?
I do not have newsletters, but, I am working on some PDF documents that will be available for download in the Fall. I will announce it to my subscribers when they are available.
The Grocery store is evil!!😈😆 I can totally relate!! Aside on a serious note..thank you Paige for the informative video!!😇
You’re welcome. Those darn grocery stores! 😊
@@PaigePradkoTherapy I know right??⚘😇
I developed agoraphobia and driving anxiety after having a very bad panic attack while driving on the highway a couple years ago. I used to be the most confident driver and would go anywhere. Now I struggle to drive down the street. My problem is that I’ve had times where I’ve made a decent amount of progress, but it gets undone so easily. I got into the habit of going and getting coffee every morning but if I skip it once or twice it seems impossible and like I have to start over from square one. Any tips?
Hello. That was a great video. I would like to ask you a question. I have read many articles about the exposure therapy and many out of them say that relaxation techniques are really helpful. These articles suggest that after the exposure the person must do some relaxation techniques like abdominal breathing on order to calm down. But you said in the video not do something like this. I myself agree with you, but can you enlighten me why these articles suggest relaxation techniques? And something more... what kind of exposure therapy do you suggest for special anxiety? Thank you very much!
Hello. Thank you for such a great question. neuroscientists have done extensive research on exposures. They can now actually look at new neuropathways being formed during exposures and they have discovered what techniques make the exposures more effective. It used to be that we believed relaxation methods and doing anything we could to calm ourselves would help people stay in the exposures. We never realized that the amygdala and the fear response had to be triggered in order for the brain to create new neuropathways and new safety learning. As in all areas of psychology and science, we keep learning new things and keep advancing the field as we learn. In fact, I have even evolved my therapy practices since making this video. I no longer use SUDS scores or a hierarchy. I encourage my clients to mix and vary their exposures to keep their brain surprised and continually learning. This pdf may help you. www.paigepradko.com/erp
@@PaigePradkoTherapy Thank you very much for your answer! I am sorry if i am asking for much information. I am a new psychotherapist and i want my clients to get the best out of the therapy sessions and you have much more experience than i do. Let me ask you something more. While you are doing the exposure therapy do you urge your clients to use cognitive disputing? For example, when you do exposure therapy for social anxiety, the person has automatic thoughts. When these automatic thoughts appear while exposing do you ask the person to dispute these thoughts or to just let go of the anxiety so that it can go down by itself without any disputing? And when in the therapy sessions do you use cognitive reconstruction? Are tou using it after successful exposure therapy so the person will not relapse? Thank you very much!
This is another great question. There is some controversy surrounding cognitive restructuring and exposure therapy. The research that I am following is that of neuroscientist, Michelle Craske and colleagues. She has shown that cognitive therapy decreases the effectiveness of exposures. She suggests no longer using cognitive therapy at all….or until exposure therapy is completely finished. However, there are those that disagree in the field. I am now following an inhibitory learning model and no longer include cognitive restructuring or any logical approaches when using exposure therapy. The brain learns best and creates new neuropathways when it is surprised as opposed to logic arguments. Although, I do use ACT therapy and encourage motivation for exposures through value based activities. If a person with social anxiety values connections, they can think of doing difficult things like social exposures because they care about it and value having connections. This does not compete with the exposure itself.
Someone who is very close to me is suffering from agoraphobia and im trying to learn more about this so I can understand what she's going through. Are there any books that you'd recommend for me to read that has to do with exposure therapy or just general knowledge on this issue?
I am sorry that your friend is going through this and it is kind of you to learn more. Agoraphobia is related to panic disorder. Most people (but not all) fear having panic attacks or sometimes digestive issues when they leave their safe place and begin to avoid anything that makes them anxious. Some of my favorite books are Rewire Your Anxious Brain by Pittman and Anxious by Joseph LeDoux.
Hi Paige, I think that I have inebriphobia the fear of drunk people. This is mainly because of my dad who’s an alcoholic and I can’t even think about him or alcohol even the scent or the word sends me into a panic attack. I can’t be anywhere near him and I don’t know how to handle these situations. There isn’t much info on this phobia so it’s hard for me to find comfort and research it. What should I do? How can I help myself?
Hi Jen. The treatment is the same for all of our phobias. We have to expose our brains to that in which we fear. You can make a list of as many ways as possible to expose yourself to drunk people. For example you could watch videos over and over again, several times a day. Of course, I do not want you to be in a dangerous situation during covid. But, concentrate on exposures that you can witness drunk people and smell alcohol...as long as it makes you uncomfortable, the exposures are working to form new neuropathways in your brain.
