How to Implement An Exposure Ladder


Exposure Ladder for Anxiety and Fear 


Anxiety is the fear and nervousness of a perceived threat, most commonly anticipated in the future.

One way to face your fears and overcome your challenges is through the art of exposure.

While it's entirely reasonable for someone struggling with anxiety to seek safety in avoiding a situation they are fearful of, this approach denies them of the chance to discover their resilience.

Instead, when attempting to manage anxiety, an important step involves confronting those feared situations, places or objects, and we refer to this as “exposure”

Exposure entails the intentional and incremental immersion into these anxiety-inducing situations. It's about acclimating yourself to them, thereby reducing the grip of anxiety while gradually expanding your comfort zone.

Crucially, it's important to stress that exposure should not be a daunting, all-or-nothing endeavour. Rather, it's a steady journey toward alleviating anxiety.

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Step 1: Create a Fear List

Begin by making a list of situations, places, or objects that trigger your anxiety. For example, if you're afraid of dogs, your list may include tasks such as looking at pictures of dogs, standing across the park from a dog on a lead, or eventually stroking a puppy.

If social situations induce anxiety, your list might involve smiling at a stranger, saying “hi” to a colleague, engaging in small talk with a cashier, calling a friend on the phone, arranging to meet a friend in the car park and going into a social situation together.

If driving is your fear, it may include getting in a friends car and having a conversation in a parked car, then next step is starting the engine. Going for a short drive together, and then they take you to an empty supermarket carpark on a Sunday evening where you can get behind the wheel without the fear of other cars.

The steps can be as small as you need them to be. It is just about progression.

Here is an example you may wish to adapt:

Specific Phobia (dogs)

Julie was afraid of dogs. She refused to walk outside or take her young children to the park, for fear of being attacked by a dog. She would avoid anywhere there were dogs and would avoid shops if there was a dog tied up outside.

Her goal was to be able to be around dogs without excessive fears, and be able to take her children to places she knew they would enjoy.

Note: sometimes it is easier to overcome a fear when you are focusing on a result that will benefit others more than yourself, in this instance, Julies children were her motivator.



Fear Rating


Stroke a larger dog off the lead



Stroke a larger dog on a lead



Hold a puppy



Stroke a puppy that someone else is holding



Walk past a dog on a lead



Stand across the street from a dog on a lead



Stand outside, and watch them from behind a fence



Go to a place with dogs and watch them from within the car



Watch a programme on television with dogs



Look at photos of dogs



Step 2: Construct a Fear Ladder

Once your list is complete, arrange the items from the least scary to the most terrifying. You can achieve this by rating your level of fear for each situation on a scale from 0 (no fear) to 10 (extreme fear). After rating each scenario, use the Fear Ladder form to create a final, organised list.

When building your fear ladder, it's helpful to identify a specific goal, such as having a meal in a restaurant, and then list the steps necessary to achieve that goal.

If you have various fears, consider creating separate ladders for each theme, ensuring each ladder encompasses a range of situations. Some steps should be manageable with mild anxiety, some with moderate anxiety, and others may be too challenging to attempt initially. It's crucial to start with small steps and progress gradually.

Here is an example you may wish to adapt:

Exposure Ladder Example

Step 3: Facing Fears (Exposure)

Definitely start with the least anxiety-provoking situation and engage in that activity repeatedly until the anxiety diminishes. For situations you can remain in for an extended period, like standing on a balcony if you are fearful of hights, see if you can stay there long enough for the anxiety to lessen.

For shorter-duration activities, consider repeating the same action multiple times until anxiety decreases.

As you spend more time in a situation or continue to engage in a specific activity, your anxiety naturally decreases.

Anxiety requires energy, and eventually, it begins to dissipate as you grow accustomed to the situation. The longer you face something, the less anxious you will feel about it.

Track your progress and plan exposure exercises in advance to maintain control over the situation.

Speak to an anxiety specialist

Step 4: Regular Practice

Practicing on a regular basis is essential. Some steps can be practiced daily, while others can be less frequent. The more you practice, the faster your fear will subside. It's also helpful to continue and maintain the gains you've made by exposing yourself to situations you've conquered on a regular basis.

Step 5: Reward Brave Behaviour

Facing your fears is no small feat, so be sure to reward yourself when you do. Consider using specific rewards as motivation to achieve your goals. Whether it's a special gift or a fun activity, acknowledge your accomplishments. Positive self-talk, such as reminding yourself "I did it!" can not be underestimated.

Step 6: Don't Be Discouraged

It's natural for fears to resurface from time to time, especially during stressful periods. This is normal, and it's an indication that you need to practice using the strategies you have learnt. Coping with anxiety is a long journey, and it's okay to have a blip.

If You Need Further Support

If you need further support with your Mental Health, a trained Anxiety Specialist can prescribe a personalised plan to understand the root cause of your fears, stress and anxiety, as well as help develop healthy coping strategies that are focused around your individual needs.

Taking care of your mental health is an essential part of your overall well-being. Left unresolved, mental ill health can spiral out of control and have a significant impact on relationships, work, school and family life.

So if you want to take the next steps to have a happier life, click the link below and book a free no obligation consultation call. 

Speak to an anxiety specialist

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