The Exposure Hierarchy: How to do Exposure Therapy for Anxiety: Anxiety Skills #20
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- čas přidán 10. 04. 2019
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An exposure hierarchy is just a fancy way of saying "the skill of breaking your fears down into tiny steps and facing them in your growth zone instead of panicking or avoiding."
You can overcome your fears, phobias, anxiety, and OCD using an exposure hierarchy. An exposure hierarchy is a tool developed by psychologists to help you develop the skills needed to beat anxiety through tiny little steps.
When you face fears in the right way, without jumping in too fast or avoiding them, your brain basically rewires itself to believe that you are safe, reducing anxiety and increasing your ability to face your fears without that fight/flight/freeze response.
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I’m Emma McAdam. I’m a licensed Marriage and Family Therapist, and I have worked in various settings of change and growth since 2004. My experience includes juvenile corrections, adventure therapy programs, wilderness therapy programs, an eating disorder treatment center, a residential treatment center, and I currently work in an outpatient therapy clinic.
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I like your description of exposure therapy! Thank you for helping educate folks about the value of exposure in treating anxiety.
awesome, glad you like it!
Really? That's awesome. "You did a hard thing"!.
How do you do this if your anxiety is about having the anxiety. How it makes you feel, if you will get better etc?
@@cforte0423 yes exactly!! Just thinking about it makes me freak out
@@phyllisboyle1162 I am on Cipralex and I feel better than ever. It has given me a chance to challenge the anxiety without the terrible affects
ive been dealing with extreme anxiety for about ten months ago but today I went to the grocery store and felt normal. I'm very proud of myself.
Amazing...hope you're still progressing/overcoming it ❤🎉😊
As my brother always told me, the opposite of anxiety isn't not having anxiety, it's "doing". Eventually by doing (with anxiety), will extinguish the fear. The amygdala learns to unpair the unnecessary response. In fact, you sort of need to have fear in order for it to work. That means you've activated the right part of the brain! It's not comfortable! But neither is upping weights at the gym! Yet this is how you grow stronger and eventually it's not even a challenge. If you lift weights without a bit of strain, muscle soreness etc, chances are you won't grow strong. Brain is no different... Speaking of the gym, I have found exercise, like good heavy exercise a few times a week, tremendously lowers anxiety.
Exercises helps anxiety. I feel energous after dking excercises
Ohhh i like that, the needing of fear to confirm you have activated the right part of the brain. Iv come to these videos because iv been practicing this by going to small cafes etc. for social anxiety and today even though I did well I felt so defeated that I couldnt just be at peace in there, tired of not being able to act as myself. Sometimes I get discouraged when I dont see the progress.
You won't get better until you stop trying
have been a victim of Anxiety disorder for the past years and all through college, thanks to #DoctorEromon on CZcams… .. I'm getting hold of my self now,
I dunno I'm so old. It seems too late.
I’ve watched 100’s of anxiety videos in my life, and idk why, but this video is pretty calming and encouraging to me. You have s nice gift and this was helpful. THANks!!!
So true
Did you know she sells full courses? I might be the only one who didn't notice it in her description but I found out about it today. I love her too 🤗
i think it’s bc of her voice
This human is simply a gift to humanity. I hope your life is as amazing and generous as you are.
Thank you for your videos. I was having anxiety attacks while driving. Then the quarantine started and I didn't have to drive...and I just stopped (a huge mistake). Now I am trying to drive again and will try exposure therapy. I used to enjoy driving and hopefully can once again.
You might get some comfort from knowing so many people are stuck at home because of the pandemic, they also have gotten out of the habit of driving and feel some anxiety about anything beyond short trips. I've driven maybe 10 times since March and when I had to drive on the highway last month to make a hospital visit 35 miles away, I was so nervous the whole way there and back. So, I'm trying to get out more frequently!
I still don't have my driver's license because I have such bad anxiety over driving :(
I have driving anxiety..I just got off the highway after trying exposure therapy...and working through it..just a few exits at a time
Can you give us an update 🙈
@@oumaimabenhzazi3115
I went on vacation and came back...and MUCH IMPROVED..
I can drive on the highway again
When anxiety pops up, I've started saying "I want anxiety because I want to live my life!!" And then I start singing "I Want it All" from High School Musical 3 but change the words to I want all the anxiety 😂 It really does help me stop being afraid of my anxiety!!
