Archive for September 2012

Tao of Anxiety: Lifestyle Factors, Part I

Certain lifestyle factors can aggravate anxiety, increasing the duration and intensity of panic attacks, and can even influence the way we think, increasing phobias and generalized anxiety.

For people with moderate anxiety, or occasional worry, implementing lifestyle changes may be all that is needed to live an anxiety- or worry-free life. For those who suffer from severe anxiety, who need professional counseling and drug therapy, these same lifestyle factors are not cures in and of themselves, but are no less helpful.

I will focus on negative lifestyle factors in Part I—on our bad habits which lead to increased stress. You may find that avoiding these factors are beneficial for people without anxiety as well, and for people with depression.


Stress is a general cause of anxiety and panic attacks. Each topic in this post is an example of a stressor, be it drugs, poor diet, the way we think about others and ourselves, conflict, or emotional and physical isolation.

Not dealing with stressful events as they occur leads to a buildup of stress over weeks, months, or years. This chronic stress causes illnesses, mood swings, and unpredictable behavior, further compounding life's troubles.

Though stress should not be (nor can it be) avoided at all costs, it's good to have a way of coping with the stress, and avoiding what stress we can do without. Being aware of stress's role in life can be a big first step. Knowing the difference between avoidable stress (having a disorganized schedule) and unavoidable stress (a death in the family) is important.

What follows deals with avoidable stress. Avoiding these things in our lives can go a long way to reducing or even curing anxiety.


Drugs like alcohol and tobacco give people a false sense of security. The first drink or smoke can make us feel good, take away feelings of stress and apprehension, but the more someone self-medicates with drinking and smoking the more they play “catch up” as the body craves another drink or smoke.

Addiction is a see-saw between feeling a high and being in withdrawal. Withdrawal symptoms are similar to panic and anxiety symptoms and so an alcoholic or smoker who is dealing with an anxiety disorder may not realize the difference.

The chemical compounds in alcohol and tobacco are also detrimental. Nicotine in cigarettes acts as a stimulant, much like the caffeine in coffee or chocolate. Alcohol can quickly dehydrate the body, causing hang-over symptoms which can feel like the pounding headache and churning stomach of a severe panic attack.

Unhealthy Diets

Poor diet negatively effects our moods and increase anxiety, especially foods high in sugar and chemical additives.

Sugar (and other processed carbohydrates) is digested quickly, and just as quickly used by the body, resulting in a quick high and an even quicker crash. Many people who consume large amounts of candy or soda are familiar with these mood swings. But instead of avoiding sugar, most people remedy the crash by eating again, and the cycle repeats itself.

Overeating can also mimic panic attack symptoms like uncomfortable bloating, upset stomachs, heartburn, and headaches. Some people have trigger foods like greasy pizza or milk. Chemicals like MSG in processed foods can cause migraines. Other food additives like artificial sugars can increase appetite, leading to even more sugar intake. An unhealthy diet can lead to obesity, heart disease, diabetes, and cancer, creating even more instability and anxiety.

A majority of my own panic attacks have come during or shortly after a meal, and controlling my diet has been one of the most effective means of controlling my anxiety.

Sedentary Lifestyles

Exercise and anxiety medications have something in common. Serotonin. Serotonin makes us feel happy, but when we sit and watch TV all day, unless we're taking a healthy dose of drugs, we're probably lacking this one vital neurotransmitter.

Watching TV and playing video games has been linked to increased feelings of uneasiness, and when we sit for long periods of time we're also more likely to get bored and eat, or dwell on negativity. Sitting too much also depresses the immune system and a slew of other hormones and bodily activities.

A lack of activity also impacts self-esteem. Few people can gain confidence on a couch.


If life were a race, it would be smart of us to begin at the start/finish line with the rest of the runners.

Having a pessimistic outlook on life means starting a mile behind where we're supposed to. By the time we catch the other runners, assuming we even do, we've come farther than we had to, and worked harder than necessary, because we were holding ourselves back. And the other racers—life's challenges—have the edge on us.

