The Most EFFECTIVE Way to STOP Anxiety: Exposure Therapy | Dr. Rami Nader
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- เผยแพร่เมื่อ 8 ก.ย. 2024
- Anxiety disorders can be incredibly distressing and can interfere in a person’s life, limiting what they can do and where they can go. The number one most effective tool to overcome anxiety is exposure and exposure therapy. Anxiety is often maintained by avoidance of the feared trigger and this makes sense, because, by avoiding the feared trigger, a person does not experience anxiety. However, this avoidance is what makes a person’s life so small and limited by anxiety. Avoidance works to reduce anxiety in the short-term, but keeps anxiety going in the long term. Exposure, however, works in the opposite way. By engaging in exposure to the feared trigger, this will cause a person’s anxiety to increase in the short-term, but with perseverance and persistence, the anxiety will come down and go away in time. Exposure is difficult in the short-term, but works to eliminate anxiety in the long term.
The first step in exposure therapy is to build a fear hierarchy, or fear ladder. This is a list of various levels of exposure to the feared trigger and ordering them from least anxiety-provoking to most anxiety provoking. Then, exposure therapy involves repeated exposure to the lower-anxiety steps until a person’s anxiety goes away on its own. Then the person moves on to the next item in the exposure hierarchy until they work their way all the way through the fear ladder and overcome their anxiety. Exposure therapy takes work and effort, but it is the most effective (and quickest) way to overcome anxiety.
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This was helpful. I liked the part about exposing yourself to what’s making you anxious and learning that nothing bad is happening so the anxiety goes down.
Hi Siobhan - glad you found it helpful!
I had agoraphobia and after walking around my neighborhood I ended up shopping in a different town.
my life improved after finding your channel thank you so much
Hi Ali - glad you have found the videos helpful!
How do your videos not have more likes??? I am currently working through your anxiety series and have found it to be SO helpful. You explain clearly, you have a very relaxing voice and kind demeanor. Everything makes so much sense. Thank you 🙏🙏🙏
You're very welcome! Glad you have found the videos helpful. By watching, commenting and sharing, you get the videos out to more people, helping the channel grow, so I appreciate your support!
You are helping me so much. I am struggling because I have made such horrible decisions and by that I mean....I trusted, really trusted the narcissists in my family. Now I am completely ALONE.
This video really hit home with me. Because to a certain degree I have GAD...
and the uncertainty that comes with it gives me a very
unsettling
feeling. Like you said avoidance only works for the short term... but when you face those anxious feelings
head on it always has longer lasting results. At least that's the case for me. Thanks again for another informative video!!❤
Glad you found the vide helpful Jayde!
Wow..such a calming voice! I don’t even have anxiety and have no idea how I ended up here on your video BUT I’m listening because your voice is so, so, so mellow 🤣…Thank you 👍
You're welcome. Thank you for your kind words!
Absolutely powerful information here doctor and game changing. You have given me a completely different viewpoint on this condition. It's not something that I need to accept as a part of my life now, it's something that needs work and it needs to be understood intellectually and it needs to be consistently, vigilantly and methodically approached over the long haul to sustain maximum and permanent freedom from these ailing conditions. I am learning so much. Thank you.
You're very welcome. I'm glad you found the video helpful.
Great explanation. You have a great gift and talent; walking us through a difficult process and then how to implement a positive resolution. All things that are worth it have no shortcuts.
Hi C J - thank you for your kind and encouraging words. Exposure isn't very much fun, but it's extremely effective. Glad you found the video helpful.
the sirens speeding by my apartment all day have been tough but since I can't stop them, I notice, anxiety much less.
I find these videos extremely helpful as someone who has issues with health anxiety. Lots of your videos deal with ways to deal with HA but I think a lot of people would benefit from your wisdom on HA specifically if you get the time. Thanks again.
Hi Nick - I will be doing a series of videos on health anxiety, but I just haven't gotten around to them. Please keep an eye out for this videos in the coming future!
My problem is with people. I can talk to the cashier at the checkout and other people as long as there is a context. Meeting people socially is another matter. I have been trying to expose myself by going to meetup groups. So far they have been negative. At one of then I even vomited. Normally I just go into shutdown and am unable to put a thought together. I make myself stay at least an hour.