I did this to get over fear of elevators after avoiding them for 20 years, which created lots of problems in my life. I learned that phobias are at their root an INABILITY TO TOLERATE anxious feelings, or a LOW TOLERANCE for feelings like dread and fear. So, little by little, I let myself feel these things... like I stepped into the elevator, touched the back wall and jumped out before the doors closed, and worked my way up to letting the doors closed but hitting the button to open them immediately, then going up one floor (with no one else on the elevator!), etc. I can now do a maximum of 6 floors with no more than 2 other people. I am still anxious, especially if the doors don't open quickly, but my body doesn't go into "I'm going to die!" mode. I was forced to deal with my phobia when I took a job as a companion/homemaker/PCA and part of my job was to accompany clients to medical appointments. Almost always, my clients needed to use an elevator. Now, like others here, I am trying to figure out how to do this with planes. I have claustrophobia in general, pretty severe, so planes are especially tough. I have also avoided them for more than 25 years. But I want to travel! (once we're past the pandemic). Am learning relaxation techniques, hoping to at least control my physical responses. Thanks for this video and the book reference. Very helpful.
That's great!
Omg same here 😢😢 I freak out in plane, start crying.
@@Jo-zx9fz unfortunately we can't practice walking into and back out of a plane, so I am expecting to have to use a few techniques to unteach my mind and body in terms of how they react to being with so many people in a place that's thousands of feet in the sky and over which I have zero control and there's no way to get out until we land again. Somehow I need to shift focus while relaxing my breathing . Again, the key seems to be not trying to force oneself to NOT be anxious but to keep the anxiety at a manageable level. I think it takes regular practice, a real commitment, and not trying to do it the day you get on the plane. That's my plan, anyway. I'm looking into tapping, which is supposed to break the circuit when one starts to freak out. And breathing exercises. And being very careful about the stories I tell myself about what's happening. Maybe, for example, telling myself I'm feeling excited and can't wait to see my friend (friends for 60 years at this point. Maybe I will look at photos of her and her home in Oregon and think about the places she wants to show me. I like to draw, so I could do that to distract myself. If I'm lucky, the person next to me will enjoy conversation. I have a much younger friend who has pretty intense social anxiety but somehow manages to push herself to do brave things like cycle around Iceland (in the summer), sing Christmas songs live on Facebook, and she's making me understand that when we don't give into fear, it gets weaker and weaker and although it doesn't leave altogether, it stops being what's in control. I figure I have maybe 20 good years left and I am sick of fear robbing me of adventure. So I have to commit to breaking old patterns and learning better skills. I wish the same for you and everyone else trying to live more courageously.
@@HTNPSullivan all the best dear, do tell me whenever you get on plane, how was your experience
Have you tried some NLP techniques for overcoming phobias?
Such a good breakdown of how it works. Sometimes I need to get out of my head and remember these points.
I'm curious what is your phobia?
Can I ask a question? It seems like the examples everyone uses when explaining exposure thereapy are things like fear of water, or of flying etc. But these are phobias. To me, anxiety is a more generalized, vague sense of dread and foreboding - a gnawing feeling that follows you throughout the day, but often isn't really about anything in particular. How can exposure therapy be applied in this case - or can it?
I was thinking this too.
Try eating tons of salad every day. A healthy one with lots of raw greens. Not joking. It’s the best treatment for my generalized anxiety.
Ive read somewhere that this kind of therapy (exposure therapy) works best for ocd than for anxiety
@@iforgot87872 i wish ,but raw salad hurts my stomach
What do you do for existential dread or fear of death?
the best therapist ever.. thank you so much.. i always put myself down.
You are so wise. You are the only psychologist I know who really understands how the brain works and the pros and cons of each technique, why they work and why they don't.
It took me half hour to make notes and watch the video. Gonna use it. Thanks dear. May god bless you. Keep up the good work
When "you can do hard things! Just keep breathing. :)" sets you off into an intense emotional moment, and sudden teary eyes...
Wow... yeah, that's a sign that my anxieties have set me up to have a lot of limiting beliefs about myself that are *much* more serious than I realized, and that it may be a longer road ahead than I've been giving credit for (thanks avoidance).
Thank you so much for this video. These are really helpful steps that I'm going to try to implement to work towards a better place. Thanks also for that encouragement. Coming from a pro who doesn't know me, but understands how brains work, that was shockingly encouraging and moving. I need more support than I realized...!
Such great advice and described in a beautiful, achievable way. Thank you 🙏🏼
You are helping millions of individuals through your informative videos! Thank you so very much. ❤️🙏
So grateful for all your videos! You really have such a wonderful way of breaking things down and make it so applicable to real life and how we can incorporate. Thank you, Emma!
This was extremely helpful to explain the success that exposure therapy has to a client. Thank you! Definitely subscribing!