With pessimism it's hard for us to overcome obstacles, or to even think clearly about life and what we're doing in it. How this effects those with anxiety disorders is simple: pessimism gives us every reason to give up and not finish what we've started or hope to one day accomplish—healing.


Some conflict is unavoidable, like a project that must be finished immediately, or a major illness in the family. But much of the conflict we face in life comes in the form of drama. Life's drama is conflict that is not dependent on others or life circumstances. This is drama we create for ourselves.

People who gossip, treat others rudely, or lose their tempers and lash out at friends and loved ones only make their anxiety worse by creating unnecessary tension in all of their activities and social interactions. It is important to understand that when we are rude and harsh to others, we will not be treated well by them. But when we are kind to others, we can generally expect others to be kind in return.

It can be very difficult to know when the problem is us or someone else, but typically if it's happening a lot, across many relationships, we're likely the ones to blame—and the only ones who can fix us.

It is far easier to heal in a happy, relaxed atmosphere than in a chaotic and tense one. Building relationships based on kindness instead of treachery is vital.


Perfectionism is a common cause of generalized anxiety and feelings of uneasiness. When it comes right down to it, what bothers many people most is a feeling of lack of control which contradicts a strong, inborn need to have things work out perfectly.

We want everything to go right on the first day of school or work, but there's an uncertainty that it won't, and so we worry. We worry when anything may turn out less than perfect. We fret over the cooking, over the kids, over neighbors and coworkers. We fret when life isn't perfectly in our control.

But life doesn't have to be perfect to be happy, fulfilling, and fun.


The last item speaks specifically to those with Social Anxiety Disorder and Agoraphobia. In the face of phobias the first instinct is to hide, but isolating oneself is counterproductive. The intuitive feeling of running away from what we feel is harmful is wrong precisely because it is just a feeling.

In reality unfamiliar social situations (like driving a car, going to school or work, or talking on a telephone) may be nerve-racking, but they are not dangerous, and so do not require the same response as meeting a predator in the wild would require, which is to run and hide.

Because there is no real, valid threat, isolation not only fails, but often results in the exact opposite of what we need to cope with life. Isolation can lead to an increased phobia by entrenching us in our comfort zone. And when dealing with a phobia, or even worry, the best tactic is to grow, not collapse, even if growth happens slowly.

Further Reading:

Tao of Anxiety: Series

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The Road Less Traveled By

I have my shit together 99% of the time, so to speak. But there's always one day that seems to unravel all I've worked for. Months and sometimes years of effort is washed away by a bad decision, by an unlucky break, or by an unleashed coil of frustration.

Sometimes there is a reason for what happens, sometimes there isn't. There's always a lesson involved, yet the learning experiences come and go and never stave off that next awful day.

Sometimes it's an illness or an injury. Other times it's the loss of a friendship. The death of a loved one. Or it's our inability to get out of our own way, to stop and think before we act.

At moments like these it feels as if all's for naught. Hopelessness sets in, reality turns dark gray. Why go on? Why work hard or do what is right when one bad day can ruin everything?

These are watershed moments. When live diverges, when we have a choice to make. To not care, or to grow. I have certainly had my moments when I caved, when I didn't care enough to try to go forward. Nothing was ever won, and I never tasted satisfaction. My life has turned out okay despite that, but I will always wonder what could have been.

For some things I refuse to wonder. I must know.

I'm getting older. I'm growing more aware. When faced with these watershed moments I no longer wish to not care. I want to stand up and take the challenge.

If it means I have to grow emotionally, I'll do it. I'll stretch my comfort zones like matter in the early Universe stretched space.

I don't have to give up. I can push through. I know what I want, and I know what I have to make myself do to get it.

But all before me is uncertainty. What am I to do with that? Uncertainty is inevitable when a single road diverges. We can be on a path for so long that it's grown quite comfortable. To turn either left or right is to drive away from the known.

Sometimes two people carry along together on that path and find they need to go in separate directions.

One path may be quite ordinary, and yet to go that way is to lose a traveling partner.

The other path may require the loss of the self.