This video says that exposure therapy involves "working your way up." This means to increase resilience accretively. I am reminded of Ben Affleck's exposure therapy in the movie, The Accountant. (Every day he played loud music and the radio, and he rubbed a baseball bat on his shins to overcome his autistic dislike for a mixture of sounds and touch).
Has it gotten any better for you?
I’ve been trying the same thing, with little success.
@@scottsteibel I am a Christian. Jesus is my Peace and I have learned how to make shalom with God, myself, and everyone. I also have to face my fears head on. I play offense instead of defense now and I have sought full deliverance and I continue to live in prayer. That was the way out for me. I think that psychology is good at describing problems, but not as good at helping with solutions because they leave out God, and without God, it just results in strife. I know that I am forgiven and loved without merit and that changes everything. I am sharing this to be honest. I pray for God's help and I keep growing. It is working.
Great video, thanks for talking about anxiety in a practical way.
Thanks Negin. You're very welcome!
I’ve been suffering from anxiety for a long time,but 4 years ago i had the first physical symptoms, mainly heart palpitations with no other symptoms. That scared me a lot, and I thought that my life is over and that i have heart problems. Since then, I’ve been checked out by a cardiologist, and done ECG and ECHO test and they came back as normal, but the anxiety was still there every day and night. It was all i was thinking about. Then,one day when i was at work, I thought to myself that I can’t go on like this and I started to get so angry at myself, I started to have an argument with myself (sound crazy,i know) and i was telling the anxiety “ come on, this is all you got? I was very angry at myself that day ,but without knowing i was confronting my health anxiety and for the next few months my palpitations were gone. They still came back after a while but not as often, just a few here and there. Sometimes i get into the anxiety cycle,but i know it doesn’t have any power over me. I know i will win the war, even if sometimes i lose a battle.
I wish you all the best in your efforts to feel better!
Jonathan Asley is who I learned about you from. This is the one video of yours, that I chose to view first, as the subject matter is of interest. You invite feedback, so I decided to write. I am 70. This is a memory. My parents sent me to a private school for the forth grade. I look back at the level of extreme anxiety it caused me. The principle of the school was the scariest, and my teacher, unkind and horribly frightening. It was only for that one year of schooling. I am now 70, and look back at that being the worst year of my life! About five years ago, I decided to park my car and revisit the campus with the security guard, as a way of trying to get over my lifelong fear. As I walked into the building, a framed picture of the principle, who established the school, was well displayed. My knees were shaking as I viewed happy kids leaving for the day from their classes. Didn't help! I rarely think of this, but feel so bad it happened. I look forward to watching your videos. You speak in such a calming manner.
Thank you for sharing your experiences and thank you for your kind words. I hope you find the videos helpful.
It's a gross understatement to say this is helpful so we're just going to thank you for this one, and this channel and gifting us with your knowledge in a way we can truly get our heads around these complex matters, ,Dr Rami.💝
Hi Michele - as always, thank you for your kind words.
Thank you for this one. I obviously use Exposure inaccurately.
Glad you found the video helpful.
You are very professional 💯
Thank you for your kind words.
What you've said to do, the hierarchy, is so much less scary than what so many exposure therapists teach, which is basically public humiliation. I'd rather die than do the sorts of things they recommend someone like me does.
The whole point of exposure isn't to flood a person with anxiety, but to have them experience some anxiety, cope with it and allow the anxiety to go away on its own.
@@DrRamiNader I actually think I tend to flood myself with anxiety. Not with those humiliation techniques, but with doing more, bringing up more anxiety at once, this way I can overcome it, then help others overcome it. Except, it's not flippin' working!! Really, I don't have any idea what to do. Different emotions dictate whether I do anything or not. When I feel depressed and go out, I want to speak to nobody, grab some ice cream, be invisible, and go home. When I feel ok, I can force myself to stay out for an hour, but I really want the hour done and over with so I can come back home and watch TV. If I'm feeling good, an hour or so will net me at least saying hi to 10 people. I honestly just throw my hands up, give up, and let my emotions decide because I have no idea.
Great video, good explanation. You touched on it briefly, but could you say more about how this works in the case of GAD? I am anxious about making choices, and uncertainty, and about the fact that I don’t know what to do with my time on any given day. So far it’s a self perpetuating cycle - feel indecisive > don’t know what to do > get anxious > avoid and do nothing > feel bad > get anxious > become uncertain.
