Posted in science, Therapy

Exposure Therapy May Drown You

My absence is attributed, this time, to preparation for a presentation that I did for my research course. We had great fun: saturated the Google Slides with relevent, cheesy memes, and presented our failed experiment data and had a great laugh about it all. I’m quite satisfied.

Finals week is next week, and all of this stress has had me tossing and turning in my sleep (partly because of my still injured back too) and has had me waking in the morning shaking, sweaty, and on edge. The other night I got minimal sleep because I went to bed angry, woke up a few hours later to a quite the slew of annoying voices, broadcasting really, and I could not sleep without some earbuds playing loud, chaotic rap music. I did not sleep soundly.

But it’s got me thinking about exposure therapy for some reason. I’ve been more talkative than usual, and although shaky the morning of my presentation and not quite as coherent as I wished to be, I was able to start out the presentation, get through my portion of the work, and relate my own experience with psychosis to our study on non-verbal cues and the effects it can have on interaction. The professor was surprised, I could see, and very rarely does anything from his students shock him, so that made me giggle internally.

If you remember me from the Mental Truths blog, you’ll have read tons of rants years old about my past battles with anxiety. So I’m not going to regurgitate everything here. Just know it’s been bad since I was about 5 years old. And every therapist I’ve been to has told me “Face your fears”. That’s the only way to rid the social anxiety–show yourself that you can do it. Prove your brain wrong.

It make sense.

Except that it doesn’t. And let me explain why.

Expose therapy, as a technique, has been proven not so much for specific phobias, but for PTSD. And when I say PTSD, I don’t mean emotional traumas. I mean physical traumas like a car crash you survived or a plane crash. It’s been speculated that it can work in other areas, but there’s no definite research with viable, proper experiments.

Remember, experiments can make claims to findings without being legitimate; it all depends on the method they used. An improper method can invalidate the entire study.

And so I’ve tried exposing myself to social situations in the past. Integrating into groups. Being nice to kids in class. And no matter what I did it seemed I always failed. I’d talk to someone or a group and still end up as the outcast. I concluded exposure therapy is a lie.

This time though, things are different. I’m doing the same things I did back then: taking risks, embracing the risks, following through with them, refusing to let the anxiety dictate whether I do something or not. So what’s the difference this time?


If you struggle with social anxiety and have been to a therapist who constantly tells you that the only way to conquer your anxiety is to face your fears, he/she is not entirely wrong. What he/she is wrong about it is pushing you into it.

If you attempt to face your fears with low self-esteem, showing yourself that you can engage successfully with people will look like a failure regardless. If anything, your therapist should be helping prepare your self-esteem. They should be encouraging you toward readiness, not tossing you in the pool without any floaters.

What helped made me get ready had a small fraction to do with the people around me. Some of it was support from friends. Some of it was a particular conversation with my therapist that, without intending to, made me realize I need to give myself permission to speak. So far, I’d been the only one holding myself back. I’d internalized this idea that I was only allowed to speak when spoken to, and that when I did speak it didn’t matter. People could tell me the opposite all they want; if I don’t believe it, them shoving it down my throat won’t make me believe it.

And so I told myself one day: you are allowed to speak.

And I continued to do so.

Over the course of a few months, reminding myself of this, engaging positively with classmates, roping them into my craziness with humor, leading my team toward good ideas, has shown me that I can communicate effectively. Speaking in front of others reminds me that I struggle with coherency sometimes–

Okay, I’ll finish that sentence in a second. I just saw these twin men who I saw the other day who had made direct eye contact with me and that was the night something was broadcasted to me and the fact that they’re walking into the library I’m in right now tripped me out for a second.


Okay, back to the important stuff.

Speaking in front of others shows me that I still need to work on coherency, and being able to say what I want to say. I always thought Anxiety was the culprit. I always thought it made my mind blank, and it does, but not to the extent I believed it did. Once I stopped believing it was ruining my life, once I worked on my confidence and depression, the effect it’s had has been infinitesimally smaller than it used to be.

In the past, I took my incoherent speaking as a sign I would never improve. Because that was my mindset. Improvement was impossible.

Now that improvement has become possible, the coherency issue hasn’t disappeared but it’s become an obstacle instead of a brick barrier.

What is the point of this post? Well, I want us to do some critical thinking here.

It is true that some people learn to swim by being launched into the deep end of the pool.

It is also true that some people learn by not being launched into the deep end of the pool, but first by gaining confidence to step into the water.

Mindset effects our ability to take advantage of therapeutic techniques which have potential to assist us: that is my hypothesis. As a rough example, were I to test this, I’d do so with those controlled by severe social anxiety as I was. That would be screened with a questionnaire. Those chosen would report their levels of anxiety so we can get a baseline. One group would be given regular, well-defined exposure therapy depending on their greatest social fear. One group would focus on their mindset, specifically their confidence in all aspects of their life with CBT. The third group would be given no technique or put on a waiting list (I know, soooo cruel). This would have to be double blind obviously, considering my intense bias.

At the end of the study, which I would hope I’d have enough resources/money to run this for months, not a puny amount of weeks, I’d ask for a self-report of anxiety but also for them to return to that social situation that makes them the most anxious and rate their anxiety during that time as well.

Would the results be significant? Who knows. I can’t base a generalization to people on how this has helped me. Just as the European study which found people handle grief differently, and that for some “getting back to life” is actually more helpful for them than therapy and being forced into the “five stages of grief”, I would expect to find severe individual variation.

The study I read about non-verbal cues (related to the experiment we did for my course) and their relation to schizophrenia, how patients labeled with such are often influenced by their psychiatrists’ non-verbal cues, is something else I’d like to study. That is, if the psychiatrist is smiling, sitting straight, not monotonous in their tone, their “patients” tend to show a decrease in their symptoms and better satisfaction with their care. I had to find this study from a European research group because there is very little information like this from U.S researchers. That I am capable of finding.

There are so many more things to study in psychology in regards to mental health than pills and there is so much more to mental health awareness than vomiting stale definitions of disorders as “information”.

It’s technique here that makes a difference. That’s another hypothesis I’d like to study. Pit pills and well-researched techniques together and see which comes out on top.

They say that medication and therapy are most successful together. I haven’t read the research on all this yet, but I will. I think there are some things which technique could be better for than medication. This has been shown a few times I believe. But I think it can include certain cases of psychosis.

Post acute episode, of course.

Cognitive Behavior Therapy isn’t going to convince you mid-episode that your neighbor isn’t part of the F.B.I.

Or can it?

Let’s research.


Writer. Reader. Science advocate. Living well beyond the label Schizoaffective.

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