In the end the decision hinges on a question. Who is more important? Self? Other?

Will we stay on the road we know will be most safe to the self? (Sheltered, protected, hidden away.)

Or will we venture the other way, risking self for someone else? (Risk, vulnerability.)

I have spent 25 years of my life living for myself, living scared, close to the vest, conservatively. It's had its advantages and has contained some hidden treasures, but I've outgrown its usefulness.

It's time for me to step outside of myself and live for someone else for a change. To be aware of others as I have always been aware of myself.

Spiritually this means something very straight-forward, if not simple. To realize the Cosmos' oneness isn't to see others as self, but to see self as others.

I do not believe that it matters then that we choose the path that requires the loss of self. Self can always be redefined. It's not possible to go back in time and live life over.

Don't be afraid to sacrifice something of who you are to lift up the person or people you love. Be something bigger than you. Be another.

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Tao of Anxiety: Search for Acceptance

In this post I'm shifting back into a personal perspective. I wish to shed light on something I face as I deal with social anxiety disorder, and at the same time justify myself as a person.

I can cope with panic attacks. I can work through uncomfortable situations. What I've largely failed to deal with is the guilt I feel because I cannot do what others can, and the question of whether or not friends and family will help me up if I fall too far behind.

If I can't hold a job or go to college, will my family give up on me? Will my friends abandon me? Will my girlfriend of six years leave me?

This isn't a confidence issue. I feel that I am a worthwhile human being, that I can add value to others' lives, that I can pull my own weight and not be a burden to others even if I can't do certain things. Yet my own expectations don't fit the cue card society has given me. I also feel a nagging sensation that others are expecting more from me—more than I can possibly give at this time.

Holding a job and going to school, driving, flying, talking on a phone, all of these activities and more are not only doable for most people, but are required. These are things that I can't do without weeks or months of preparation, or more. Not because I'm lazy, but because I freeze before I can start. My mind literally shuts off because I am phobic. It's the only way my brain can deal with an overwhelming situation.

I want to be me without the controversy. I don't want this contradiction between my nature and others' expectations for me, yet it's there, and I can't escape it anymore than I can escape panic attacks. I don't want to be unable to speak on a phone because I get tongue-tied, but I also don't want to be looked down upon because I can't be “normal,” or like everyone else.

I've begged, and I've pleaded, but I feel that I've failed to convince people that even if I am a phobic toward most things social, it's still worth having me around. At least I don't feel that I can rest on being accepted—that if I fail, I'll still be loved and wanted.

I imagine myself homeless in the years to come. Yet that's not even the worst case scenario. To me, doing what people expect of me is more difficult (at least in my mind) than losing everyone I know and love. That seems to be the decision I face.

As a phobic, I cling to the comfort zones I've built for myself. It's easier to have anxiety than it is to face the world. It's easier to be alone than shove my way through a crowd. It's easier to have nothing than it is to take risks to get more than what I need.

I know other people can relate to this. One doesn't need to have a phobia or even an anxiety disorder to understand what it's like to fear success and failure. I'm preaching to the choir when I say that leaving our comfort zones can be one of the toughest decisions we can make.

Something that helps me through some of these feelings is my spiritual practices. Listening to Alan Watts and Ram Dass, studying the writings of Lao Tzu, Chuang Tzu, and Hsin Hsin Ming, among other sages. I'm slowly working toward a worldview that encompasses all things as one thing. A connection, not a division between myself and others. Because of this practice, I have grown more comfortable with myself in social settings—less self-conscious.

Yet there is a paradox involved with this that I understand, but feel others won't want to understand. Despite my enlightened realizations, which “should” get rid of my anxiety completely, I also realize that my panic attacks and phobias are also part of this oneness. As Ram Dass would put it, my social anxiety disorder is the melodrama I'm living. I have to accept it, or live in constant conflict with myself.

I know this to be true, because when I say to myself “Okay, I have an anxiety disorder, that's all right,” much of my fear, self-doubt, and self-consciousness evaporates. It's like going into the center of a fire to escape the heat of the flames. Yet it doesn't dissolve my phobias. It makes them more manageable, yes, especially as I am thinking of this, but once I stop thinking and go on with my life, I slip back into my accustomed habits and fear. It really seems as though this is who I am and it's not changeable.