Wonderful video❣ Thank you for your great work❣💐
I'm impressed. I followed these steps to finish a task and it actually worked! Checking in helped the most
Thank you for this video, I was often doing my “exposure therapy” with the idea that I can just leave whenever I want or need to. Working on making the exposure therapy more valuable and forcing myself to sit through high anxiety and panic attacks
THANK YOU. I really needed to see this. You have opened my eyes to the truth and spoke to my soul. I just made my list and I really hope I don't let myself down again. As I reflect on myself, I realize I have been using avoidance since 4th grade. As you can imagine my anxiety levels have only progressively gotten absolutely unbearable for me. So much so that I have been smoking weed way too much for 10 years now. It helps with the feeling of anxiety, but my life has been controlled by anxiety for so long now. Today I didn't smoke weed as soon as I woke up (because I do not have any at the moment) and I have realized how bad my anxiety has gotten. So bad that its hard for me just to go outside and be around others. I really hope that I can commit to my goals for once in my life. Thank you for helping me understand myself and providing methods to help with my anxiety disorder. THANK YOU.
thank you so much i wasn't know this therapy before you saving my life
You're brilliant! Way better than any therapist I've ever been to !
I absolutely feel like you have been a huge inspiration as well as the knowledge you give for free is so rewarding to myself and family . Your voice is so soothing and you break it down perfectly . During this time in my life I have needed every bite of this . I will be taking all the paid classes . I’ve read reviews and I just believe you are not only amazing but a God send for ppl like myself who has been stuck as I have let the fear consume my life. This is where I am grateful for the internet . Thanks so much
Thank you for these videos. This one is so helpful. I think the "baby steps" technique is such a good idea.
this is really one of the best explanation of ERP
Thank you for this precious video.
i really want to be a pediatric nurse, but i’m petrified of needles, i’ll try these tips and hopefully i’ll be able to carry through with it!! thank you!! xxx
Thank you for helping me understand me
I love these , Emma. Helped me so much.
This is SUCH great information. Thank you!
amazing video! I will do my best to follow all your tips, I have been struggling for many years.
I accidentally found this and instantly subbed. This channel seems like an awesome resource. :)
Very well presented. Comprehensible and attainable process. Thank you very much.
This is awesome thank you so much!!
I Thank you from the bottom of my heart , this video is very valuable to me
Awesome videos - simple and effective thanks for sharing 💜
This was very helpful. Thank you.
Thanks for the advice i definitely going to try it
You are way of delivering is excellent.
Thank you for this video Emma.
I have been listening to various sources to explain this therapy technique and your video is by far the most comprehensive and clearly explained.
Got it~🙌👏 Brilliant~
I like facing fear as it is the cause of most anxiety if not all.
That and memory and predicting outcomes rather than just being present
Bless your heart Ma'am🙏🏾,
You are a real life saver
Thank you so much, I needed to hear this!
Emma, this vid speaks to me and I believe is exactly what I need. (much more than the Self Regulation process.) I’m stuck and have done hard things before but just got stuck in safety mode. Thank You!!
Hello Emma, thank you so much for sharing these facts about Anxiety! I always wondered why i get anxious with a thought of doing something hard or making a business call, now I understood why my brain was using avoidance!
I used to later criticize myself for not performing in a situation! Thank you for relieving me of this situation forever. I have been watching many of your videos and they are super helpful! I am going to tell myself “it’s not dangerous, it’s just hard and i can do hard things” 😊 thank you! Thank you for your willingness to share and please keep making more valuable videos like these👍🏼👍🏼
I have terrible anxiety sometimes when checking important emails or texts, and definitely talking on the phone or in person when I feel like something is on the line. I know why I avoid it, but have you found a way to make that easier? The problem is when the exposure has potential to turn out bad. With most phobias, when people do exposures the result is good and nothing bad happens.
If you can let me know that’d be great!
Thank you for this video. It is really helpful!!!
I haven’t left my house in 2 months because I have panic attack when I was out , so I can’t do nothing in my life. I can’t even go to the shop down the road!! I really hope I can face my fear now. Thanks alot
How are you doing now? ❤️
Thank you so so much!!you are helping alot of ppl.I hope you are well yourself❤Thank you
Thanks! It's quite inspiring actually!
Thank you very much for this video... really appreciated and very grateful to you 🙏
but this exposure hierarchy is awesome. I am doing it currently. Sometimes I get disappointed because I feel like I can’t do the higher things right now, but just for the record, today I spoke with somebody for a while, having a decent conversation. I also talked to a new person today. I know I’m not at the place where I want to be, but I am getting there. Thank you again!
You make a lot of sense thank you 🇬🇧
Really helpful for anxiety sufferers!
I'm in love with this woman. I have tons of anxiety issues, I try to fight them but sometimes I fail. This video is great, I got more information about how to deal with my shit with this 11 minutes that I got from tons of therapy hours with a bunch of people that never give me this tools. Thank you, I will subscribe, recommend and watch your videos. I'm in a rocky place right now but I'm sure you channel will help me tons. Pretty and smart. This is it guys.
how much did it help ? Any updates ?
I love these videos , thank you there really helpful .