What do you recommend I do during an exposure if I have a panic attack? My trigger is driving far from home. If I am far from home and driving and have a panic attack, what should I do? Keep driving, pull over? Thank you for your videos ❤️
First, Angela, I want you to know that you are not alone. What you are experiencing is terrifying, but, it is common. Panic attacks cannot hurt you at all. You cannot faint or pass out during a panic attack. You are actually safe to drive if you were to panic, but, that is your choice. Sometimes, people like to pullover on an exit and get out of the car to walk around to burn off some of the adrenaline. But, you are perfectly safe to keep driving too. During driving exposures try your best to set your goals of the exposures ahead of time and complete them. It is not a good idea to turn around and drive home because of panic. This just teaches the brain to avoid driving and avoid anything and everything that makes you anxious. Your job is to teach your brain that eventhough you may feel anxious and uncomfortable, you are NOT in danger. You will gain confidence as you go.
@@PaigePradkoTherapy thank you
@@PaigePradkoTherapy great answer Paige. I'm sure you help so Many people . Awesome 👍🏽
Do SSRI's also effect the helpfulness of exposure therapy?
I am not aware of SSRI’s helping or weakening exposures. For some people, SSRI’s can reduce some of their anxiety and OCD symptoms.
Thank you so much Paige, that's been really helpful! It's simple and such a gift. I send love in your direction🤗💗
You're awesome Paige!
You've made me understand why I need exposure to the uncomfortable situations. It's what'll actually help. Thank you thank you so much Paige!
Glad it was helpful!
I have a question...if I am doing an exposure, for example, if I were to go into an underground parking garage, usually I would really freak out, even sometimes yell and scream. So in doing the exposure intentionally, would I allow myself to have that freak out? Or force myself to be outwardly controlled?
I would ask you what you are willing to do? If the parking garage is at the height of your anxiety, but you are willing to do that exposure and repeat it in different parking garages and stay in the exposure until your anxiety has started to lower, then I would say...do it. If it is too difficult, work your way up. Look at photos and videos of parking garages and do exposures on those images first. Park outside of the parking garage and do exposures there. Then, work your way up to parking in a parking garage....maybe do an above ground one first and then a below ground one. We don’t recommend using relaxation techniques during exposures. We want your brain to learn that you can tolerate the anxiety. Great question.
Greetings, is there any advice for fear of taking blood pressure? I have a machine at home. When I took my blood pressure, I only recorded my anxiety (My b/p was elevated). Thanks.
Exposure therapy involves doing exposures on our triggered fears. The blood pressure machine and taking your blood pressure are triggers that you can do exposures on by repeatedly taking your blood pressure. But, the real fear here is a fear of a high blood pressure and what that brings up for you. You will need to do exposures on holding those fearful thoughts several times a day and allowing yourself to float through the anxiety. You can get help with this from a therapist that is familiar with doing exposures. Therapists that treat OCD are usually the best therapists to go to for expertise in exposures.
@@PaigePradkoTherapy thank you for the great advise. I will try this.
I have an intrusive thought of having sensation of heart pounding (same like when you fear)and due to fear it actually happens and the cycle goes on and on. Miss paige hope you will suggest me some ideas.How can i do interoceptive expouser on this .I fear and feel irritated of the sensation of heart pounding.I have echo ,ecg all the reports are normal ,I am a commerse student of grade 12.You have done a great job miss paige. Lot's of Neaplese are really enjoying your videos.Thank you very much.
Hi Nokia. Yes, when you explained a fear of pounding, I was suspecting that it was your heart pounding that you were referring to. I am glad you clarified that. This is called somatic awareness or Sensorimotor OCD. I have the same thing, but with breath awareness. For most of us that experience this, the fear is that we will always have this constant awareness and it will not go back to being unconscious. There are several options for ERP treatment. As I may have explained, I use the allowing, accepting and welcoming method myself. I do my best to allow my awareness without frustration or checking on it or focusing on it. I would use the I. A.M. method, but my awareness comes at times when I try to sleep. Therefore, I cannot use the method of shifting focus. If your awareness of your pounding heart comes at bedtime, my advice is to give yourself messages of inviting the awareness to come and go as it would like, and not get frustrated but just try your best to rest whether it is present or not. If your brain believes you are frustrated it will get likely get worse. The other methods include day time activities of making your heart beat awareness on purpose. You would be exposing your brain to constant reminders that your heart is beating. You can place reminders everywhere that your heat is beating, you can listen to recorded scripts about your worse fear that you will always be conscious of this pounding and completely overwhelm your brain for days about this reminder and worst fear. Your brain will after a few days habituate to this fear and not react to your awareness. Many people do not like the ERP approach of constant awareness and prefer the incidental I. A.M. approach that I discuss here: czcams.com/video/9nEC8yIgFKg/video.html. I hope these treatment options help you.