I feel like I can and have accepted that, but will others? Am I going to have to continue to contradict society to be myself, push against others constantly? “I can't do this, I can't do that, but accept me for who I am?”

Acceptance is such a large part of social phobias and panic disorders. Speaking with people with anxiety, I get the feeling that the root cause is an existential split between self and other, and self and self. Anxiety is, at its core (at least on a philosophical level, if not psychologically), an attempt to escape oneself, a denial of one's nature, an attempt to swim against the current. It's a constant war against life as it is, a craving for a life how it's viewed by a distorted ego. And because our expectations never pan out, we with anxiety must continuously face failed expectations. It's tough.

This is why merely accepting myself and my anxiety helps so much. But this doesn't seem to help the split between self and other. The extreme self-consciousness that puts us at odds against all the people we meet. Add distorted thoughts to the mix, and we must always be on guard. “Will they laugh at us? What if I mess this up? I really am not as good as others, so I shouldn't even try. What if I get sick, get lost, or get hurt? What if I screw up and hurt someone else?”

The failure of others to accept me as I am plays right into the hands of this self doubt. It seems to prove all of my worst fears. And yet all of this is nothing more than a mind game, a game which I wish to drop as soon as I can figure out how to.

My hope is that others can drop the game as soon as I do. Maybe they are not playing the game that I am playing, and all of this is in my head? Maybe when I learn to loosen up and relax, it'll rub off on them? Maybe I'll finally find a way to explain this to them? Maybe it won't matter anymore, because I'll be cured of my phobias and all will be moot?

Or maybe I will be a phobic for the rest of my life. Can I be a happy phobic? Can I live a semi-normal life? Can I be married, have kids, and be a productive member of society despite not working or having any sort of education? Do I even deserve these things if I can't pull the same weight others pull?

It's a real mess, and it doesn't make anxiety easier—it makes things infinitely more difficult. And I have no answers for these feelings.

I have nothing but to move forward and hope things work out for the best. To accept the one truth of life, that it is an uncertainty.

Further Reading:

Tao of Anxiety: Series

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Taoism and Football

My beloved but sucky Dolphins lost on Sunday. I wasn't surprised by that, because I knew Houston has our number, but I was disappointed by the catastrophe that was the end of the second quarter. I was hoping for a more competitive game.

But I've been thinking about the loss, bad teams, and sports in general.

Houston fans are pretty stoked after Sunday. Their team played great—doing what they needed to do to win—and the fans get to celebrate for a week.

Sports is entertainment. Objective fans hope for nothing more than a competitive game. I am not a fan of Denver or Pittsburgh (though I love Peyton Manning), but I was very happy after Sunday night's game between these two teams because it was a close, exciting game. I got what, as a fan, I hoped for.

And I can relate to Steelers' fans. My team lost, too. There is no upside to losing. It hurts. Period.

Yet I realized something interesting. In order for one team to win, the other team obviously has to lose, but teams that lose play a vital role in sports. The Miami Dolphins and Cleveland Browns, perennial losers, are just as important to the game of football as the New England Patriots and Pittsburgh Steelers, perennial winners.

Enter Taoism.

To have a positive, you must have a negative that coincides with it for contrast, or you really have no way of knowing what you're seeing. Alan Watts described this phenomenon well by comparing a hand placed against a white, blank background. The background gives birth to the hand because it is different from it, and vice versa. Another great analogy for this is the magnet. It has a positive and negative, but neither is better than the other, and for a magnet to exist at all it must contain both charges. 

Positive and negative, up and down, good and bad, and winners and losers are neutral ideas until humans start tossing expectations around. “People should be good. My team should have won that game.”

In football, we root for the winners, but if we didn't have the losers, there would be no game!

And so I contented myself this week knowing that my team at least made a good portion of Texas happy. At least someone is happy.