Hi Sjors - I've done a number of videos about worry management and how to address issues like intolerance of uncertainty, and you can find them here: Generalized Anxiety Disorder and Worry: th-cam.com/play/PLG_XiSJeP3s3uiRj-4CNEUn2qoK3mLAzD.html
Praying I can manage🙏
I have subscribed. Your explanation is very clear. Love your videos
Thank you for subscribing! Glad you have found the videos helpful!
Thank you very much for this video. My partner suffers from anxiety for some years now. I find him facing all his fears, he still lives his life and exposes every day for several times (not to say all day long). Anyway his anxiety didn’t improve by now. There is no “plan” behind exposure, he just does everything and tries to “survive” the painful situations. But he doesn’t “climb up” an exposure ladder. My question: what can he do so that he recognizes improvement ? And what can I do as his partner ? How do we have to behave during exposing ?
I’d be very happy and thankful if you gave me a little advice on that.
Thank you!!
I would encourage you to take a look at this video on how to make exposure therapy more effective: th-cam.com/video/33pbkJTZvlM/w-d-xo.html
No.
No. I am afraid every day, and every day I face my fear. And the next day I'm still afraid. And the day after thst, I'm still afraid. And so on. And I'm 46 years old. And I'm still always afraid, no matter how often I face my fear.
Very interesting video. I would like to know how to apply it for my case. I don’t have a specific phobia but I have a generalized anxiety/ excessive worry/panic.
Hi Mohamed - for generalized anxiety and excessive worry, I'd encourage you to take a look at the various videos I have made for managing worry: Generalized Anxiety Disorder and Worry: th-cam.com/play/PLG_XiSJeP3s3uiRj-4CNEUn2qoK3mLAzD.html
Your channel is absolutely fantastic. Thank you so much for taking the time to help out. Would you please consider talking about fear of flying and fear of death? How do you fix this type of fears?
Those are topics that are on my (growing) list of future videos. I will get around to them at some point. Thanks for supporting the channel!
Loved the video sir
Glad you found it helpful!
I've been doing prolonged exposure for PTSD and have not felt it helpful. Plus the stress of reliving the trauma incident over and over again has just caused more stress. Maybe exposure works for anxiety but not for PTSD
What about pain - stress and anxiety have caused pain my legs for a long time - months really - also had some sleep deprivation which added to this. Any suggestions. I am trying to just keep up my walks and working while adding some relaxation into the mix...and I am praying earnestly for God's help and guidance. May my prayers be answered. Amen.
The video is so insightful , thank you
Glad you found it helpful!
Thank you for this great advice, it makes total sense. How can you do exposure to flying tho?! I have a trip coming up in six weeks!
Do you have any videos on health anxiety? Almost every odd unusual sensation I get in my body sends me into fight/flight. I always think it will ultimately cause me to die or be some horrible illness. I also think I will end up in a psych ward when I have a panic attack.
Hi Robin - I'm planning on doing some videos on health anxiety, but I just haven't gotten around to them. I'd encourage you to take a look at some of the videos I've done on panic attacks, as they also touch on anxiety associated with physical sensations:
th-cam.com/video/VVudLksCbfo/w-d-xo.html
th-cam.com/video/hwteV__My2M/w-d-xo.html
th-cam.com/video/jckYi91KP-g/w-d-xo.html
Good
👍
How do you work on exposure therapy to imaginary fears?
Not my actual phobia, but for example, ghosts. If you consciously know ghosts aren't real, but still fear them in the dark or other scenarios, how do you build exposure without flooding?
In situations like this, people can do what is called imaginary exposure, or exposure to dropping safety behaviors they might do to try and manage their anxiety (e.g., sleep with a light on, checking the closet before bed etc).
Do you believe that ghosts are real? I believe in all types of things that can not be scientifically proven. I have actually found spiritual activity to be a safe space for me. Perhaps another exposure choice would be reading about the paranormal from a different perspective and speaking with different researchers to understand how a fear can become something you can at least find peace with. You may find this interesting, a lot of known researchers are still afraid of the dark. Doesn't that sound strange because of what they love doing? I do hope you find a way forward that brings you peace and comfort.
