Public Speaking Exposure Therapy
Although exposure therapy is generally conducted by a therapist in the context of treatment such as cognitive-behavioral therapy (CBT), you can also practice exposures on your own as part of a self-help program. Standing up today in front of a huge auditorium and giving a speech would not be an example of exposure therapy. Instead, you would take small steps and accomplish small goals that give you confidence and build your strength to handle more difficult situations.
Avoidance Behaviors
When practicing exposures, it is important not to engage in what are known as “partial avoidance strategies.” For example, giving a speech but reading directly from your notes and never looking at the audience. Instead, you need to do everything that makes you afraid and nervous; but do it gradually as you become less anxious. One way to practice exposures is to do them in imagined scenarios before tackling the real thing. Doing exposures in real life is called “in vivo,” which you can build up to when you are ready.
Fear Hierarchy
Below is a sample hierarchy list of situations that you could progress through as part of your exposure training. Everyone will fear different types of scenarios so it is important to tailor the list to what makes the most sense for you. Remember that you want to start with the situation that causes the least fear and anxiety, and gradually work up to the most difficult scenario. The purpose of the fear hierarchy is to gradually expose you to feared situations. In order for exposure therapy to work, you must stay in the situations long enough that your anxiety decreases and you become desensitized to the triggering scenario. If you find that a situation is still problematic, stay with it until your anxiety is reduced before moving on to the next one. If your social anxiety, in general, is severe and self-help strategies are not sufficient to reduce your fear, consider contacting a mental health professional or your doctor for a referral. There are effective treatments for SAD, such as cognitive-behavioral therapy (CBT) and medication, that can make a difference in your life.
