Confronting Your Fears Through Exposure
161UÊPlan practices in advance. Set aside time to practice exposure.
UÊExposure practices should be predictable and under your control (particu -
larly early in treatment).
UÊExposure should be frequent (almost daily), especially at the start.
UÊExposure should be prolonged. Try to stay in the situation until your fear 
has decreased.
UÊUse cognitive strategies to challenge anxious thoughts before entering the 
situation.
UÊUse cognitive strategies to challenge anxious thoughts during the practice.
UÊUse cognitive strategies to challenge anxious thoughts after leaving the 
situation.
UÊDon’t ﬁght your anxious feelings in the situation. Just let the feelings 
happen.
UÊEliminate subtle avoidance strategies like distraction, alcohol use, and over -
protective behaviors.
UÊPractice in a number of different situations.
UÊChoose practices in which the actual risk is minimal, especially at ﬁrst.
UÊChoose practices that are challenging, but not impossible.
UÊComplete exposure records (see chapters 8 and 9) with each practice.
TROUBLESHOOTING
Problem:  My fear does not decrease during my exposure practices.
Solutions:   This is normal to some extent. Although anxiety and fear usually decrease 
during the course of a particular exposure practice, most people experi -
ence occasional practices in which their anxiety doesn’t decrease. Here 
are some suggestions for dealing with this situation.
Make sure that you are staying in the situation long enough. Sometimes 
it can take several hours for a person’s fear to diminish.
Make sure that you are not using subtle avoidance strategies. The 
normal pattern during exposure is for fear to increase and then gradu -