Exposure therapy is a type of cognitive-behavioral therapy that is used to treat specific anxieties or phobias. It involves exposing yourself to what you are fearful of with the hopes of eventually retraining your brain to be less afraid. It is much deeper than just getting used to the fear - exposure therapy retrains your brain to stop sending the fear signal when there is not any real danger. Most people understand that their anxieties and phobias are irrational and exaggerated, but this does not necessary reduce the fear response. What ends up happening is the person will avoid the fear, which can end up strengthening it.

When our brains receive a danger signal, we react with an innate response called ‘fight or flight’. We need our ‘fight or flight’ mode so that we can react quickly and powerfully to danger. We once lived in a very different world where our main job as humans was to eat enough food and not be harmed. Our bodies reacted in a way that kept us on high alert and safe.

The Amygdala

The amygdala is the part of our brain that is responsible for the ‘fight or flight’ response. The only way to know what your amygdala does is when you feel the effects in your body or behavior. Example: panicky sensations or trying to escape. The reason we do not know what is going on is due to the amygdala working quickly and without conscious awareness. This happens because a speedy reaction is necessary to react to potential threats. Your amygdala has an objective: keep you alive. This means that it does not care how many times it scares you unnecessarily.

Your amygdala learns by association, meaning that if you become anxious or worried in one scenario, such as going into a grocery store, you will be conditioned to see the grocery store as dangerous. This then means that your amygdala will make you afraid next time you see a grocery store in order to avoid a potential dangerous situation. It is associating the grocery store with danger. This subconscious response is the reason you cannot just talk yourself out of a phobia or anxiety attack. The conditioned fear has been stored by your memory and can be relieved by more conditioning. If you want to overcome your constant fear and panic reactions, you have to retrain this part of your brain. That is where exposure therapy comes in.

Retraining Your Amygdala

The amygdala only has the opportunity to learn something new when it is fully activated, such as spotting something dangerous. It only forms new memories and associations when you become afraid. The rest of the time it remains on autopilot, passively watching. That is why avoiding your fears can allow your amygdala to keep believing there is something to be fearful of and prevent you from learning a new association.

In order to teach your amygdala something new, you have to activate it by exposing yourself to a trigger that makes you afraid and sit with your fear. For example, if you are afraid of dogs you can think about dogs, look at pictures of dogs, or eventually even be near a dog. This gives your amygdala the chance to learn that it is safe and that it got worked up for nothing. It will have the opportunity to learn that dogs are not the threat that it had been conditioned to believe. With repetition, it will develop a new memory that allows your life to not be disrupted by phobias or anxiety attacks.

Exposure therapy is not something that has to be done quickly or abruptly. You can engage in a continual, gradual exposure to what you fear and then stay in that place to make sure the fear leaves before you do. You can use coping skills or simply wait for the fear to subside.

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