What are the learnings according to research that actually makes anxiety decrease for what is feared?
It is thought that during exposure people learn new associations with regard to what they fear. This new learning can overrule old learning such as a spontaneous fearful reactions. Hence, it is important to maximise the ways that new learning occurs. This could be done by making sure that in the exposure sessions:
-Have a variety of activities in the exposure hierarchy, both with lower and higher SUDS and for different length of time of actual exposure time
-Make both in vivo and imaginal exposures in the same session
-Do exposures at different locations, environments, rooms, time of day, different degree of awakedness/tiredness etc. This to avoid make the new learning dependent on a specific environment
-Acknowledge and discuss to what degree the expected negative outcome actually happened and other surprising elements making the learning more explicit and reflected
-Dare to experience what is feared, i.e. increasing uncertainty, for example in social phobia by daring to make social mistakes – the feared situation
-Avoid safety behaviors such as distraction which hinders learning and instead dare to feel the feelings by rating fear instead of avoiding the experience
-Continue live a life according to one’s desired values, not letting fears and anxiety run one’s life but accept them to be present in the background. This can load anxiety and fear with reactions of openness, curiosity and compassion. To accomplish this the feared object or activity is in exposure done together with valued activities
-Discuss openly willingness to experience negative emotions or anxiety as a step to increase psychological flexibility and curiosity, i.e. allow the experience to be there and not fight it.
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