Graded Exposure, Systematic Desensitization & Anxiety

When we’re feeling anxious about something, it’s natural to want to avoid it, but avoidance is one of the worse things we can do for anxiety, and the more we avoid something, the more anxious it tends to make us. The opposite of avoidance is exposure, and one of the keys to reducing anxiety is to exposure ourselves to the things that cause us anxiety, through a gradual and controlled process called Graded Exposure or Systematic Desensitization.

Watch the videos below to learn why avoidance increases our anxiety and how we can use graded exposure or systematic desensitization to lower our anxiety.

Reducing Anxiety and Avoidance with Exposure

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Managing Panic Attacks With Cognitive Behavioral Therapy (CBT)

panic attackPanic attacks, also known as anxiety attacks, are sudden and intense waves of anxiety that can leave you worried you’re having a heart attack, about to pass out, going crazy, or with any number of other fears that something is seriously wrong with your health. Panic attacks are terrifying in isolation, and panic disorder occurs when panic attacks arise on a regular basis.

The most effective treatment for panic attacks and panic disorder is Cognitive Behavioral Therapy, or CBT. In the videos below, learn how anxiety escalates into a panic attack, and how you can use CBT to defuse a panic attack and make it less likely you have panic attacks in the future.

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How to Sleep Better & Cure Insomnia With CBT-i

Cognitive Behavioral Therapy for Insomnia (CBT-i) is the most effective treatment for insomnia. CBT-i teaches you how to sleep better and can often cure insomnia altogether. The main components to cognitive behavioral therapy for insomnia are reducing negative sleep thoughts (NSTs), and practicing good sleep hygiene and more effective sleep scheduling, sometimes known as sleep restriction therapy. Learn more about CBT-i in the videos below.

How To Sleep Better And Cure Insomnia With CBT

 
 

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Cognitive Therapy and Challenging Negative Thoughts

 

When we’re feeling distressed about something or going through a difficult emotional experience it can feel like our thoughts are running out of control. Our minds start racing and we find ourselves dwelling in the past, worrying about the future, or just spinning our wheels trying to think ourelves out of our problems.

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Breaking the Vicious Cycle of Anxiety

upward spiralIn a previous post, we looked at the vicious cycle of anxiety, in which an anxiety-provoking events triggers an anxiety-related thought, feeling, behaviour or physiological symptom, which generates additional anxious thoughts, feelings, behaviours and physiological symptoms.
 
One of the keys to overcoming anxiety is break this cycle before it begins to gain momentum. We often don’t have control of our initial response to an anxiety-provoking situation, but once we become aware that something has triggered an anxiety-related thought, feeling, behaviour or physiological symptom, then we can choose how we react. Mindfulness, and congitive behavioural therapy (CBT) or cognitive therapy, are effective ways to help you stop these cycles before they can build.

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The Vicious Cycle of Anxiety

downward spiralAccording to the cognitive behavioural therapy (CBT) approach to anxiety, one of the reasons that overcoming anxiety can be so difficult is that anxiety generates vicious cycles involving your physiological, cognitive, behavioural, and emotional domains. We looked at these four components of anxiety in a previous post. Now we’ll look at how they act together to form vicious cycles that create and maintain anxiety.
 
In the cognitive behavioural therapy (CBT) model of anxiety, the vicious cycle begins with an anxiety-provoking situation. This situation can be something external such as a work commitment, a trip, a social engagement, or any other event happening in the future that you’re worried about. Anxiety can also be provoked by something internal such as a physiological sensation, a thought about something you’re dreading, or an unpleasant emotion.

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Cognitive Fusion and Defusion in Acceptance & Commitment Therapy

 

In a previous post we looked at some ways to practice letting go of thoughts, but it can often be difficult to let of thoughts because they have such a powerful pull, especially when the thoughts are related to a strong emotion. In my post, What is Acceptance and Commitment Therapy?, we learned why acceptance is so important in ACT. Cognitive defusion is a way of accepting our thoughts, allowing them to pass into and out of our minds, without getting stuck in our heads.

Steven Hayes, who developed Acceptance and Commitment Therapy (ACT), coined the term “cognitive fusion” to describe times when we are so tightly stuck to our thoughts, we become “fused” to them. When we’re experiencing cognitive fusion, we can’t separate ourselves from our thoughts. Our thoughts become our reality. We feel removed from the world outside of our thoughts, removed from our senses, from what we’re doing, and even from the people around us.

The opposite of “cognitive fusion” is “cognitive defusion.” Cognitive defusion involves taking a step back from what’s going on in our minds, and detaching a little from our thoughts. In this state of defusion, we can observe our thoughts and other internal processes without getting lost in them, stuck in them or fused with them. We can simply notice our thoughts, watch them, accept them and let them go if we choose to.

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Watching Thoughts and Letting Them Go

 

In a recent post we looked at how mindfulness can help us let go of our thoughts when we get caught up in ruminating or worrying or just thinking in circles. Letting go of thoughts is never easy, however, and in this post we’ll look at how simply watching our thoughts can help us let them go.

Thoughts pop into our heads all the time, and usually we don’t pay any special attention to them: they enter and leave our minds all on their own, just like a car that drives into our line of sight, remains in our field of vision for a few moments, and then drives along and passes out of our line of sight again.

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Letting Go of Thoughts Mindfully

racing thoughtsIt’s easy to get swept away by our thoughts, especially in the face of strong emotions. We get stuck ruminating and dwelling about the past, filled with guilt or regret. Or our minds start racing and we can’t stop worrying about the future and imagining all the things that could go wrong. Or we replay conversations over and over again in our heads, trying to make sense of them or figure out what we could have said differently.

When our minds get going like this, not only is it exhausting; these patterns of thinking tend to make us feel bad, intensifying the emotions we’re already feeling and generating additional negative emotions as well. Because this experience is so unpleasant, it’s natural to want to these thoughts to stop, and to be able to prevent yourself from even having them in the first place. We often wind up trying to make these thoughts go away, and shut them out completely and make sure they don’t come back. But just like we can’t control our emotions or suppress our emotions, neither can we control or suppress our thoughts.

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STOPP and Be Mindful

 
 

When you’re feeling overwhelmed by stress and anxiety or distressing emotions, it can be diificult to know how to manage these feelings.

Often we allow our stress and anxiety and emotions to build and build all day without doing anything to calm them, trying to just ignore them and hoping they’ll go away. Then, when we finally can’t take it anymore and start feeling overwhelmed and desperate, things have often accumulated too much and begun to spiral downwards and it can be so hard to get any relief.

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