To lose is a virtue. It means that we've given someone else an opportunity to win, and with that comes celebration and elation.

No one remembers the losers, but they're at least as much a part of the game as the winners are. They are bonded. Inseparable.

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Tao of Anxiety: Healing Phobias, Part II

Even as there are effective treatments for phobias, some treatments fail, slow recovery, or even hold sufferers back.

Not committing to CBT or exposure therapy consistently is counterproductive, making it difficult to capitalize on the gains made during each session. Practicing exposure therapy once a month simply won't be efficient to desensitize most people from their phobia. Two or three or more times a week is recommended. The more often CBT is practiced, the more results we can expect.

Negative environments (not having supportive family and friends, or having critical or abusive family and friends) are extremely detrimental to the recovery process. Some people are very strong and can plow through the negativity and recover despite it, but most people will find that this negativity slows them down, stops their progress completely, or is actually making their anxiety worse—or is its cause.

Though finding new friends or leaving home can be very difficult, for those who have this option it's important for more than their emotional well-being to do so. We are the company we keep, and if we choose to keep good company instead of bad company, we clear many obstacles that once blocked our life goals. Positive people wear off on us, help us grow, and make life much more bearable. Likewise, we pick up the habits of negative people and become negative.


The next two deal with the treatment of phobias, and is a warning to those who may not want to take a whole approach to healing. Each of these is beneficial when paired with CBT, but as separate tools, rarely stand up by themselves.

Talk Therapy

For years I was involved in talk therapy, the most common therapy for depression and anxiety. It never helped me, and often confused me more as it brought up a lot of difficult emotions that my short sessions or switching doctors never resolved.

Looking back I see how futile this method was. Discussing why I had anxiety, or why I was depressed didn't help me because it was focused on what had already happened, whereas the depression and anxiety were happening right now. Talk therapy was great for knowing why I was the way I was, which was useful later on when I started CBT, but I missed out on the most effective coping strategies during my talk sessions.

There is no way of measuring talk therapy's effectiveness—if it is effective at all. With CBT, especially when exposure therapy is used, because I was actually doing something, learning and practicing coping mechanisms, I could write down and observe my progress in relation to the activities I performed. I could then set goals for myself, and observe what was working and what wasn't. But using only talk therapy I had no way of setting individual and short-term goals, and no way of tracking my daily or weekly progress.

If it doesn't work, why is talk therapy still so popular? Because it is convenient. It allows patients, if they wish, to talk about their feelings openly without fear of criticism. Many talk therapists do not challenge their patients, and so there relationship becomes non-confrontational. For those who just want to be heard, this is perfect.


I was medicated for most of my teens. I took Paxil and Zoloft for years, yet neither medication helped me overcome my phobias—some of my phobias grew significantly worse.

Medication does one thing: it relaxes us enough so that we may feel comfortable. Stronger medications like Xanax and Valium are more effective, but are also highly addictive and potentially dangerous. What medications do not do is give us the motivation we need to take advantage of these relaxed states.

Relying on medication alone failed to cure my phobias because it could not give me the motivation or confidence a good therapist using an effective CBT program could. Yet coupled with CBT, medication can get sufferers through difficult situations, helping to build confidence and motivation. But eventually for the sufferer to test his or her progress, it will be necessary to taper off meds and go through exposure therapy without this aid.

I chose to stop medication and live pill free because I wasn't comfortable with their side effects, and I knew that to be fully healed I would have to do the things I wanted to do without their help. For people who are comfortable taking pills, medication can make a profound difference in their recovery, but even then medications should not be relied on completely, or be treated as a cure-all.

Just like with talk therapy, taking medications is convenient. Drug companies tout their medications, but it's rarely ever mentioned that pills work best when coupled with CBT. And in our world of instant gratification, people hoping for a quick recovery can easily be swayed by the belief that meds alone can cure us, though this is rarely true.


In the end phobias are complicated events, but getting over them can be as simple or as complicated as a sufferer wants to make it. With a little motivation one can begin taking slow and planned steps to recovery, building confidence with each small achievement. Though talk therapy and medication are not cures in and of themselves, they can, when part of a CBT and exposure therapy program, help bring understanding and relaxation to the process, further bolstering confidence.

