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  • Exposing Yourself to Negative Emotions. Part 4: Creating an Exposure Hierarchy

    We often spend a great deal of time and energy avoiding negative emotions. Negative emotions feel uncomfortable and avoiding them provides us with short-term relief. However, if we avoid situations that make us uncomfortable we rob ourselves of important life experiences. For example, if social anxiety leads us to avoid talking to strangers, how will we ever make a new friends and try new activities? Likewise, if fear of rejection prevents us from applying for a new job, how will we ever start our path on our dream career? In the book The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook David H. Barlow and colleagues discussed how we can practice exposing ourselves to negative emotions in order to help us to achieve our goals.

    Creating an exposure hierarchy

    In previous articles, we discussed the value of exposing yourself to either a stressful situation in real life or through the use of your imagination. Now that we have learned about exposures you can begin creating an exposure hierarchy. An exposure hierarchy is simply a list of exposure exercises that includes a rating of the level distress the exercise is expected to induce. A worksheet created by Barlow and colleagues can be used to list your exposure exercises creating a hierarchy. After creating the hierarchy, we begin facing the exposure exercises one by one. It is often best to begin with an exercise that induces a moderate amount of distress.

    Things to keep in mind when practicing exposure exercises

    1. Keep practicing! It is important to do the exercises over and over again. It is likely that you have been avoiding certain situations for a long time. Therefore, it makes sense that you would need to expose yourself to those situations several times before you begin feeling more comfortable.
    2. Set backs are normal. Occasionally, you will feel overwhelmed and end an exposure exercise early. It is important to not allow feelings of discouragement to prevent you from continuing the exposure exercise at a later time. As long as you continue doing the exercises, little by little, your level of discomfort will decrease.
    3. Make it a regular part of your routine. It can be very easy to put an exercise off until tomorrow, only to procrastinate once again the next day.

    Practicing exposure exercises helps us to avoid avoidance. It is often the avoidance of negative emotions that causes more problems and limits our lives more than the actual negative emotions. Creating an exposure hierarchy and consistently engaging in a variety of exposure exercises, may sound unpleasant, but will help us to learn that we are more capable of handling negative emotions than we previously thought.

    If you are interested in learning more about how exposure exercises and cognitive behavior therapy address negative emotions please contact us to schedule a free phone consultation.


    Author Dr. Jason von Stietz specializes in Cognitive Behavior Therapy and Sport/Performance Psychology in Torrance, CA.