I have ptsd and struggle with dissociation/depersonalization/derealization when I’m anxious and stressed do you think exposure therapy will still work even if I dissociate?
Hi Kayla. Yes, exposure therapy can work with dissociation, but, there are other treatments that work too. I am working on a new video on what to do. It will be posted in a little over 2 weeks. It is a much more common condition than people realize and I have been getting many requests for a video.
@@PaigePradkoTherapy ok!! Thank you I’ll make sure to check it out. I start exposure therapy this month and I’m scared but I’m ready to start feeling like myself again.
Is it possible to do this unconsciously without realizing it?????
I had a strong phobia several years ago and gradually it went away. I had no choice in being exposed to it from time to time. I started to handle those times of being exposed differently and it gradually dissipated. And now i no longer react to it in a fearful way. I was not aware of this type of therapy at the time
Yes, absolutely. I think many people do it all the time...work on exposures and rewire their brains without even knowing it. Great job!
I have a severe fear to even leave my house, I hope this helps!!!
I am so sorry, Zainab. Here is a playlist to help. czcams.com/play/PL1lUhuKpYUYoJdExc0g8zVZuekW2zhGG7.html. I am currently working on an online treatment class for people with agoraphobia where I take you through step by step what to do. If you would like more information when it becomes available, please email me at info@paigepradko.com
Can you explain how to practice exposure therapy for health anxiety sufferers?Tqvm
Yes, absolutely. First, you begin to practice Response Prevention. That means that when a worry or bodily sensation happens, you do not seek reassurance or google symptoms or research or check or monitor your body, etc. Of course, I recommend that people have a check up with their physician before they begin Response Prevention. Then there are several different types of exposures like Scripts, which are Imaginal Exposures, Real life or In Vivo exposures, interoceptive exposures and incidental or in the moment ERP. Here is a playlist to help you czcams.com/play/PL1lUhuKpYUYonn-zlZxzTRR8V4myEHgCY.html. I have an online therapy course on how to recover from health anxiety that will be available for the public in a few weeks, if you are interested in more help. Please email me at paige.pradko@gmail.com if you would like more information.
@@PaigePradkoTherapy tyvm for the reply.I’m certainly going to try that!
does weed prevent nuro pathway generation? If I use weed during exposure, I assume it wont be helpful ,but what if im just having at an end of a stressful day/party?
Thanks a great question. The general rule is that you want to feel at least some level of anxiety or discomfort at the beginning of an exposure. If there is not anxiety at all due to a substance, then, it is likely that the exposure did not do anything.
What if your fear is a feeling that you get in your body when panicking, like fainting, heart attacks
How would I expose that
Heart racing pounding, sweat pouring down my face, prickly all over down my chest
There are exposures that we do where we try to get the same feeling as the body sensations you are describing. It is called Interoceptive Exposure Therapy. I made a video on how to do it and have a link in the description to more techniques. I advice my clients to start with easier exposures and work their way up. In session (even video sessions) we do jumping jacks and get dizzy and hyperventilate together. It is very effective, but, you have to be committed to doing the exposures. Sometimes it helps in the beginning to have someone do them with you, then eventually do the exposures alone. I wish you the best. 😊
1) If therapist cannot conduct vivo exposure than Do the client needs to carry on exposure on his own with some person or alone ?
2) Does really unbearable exposure causes any other problem in client which therapist need to be alert of. What are its signs and solutions?
Thank you for these questions. I will be doing some question and answer videos and I will talk more about the specifics of exposures. Yes, clients must do exposures on their own and / or with others depending on what they are doing exposures on. In the beginning, I have clients typically choose milder or easier exposures before moving on to their more challenging exposures. Feel free to contact me by going to PaigePradko.com. If you give me more details in an email, I may be able to use your case in a question and answer video if that would help you.
@@PaigePradkoTherapy thanks..I will email you a case..