Exposure to Social Situations
181Purposefully Increasing Your Anxiety Symptoms
In addition to entering the situations you fear, a more complete test of your anxiety-
provoking beliefs is to deliberately arouse some of the symptoms that frighten you in 
social or performance situations. Chapter 9 discusses these strategies in some detail. 
Some examples of possible exposure exercises include the following: wetting your fore -
head (to simulate sweating) before giving a presentation, purposefully appearing to lose 
your train of thought during a meeting or presentation, and purposefully allowing your 
hands to shake while writing or holding a drink. By deliberately bringing on the symp -
toms you fear (in a predictable and controlled way), you will learn to be less frightened 
of having these symptoms show in front of others.
Expressing Personal Opinions 
Finally, if you are afraid to express personal opinions during a conversation, just 
engaging in conversations, without expressing personal opinions, will not be enough to 
test the validity of your fearful beliefs. Conversation alone will not teach you that your 
fears are unfounded. Instead, you should make sure that you express your feelings or 
opinions during your exposure practices.
DEVELOPING A SITUATIONAL EXPOSURE 
HIERARCHY
Before beginning exposure therapy, it is helpful to generate a list of very speciﬁc situ -
ations that range in difﬁculty from mildly to extremely anxiety-producing. This list of 
situations, called a situational exposure hierarchy , will help to guide your exposure practices.
Usually, the situations on the hierarchy include details that take into account particular 
themes that contribute to how much fear you are likely to experience. These themes may 
include the size of the group or audience (for example, it may be easier to talk to one person