Have you ever avoided doing something over and over again, even though you really wanted or needed to do it, because of the emotional and physical response you would have as a result?

In this scenario, by avoiding the experience you avoid the uncomfortable response which in theory is great, because who wants to feel uncomfortable or distressed if they don’t have to, right? If all you were avoiding was the unwanted emotions/thoughts/sensations this would be an ideal solution. However that is most always not the case. What ends up happening is that you also avoid experiences that you desire, that you need to do, that could make your life more meaningful, or that could help you grow. 

An uncomfortable response is subjective and can look like many different things including but not limited to: anxiety, panic attacks, sadness, racing thoughts, fatigue, sweating, social anxiety, anger, physical sensations, feeling vulnerable, fear, failing at something, etc.

Exposure response prevention therapy allows us to master managing the discomfort that certain scenarios bring us, or in other words helps us build our distress tolerance. If we can learn how to better prepare for and manage the distress that may come from engaging in certain experiences, avoiding is no longer our only choice.

Through exposure work, which is the thoughtfully planned and realistically paced practicing of the experience that causes distress until that distress has been significantly reduced. Exposures are challenges that can be created with the help of a trained therapist who can guide a client in these important steps:

• Appropriately assess severity of distress created by experience

• Identify the tools needed to prepare for and complete the exposures related to experience

• Identify the best skills and strategies to cope with the distress before, during, and after the exposures

For example, someone who has panic attacks at the doctor due to fear of needles isn’t necessarily going to go to the doctor to get their blood drawn for the first exposure. An exposure with a lower level of distress to be attempted first might be accompanying a family member to their doctor appointment to just practice being in the waiting area and getting familiar with the space and the providers. Another exposure at a lower distress level might look like going to the doctor for a physical exam with the caveat of scheduling any vaccines or blood tests for a later date. Breaking the avoided experience down into less distressing exposures, allows for the learning and practicing of coping skills that better manage the type of distress the person is experiencing. The exposures that cause the lower levels of distress, or versions of them, can and should be repeated until there is a sense of mastery and confidence before attempting the exposures that create higher levels of distress.

Our ability to avoid distressing situations is a helpful and necessary survival mechanism at times. However much of the time, it is actually better for us to learn to manage our distress and discomfort in healthy ways so that we can live a life that is more in line with our values and goals.