Recovery does not need to be overnight. All that is necessary is moving by inches, until finally the sufferer looks back and sees miles have gone between.

Further Reading:

Tao of Anxiety: Series

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Labor Day 2012

My hat is off to the men and women who fought the Man and won rights for workers in the streets outside the factories and mines they worked in. Most of you are dead by now from old age, but in your youth you took a beating from the police and governments pushing the company line, and pushed back harder than they could take. Change came through you, by your hands, and you were a greater generation than ours measured by your deeds and the challenges you faced.

I'm only sorry that your leaders ended up in bed with the Fed and the Mafia and in some cases the companies you fought. But what was won is ours. Ours to keep or ours to lose. Thank you for Opportunity.

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Tao of Anxiety: Healing Phobias, Part I

What is a phobia?

Many people know what it feels like to experience a phobic reaction. We can imagine someone who is afraid of heights staring down from a high place, feeling dizzy as they wipe the sweat from their palms, because most of us have felt this type of fear before.

We've experienced these feelings before walking onto a stage, starting a first day of school, or first getting behind the wheel of a car. For some people this excitement helps them perform, but for others it causes them to draw into themselves.

Just about anyone can rattle off a list of common phobias. Fears of tight spaces, of falling, of bugs, of the dark, of sexuality, of lightning. These phobias are to things, to experiences, but some phobias aren't so easily classifiable. They are vague and difficult to explain because they are highly subjective.

A fear of new, unknown experiences where escape isn't possible: Agoraphobia.

A fear of criticism: Social phobia.

These two phobias cause millions of people to struggle and fall. They experience intense emotional turmoil when they find themselves in new situations; where they're not sure what to do, have no one they feel they can rely on or trust, and fear the criticism of the strangers around them.

Some anxiety sufferers cannot go into stores alone, or at all. Some cannot try new experiences or do things they once loved (like going to a ball game or a movie), even if they want to. Some cannot even stay at home by themselves, work, or go to school, because they lack the confidence to handle ordinary situations.

These phobias center around people, but they don't always make sense to those who haven't experienced them. Why, for instance, would a phobic be comfortable around one person and not another, or feel comfortable in one situation and not another, similar, situation.

These phobias can occur for many reasons. In my own experience an illness triggered my panic attacks, which eventually led to my phobias. Environmental and biological factors were present throughout my childhood, but what finally brought me down was my body's inability to cope with the stress of illness.

Other people become phobic from overbearing and overcritical parents, childhood bullying, or for no apparent reason at all. Often the creation of a phobia is a long process, involving years of similar life experiences that slowly “teach” the individual to fear certain situations, or people in general. Other times a phobia can come out of the blue, striking at any age.

Yet phobias are not untreatable.


Getting over a social phobia is difficult for many reasons. The largest hurdle is a lack of understanding. The sufferer may not understand what he or she is experiencing, and family and friends may not understand, or want to understand. Phobias are sometimes met with disbelief or criticism.

Getting over any phobia requires not only an understanding of what it is, and of the process of recovery, but it requires motivation. For those who suffer from constant anxiety, this motivation does not always exist. As illogical as it may seem, the disorder or fear itself becomes a sort of comfort zone, and healing requires leaving that comfort zone, which some anxiety sufferers view as dangerous and uncomfortable—even more uncomfortable than living with panic attacks and distorted world views.

Another factor for recovery is the willingness of family and friends to help the sufferer grow. There's a fine line between encouragement and criticism, and saying the wrong thing can hold those with anxiety back as easily as simply being there and showing physical support can instill confidence in difficult situations.

Many with severe phobias do not seek therapy, and live a secluded lifestyle. For those lucky enough to have understanding family and friends, and are motivated enough to overcome their predicament, finding the right treatment becomes the most important step.

There are several methods to treat phobias and anxiety disorders. Some doctors rely on medication or talk therapy, but in my personal experience neither are as effective by themselves as cognitive behavioral therapy (CBT) is, especially when the focus of CBT is in vivo exposure therapy.