How do we apply this when we fear anxiety itself. When we fear mental health issues and racing thoughts etc
Hi Almira - it depends. If the fear is about physical symptoms of anxiety, that may relate more to issues surrounding panic. If the fear is about worrying, that is something called "metaworry" and those worries are managed using the same worry management skills a person uses for any worry. If you are interested in learning more, I'd encourage you to take a look at the panic and GAD playlists on my channel.
Dear Sir, may I ask what to do if I don’t know what’s the reason behind my anxiety?
Hi dr rami I hope your well interesting video I have a fear of heights balcony high bridges would watching videos of people standing on high balconies walking across high bridges help with my exposure ladder and do I just keep watching until there is no anxiety there ?
thanks dr for another great video🙏🏻, but i want to ask you in the recovery time from anxiety you have expirance the depersonalaiztation as part of recovery or is that advainced level of anxiety or there is no link between both of them ?
I usually see issues with depersonalization as a symptom of another condition such as panic attacks/panic disorder or PTSD. So a person can experience depersonalization as part of these conditions and improvement in the conditions usually corresponds with improvement in the depersonalization.
@@DrRamiNaderso Dr you mean like person cant expirance anxiety while having deperonalaization symptoms going on ?
I'm having severe agoraphobia after having 2 severe panic attacks recently that landed me in the ER. I really want to overcome this as soon as possible but I'm hesitant to try exposure therapy without the presence of a medical professional. Is this common? It may not help that I've been around the medical industry for several years. I'm scared to try anything alone.
You're AWESOME❤❤❤
Thank you for your kind words.
Will this help with my panic disorder? I've been dealing with it for 3+ years now and it is awful. Yesterday I was in class and I completely randomly got a wave of heart palpitations and feeling like I couldn't breathe, and I started screaming in front of my whole class. It was so. Embarrassing. Now I don't want to go to school on Monday and have to face everyone. I really am tired of feeling this way 😞
I have done a series of videos about panic attacks and panic disorder and you can find them here: th-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
What if you're anxious about becoming anxious? Or anxious about having another panic attack? How do you expose yourself to that?
Have you had a chance to take a look at the videos I've done on panic and panic disorder: th-cam.com/play/PLG_XiSJeP3s0vBPGLL-Jn_Dxen04L795w.html
@@DrRamiNader thank you for replying! I'll check them out
When you're anxious about health, how does exposure therapy work?
For example, if a person is avoiding reading news stories about health, or avoiding going to the doctor out of fear of what the doctor might tell them, those would be targets of exposure.
Exposure therapy Also called progressive involvement by psycho-politicians. The rosary is the most effective at stepping on intrusive anxiety. But if you have religious aversion his advice is solid.
Dc RAMI NADER my mom have a compulsion end no one sleep in the house wat the trouble she have she’s always push from the troat she’s say thei have samething stock in the troat ist so anoid thei went so many times to a doctor end lats test thei fund it’s a compulsive she’s 83 it’s so hard for me wat I supost to do please thank you
One question. What if i am prematurely exposed to a flooding level outside trigger before I was really ready? Do i fail till the level of anxiety ive trained myself or do I push through?
I encourage people to do the level of exposure that they are able to do and build up gradually. If a person does too much, then scale back to a level that is still challenging, but doable.
@@DrRamiNader my problem is anxious attachment triggers and rocd. Most of the exposures are beyond my control if i am within an active anxious-avoidant dynamic relationship. Thank you though. So grateful for you
Can we connect online
Hi Vishal - I am only licensed to practice psychology in BC, Canada, so I cannot provide psychological services or treatment to anyone who does not live here.
🙂
Hi can you please take a look at you ✉️ email? As i had written some doubt related to therapies there.please check and reply soon as can.and nice video.keep moving on.😊
When you start to think about suicide, that's when SATAN has done a mighty work in your life.
Actually a lot of empty words ...none of this help people with severe anxiety
I would disagree, but you're free to have your opinion.
@@DrRamiNader My opinion is based on my experience ...you cannot disgree with that
@@learnlanguages1916 You said "none of this help people with severe anxiety" Unless your experience represents ALL people, then it is just your opinion based on your situation. That doesn't generalize to all other people.
@@DrRamiNader Yes my wrong expressions of words .What i meant was doesnt help everybody
Fair enough. I hope you find something that does help with your anxiety. I wish you all the best.