Exposure to Uncomfortable Sensations
201if you are still fearful of experiencing anxiety symptoms in front of others. As your fear 
continues to decrease through exposure and cognitive therapy, you may also consider 
working on your social and communication skills (chapter 10).
USING SYMPTOM EXPOSURE RECORDS  
AND DIARIES
Keeping good records during symptom exposure practices will help you to monitor your 
progress over time. The Symptom Exposure Diary at the end of this chapter will help 
you to measure changes in your fear across symptom exposure practices. Furthermore, 
this diary is designed to help you challenge your anxious thoughts during exposure 
practices. The ﬁrst column indicates the trial number (1, 2, 3, and so on). In the second 
column, you should record the speciﬁc sensations that you experience. In the third 
column, record your fear level during each exercise trial. Finally, the fourth and ﬁfth 
columns are for recording your anxious thoughts during the exercise and for countering 
your thoughts with more realistic beliefs.
TROUBLESHOOTING
Problem:  The symptom exposure exercises don’t frighten me.
Solution:   If the exercises don’t cause anxiety when you practice them in nonsocial 
situations, try practicing them immediately before entering social situa -
tions. If they still don’t increase your fear, then discontinue the symptom 
exposure exercises. However, you should continue to use the cognitive 
strategies (chapter 6) and the situational exposure exercises (chapters 7 
and 8).
Problem:   The symptom exposure exercises are too overwhelming for me to complete.
Solution:   If a symptom exposure exercise is too overwhelming, even when conducted 
in a nonsocial situation, try an easier exercise from your hierarchy and