Basic principles of successful exposure

If you are being treated for a compulsive disorder, your treatment will often involve exposure treatment. To ensure successful exposure, it is best to take these basic principles into account:

• Test your compulsive thoughts: Do your fears actually come true? Keep testing this.
• Test your If-then expectation:
  – Always state what exactly you are afraid of (disaster) in advance
  – Did this actually happen?
  – Is this surprising?
  – What did you learn?
• Merge them together: Try to perform several exposure exercises simultaneously. For example, if you suffer from social anxiety, you could tell a joke at a party, wear a striking sweater, and chat with a stranger. Usually, you tend to try them one by one, the next step is to combine them.
• Confront yourself: If you want change, you have to do something about it. Consciously seek out frightening situations that cause the anxiety to (re)surface. Experience the anxiety completely.
• Variation: Try to vary between the exposure exercises as much as possible. Practice during as many different situations as possible. It also helps to conduct exposure exercises in your imagination. For example, you could write a movie script about your most feared situation.
• Experience feelings: Experience your emotions during the exposure exercises and do not try to change them.
• Discard the compulsive behaviour: Keep in mind that the compulsive behaviour is not just having a negative impact on your daily life, but that this behaviour also sustains the compulsion, as well as providing false security.
• Attention: Stay focused on the exposure exercise and avoid distractions.
• Tension: The aim of the treatment is to test the expectations, not to avoid tension. Don’t be afraid of tension.
• Reminder: Remember the successful exposure exercises. Find a tangible object that will remind you.