Thank you. I will practice these tips to overcome social anxiety.
Best video on this topic, thanks
I love this video and exposure therapy is something I plan to get started with for my performance anxiety when playing piano before othets. Something interesting I thpught about when watching your video is often the things we're afraid of are not really physically dangerous, but your fear of falling can realistically be something that can happen (a fall) if you make a mistake or don't know what you're doing. However, I can see how it's still important to overcome this fear when doing this sport is something that you enjoy doing and enjoy challenging yourself at harder climbs. Thank you for this video!
What a amazing video, thanks a lot
This was great..thank you so much!
Omg you helped me so much! Thank you!
This is a great video. Puts it into words better than I can. Totally going to use this in my work. :)
Awesome, I work hard to make my videos clear and concise, it's making me a better therapist
Hi there i admire what you doing for the mental illness community your content is so descriptive and accurate.alota people make treatments and exercises vague.. as to pay them to get there service you do it for free! Thank you ..god bless
More great content. Thank you.
Thank you for sharing this video. You truly helps a lot...God Bless you...🙂❤
Thank you so much for thesee wonderful videos, they really help me find hope in what seems like a hopeless situation:)
you've earned yourself a subscriber! ❤️
This is a very helpful video . Great job ! ☺️☺️☺️☺️☺️☺️☺️☺️
Thanks this was very helpful
This is a really good video. I used to be able to push myself through the things I feared, but now, it leaves me paralyzed and unable to be productive and fulfill my responsibilities.
I’d like to learn from this video, though. Very good information…
I'm doing exposure therapy at the moment for fear of tall buildings. It's tough it's literally one step at a time but I've gone a few blocks and I'm working towards being able to see my partner at her work in the city. Keep fighting guys.
Thank you so much.
Can you say more about using mindfulness or grounding as avoidance? Thanks.
Your the best !!! Thank u 😇
I’m gonna beat my avoidant personality disorder. Thank you for this.
Thanks Emma
Thanks
Thank you.
so helpful 🧡
Thank you very much
Really fantastic
Do you do therapy online? I need to talk to someone but I live in Thailand.
Hello! Thank you!
I just want to tell you, Thank you so much :’)
thank you
Welldone👏👏👏
Thanx a lot
Amazing 💗
Hate driving on highways. I’m not scared of driving. I’m scared of having a panic attack. This video was very helpful
How has that been for you?
@@jlove0311 better! Life is full of ups and downs.
@@infinitegaming1015
True...
I Jumped on the highway for abit..
Not too bad at first
But it got a little bad..
Gonna work on it again tomorrow Just a little more at a timeI believe the Holy Spirit dropped in my heart to do exposure therapy..It came out of the blue..never heard of it beforeJust a little more at a time
@@jlove0311 glad to hear that you are trying. I’ll be praying for you. Remember one step at a time. The smallest victories helped me through it. It’s bound to happen again because we go through seasons. The more you go through the more you learn.
@@infinitegaming1015
Thank you...please keep me in your prayers...
I fear the actual feelings of anxiety, adrenaline rush, feeling scared, feeling hypervigilant, the worried feeling of doom and the future...so since i am afraid of all of these feelings, I keep them alive. Anxiety is so tough... i do challenge myself by doing things, socializing, work, etc, but many times the feeling persists, and I can't wait to be home in my apartment. I know this is a false sense of security as my world gets smaller, but for the "moment", I feel a sense of relief. Vicious cycle.
I love your videos...so calming and encouraging with supporting science. Thank you! How would you help a 3 year old girl get over fear of using the toilet and abandoning the familiarity of her diapers ?
Do you have any advice on dealing with fear of giving a presentation or public speaking ?
Does this work with anxiety symptoms as well? Like sitting with them to face them until you understand they’re not dangerous just uncomfortable?
so I am working with a therapist, she is giving me EMDR treatment, I am also working on my severe social anxiety. There have actually been times where I’ve tried on my own to jump the gun and do the horrible scary activities that are a threat. This never ended well, every time I have disassociated and the trauma comes back
Please can you do a video on the fear of death
Can this help with health anxiety?
Thank you so much for all your helpful information.
Yes, great question!!!!
Thank you so much! I experience social anxiety that was so bad that it developed into agoraphobia that lasted a year. I've overcome a lot to where I can engage with people at work in novel situations and I can take the initiative even if it requires having conversations with people I perceive as intimidating. I still notice avoidance behavior in other areas of my life relating to social situations so this will be a fun way to order activities I want to do and expose my self to my fears.
same story
Same as me so bad but still manage to go out and i notice dt i dnt hv it alot.but still hv it
any updates?
What if your anxiety deals with relationships, like the fear of being rejected by a person you love if you make "mistakes" or "annoy" them? I can't exactly do unpleasant things to that person in the name of exposure.