Exposure therapy (along with medication and talk therapy when necessary) is cognitive psychology's answer to treating phobias, and where social anxiety disorder is concerned, exposure therapy has the highest success rate.

What is exposure therapy?

Exposure therapy involves desensitizing ourselves to a phobia. If we are afraid of spiders we may start our therapy by looking at pictures of spiders. Once the first step is conquered,d the next step would be to sit in a room with a spider in a jar. The third step would perhaps be to touch a non-venomous spider.

The purpose of this method is to retrain our cognitions—our thoughts. By experiencing spiders in a non-threatening way, over the course of weeks or even months or years, we rewire the brain to not fear arachnids, resetting the amygdala which before then stored our fearful memories and reminded us to be afraid when we came across similar situations..

Treating a social phobia works in the same way. If we have a fear of eating at restaurants, we can break going to a restaurant down into small, convenient steps. The first step may simply be to visualize going out to eat. The next step may be to drive to a restaurant, but not enter. The next step may be to go in, sit down, but not eat anything. The final step would be to go out and have dinner.

Each step may be done as many times as is required to master that step, or at least to face the step with a manageable level of anxiety.

At any time in the process the sufferer is allowed to get out of the situation. In fact, in Edmund J. Bourne's “The Anxiety and Phobia Workbook,” he advises sufferers to make sure they have an escape plan for each step.

It is more important to quit than to go through a stressful event, because the purpose of exposure therapy is not simply to accomplish each individual goal no matter what, but to retrain the brain. If a sufferer experiences too much fear at any given step, he may only reinforce the anxiety instead of getting over it.

This makes exposure therapy a very low-key exercise. It can be as difficult or as easy (comfortable) as the sufferer wishes it to be, and there's no right or wrong way to set it up so long as each step is a little more difficult, or challenging, than the last, and each step is practiced consistently.

Exposure therapy works because it is flexible. It can be used in many different ways to fit the needs of the sufferer, and it can be taken as slowly or as quickly as one feels comfortable.

Other CBT methods

There are several other therapies worth mentioning, which can by themselves make a large difference, and are vital for making exposure therapy successful.

Using coping statements to counter negative thinking helps to replace negative thoughts with positive ones. Negative thinking is a major reinforcement of phobias and anxiety. Therapists can help sufferers deal with mistaken beliefs, guilt, and worry by teaching them how to use the mind in a more constructive way.

A negative thought may be “I can't do this” when confronted with a difficult social situation. Someone trying to work through this negative thought could challenge it (“why can't I do this?”), replace it with a positive statement (“I am fully capable of doing this!”), or putting the thought into perspective (“I haven't always failed at this.”).

Visualization is an underrated practice that has the potential to transform reality. Using visualization to counter a phobia requires nothing more than imagining being in a difficult situation and working out ways to get through it, mentally preparing oneself for the real event.

Visualization is especially helpful because the mind has difficulty telling between reality and imagination, making visualization almost as good as the real thing if done intensely enough. We can go through the motions without taking on the risk of a real life situation.

Visualization is a great way to prepare for a session of exposure therapy, to practice what to do, where to go, how to do what needs to be done so the sufferer is mentally prepared and not entering an uncertain situation. This can significantly reduce anxiety, and even put control back in the sufferer's hands.

Learning to assert one's feelings can also help lift a sufferer out of a phobia. Some people suffer phobias because they feel trapped, as if they have no power over the situation or even over themselves. They feel they have to do something because others demand that they do, and this contradicts their own needs. Learning to stand up for oneself, to ask for things, and to voice an opinion or to say no to others' demands can put the power back into the hands of the sufferer, reducing much of life's pressure.


Exposure therapy when coupled with other CBT techniques, as well as breathing and meditation, can help sufferers make gains quickly.

For the same reason that CBT and exposure therapy work so well, talk therapy and medications can fail, or slow progress.

Find out why in my next post.

Further Reading:

Tao of Anxiety: Series

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