I'm An Exposure Therapist. Here's How I Confront Patients With Their Worst Fears. - HuffPost

So when I saw a listing for a position that would give on-the-job training at an anxiety center, I was intrigued, even though it was not in my area.

So I moved halfway across the country to try something new: working exclusively with clients with anxiety disorders and Obsessive Compulsive Disorder (OCD) using an approach under the Cognitive Behavioral Therapy (CBT) umbrella called Exposure and Response Prevention (ERP).

I use ERP to treat specific phobias like agoraphobia (fear of leaving one’s own home), emetophobia (fear of vomit or vomiting), aerophobia (fear of flying), nosophobia (fear of contracting chronic illnesses), fear of driving, fear of natural disasters, and even fear of monsters under the bed.

I often give my clients homework that I call “experiments.” These experiments allow the client to build trust in themselves and their ability to tolerate uncertainty and feelings of distress.

For example, a client with fear of flying asked to be locked inside a closet to mimic the feeling of being trapped.

Another client ventured down into a creepy basement with me to face fears of contracting leptospirosis.

For example, while I myself don’t experience emetophobia (fear of vomiting), making a concoction of split pea soup, white vinegar and crackers to put in my mouth and spit into a toilet was definitely a discomfort I could have lived without.

One of the first things I say to them before we engage in exposure work is, “I won’t ask you to do anything I wouldn’t do myself.” This helps the client build trust in me and build back trust in themselves.

When a patient first lands in my office and is told about exposure therapy, they are often reasonably scared and reluctant.

Sometimes they have had bad experiences in therapy, have been told exposure therapy won’t work, or they have confused it with “flooding” (also called implosive therapy).

Exposure and Response Prevention involves gradual exposure to the fear using a fear hierarchy created in session.

When someone understands what’s happening inside their brain and what they can do to calm their fear center, hope is restored and their awareness increases.

When exposure therapy is successful, they are able to get back what anxiety has taken from them?