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Struggling With Social Anxiety? Give ‘Exposure Therapy’ a Shot

It’s important to realise that social anxiety is more than just feeling uncomfortable at the beginning of a party.

Updated
Health News
4 min read
Struggling With Social Anxiety? Give ‘Exposure Therapy’ a Shot

Dear Zindagi’s recent success has opened up a refreshing conversation about mental health in India. Dealing with mental stress or anxiety, however, may not be as rose-tinted and smooth as Alia Bhatt’s character, Kaira, finds it to be in the picturesque backdrop of Goa’s bylanes.

Anxiety is overwhelming and confronting what makes you anxious can be gut-wrenchingly unpleasant to say the least. But fortunately or unfortunately, confrontation could be imperative in overcoming an anxiety disorder.

Social anxiety, or feeling nervous about being negatively judged in a social situation, is a vexing reality of our times. More and more of our jobs involve networking, meeting people, and most importantly, getting that first impression right.

According to a NIMHANS (National Institute of Mental Health and Neurosciences) report, one in five urban adolescents will suffer from some form of depression or anxiety before they turn 18.

While it might be more comforting to avoid engagements and stay at home (perhaps relating more to internet memes than people), it may actually be detrimental to the situation.

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What is Exposure Therapy?

One of the widely recommended and tested methods for overcoming social anxiety is ‘exposure therapy’. It’s a practice where people ‘expose’ themselves to situations they fear, until their anxiety decreases.

But it’s important to realise that social anxiety is more than just feeling uncomfortable at the beginning of a party. It triggers legitimate fear and trauma that could begin to affect day-to-day lives of people who experience it.

Naturally then, for a person to expose themselves to anxiety-inducing situations is not easy, and the technique doesn’t necessarily have the desired effect for everyone.

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So, How Does it Work?

There are varying methods of employing exposure therapy. Consulting a therapist to guide one through the process is recommended.

It can be done through simulating situations, role-playing with your therapist, real world confrontations or even virtual reality.

Therapists usually grade the level of exposure. For example, if what you feel anxious about is attending a large party or say a crowded concert, identify situations that make you less uncomfortable than that.

Make a list of things that make you anxious and rank them according to level of anxiety. (Photo: Suhasini Krishnan/<b>The Quint</b>)
Make a list of things that make you anxious and rank them according to level of anxiety. (Photo: Suhasini Krishnan/The Quint)
  1. Identify what gives you the highest level of anxiety.
  2. Rank your next fears in order.
  3. Attempt to do the things that make you less uncomfortable.
  4. Keep at it and repeat until you feel your anxiety lessening and eventually disappearing.
  5. Move on to the next thing on the list, but only when you feel comfortable with the current task.

At the end of the ‘task’, it could be that the things you were terrified about never actually happen.

In other words, it helps to not look at anxiety as a large overwhelming monster that needs to be combated, but one that can be strategically disassembled, one step at a time.
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Social anxiety or feeling nervous about being negatively judged in a social situation, is a vexing reality of our times. (Photo: iStock)
Social anxiety or feeling nervous about being negatively judged in a social situation, is a vexing reality of our times. (Photo: iStock)

But It's Not Foolproof!

Exposure therapy however has several drawbacks. There are chances that the patient may feel too overwhelmed by exposure to something they find so deeply unpleasant. If imposed, exposure therapy could end up re-traumatising a patient.

Coping techniques like ‘mindfulness’ and EMDR (Eye Movement Desensitisation and Reprocessing) can be used as alternatives to exposure therapy.

Mindfulness: A practice of sitting still and focusing on your breathing. Mindfulness-based Cognitive Therapy has in fact proved to be as good as medication in cases of chronic depression and can be helpful with anxiety disorders as well.

Often when anxiety sets in, there’s a chance the stress could blow into a panic attack. Breathing correctly, in that case, sends your brain a signal that all is well.

EMDR: The patient is asked to think of a particularly distressing memory and then to move their eyes from left to right. The distressing memories often get lodged in at a neurological level. It can invoke a sound, smell, taste or feeling that can be overwhelming.

By alternating left-right stimulation of the brain with eye movements, the memories that have become ‘frozen’ can be stimulated in a way. They tend to lose their intensity and begin to seem more like ‘ordinary’ memories.

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Experiencing severe anxiety about most everyday things could make one feel stuck forever, as if no amount of science, logic or therapy could help. But just as one may develop anxiety over time, overcoming it too, is a process and not an event.

While one technique may or may not work, there are alternatives and sometimes even a combination of techniques that may.

If the brain has been conditioned to respond to certain situations in specific ways, it can also be recalibrated to react differently. It takes time, but it’s important to not give up.

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