Thanks very much

I practice exposure. When my GAD/SA was at it's height, I went to school on line. I still had interaction issues on line, but I got through it. After a lot of therapy and trying different meds, I decided to take the next degree on campus in class. I'm not really good at it, but I feel empowered by doing it.

I'm currently working part time as a tax preparer. Part of my job is reaching out to people to get them interested in filing with my company. It is not going too well, but when I have someone in front of me I don't pray that the earth opens up and swallows me the way that I used to.

It works wonders, it completely cured me of my sa when I did it. But I just gotta figure out how to make the results permanent, i can't do it alomost every day for the rest of my life, it's really painful emotionally.

Here is my exposure therapy journal if anyone is interested:

http://www.socialanxietysupport.com/...eraphy-118284/

I'm going to try exposure therapy and hope it works...I really want to do well in my classes this semester.

I feel like I am getting judged by everyone or that I'm going to make a mistake. I need to learn how to just roll with it.

Thanks for the information...I have enjoyed all of the posts on this discussion.

It wasn't therapy per se, but I got a job in another city, didn't know anyone, didn't know my way around, but I somehow adapted and my SAD has been significantly reduced. It really is too soon to tell how long/if it will last but I haven't been this social in years.

I would like some ideas if your still offering.

This, even if get comfortable with someone, my social anxiety just doesn't go away.

It is intended to help the patient face and gain control of the fear and distress that was overwhelming in the trauma, and must be done very carefully in order not to re-traumatize the patient.

Exposure is the standard nonsense that a psychologist will throw at you. Being exposed has never worked for me, and usually just makes my condition worse.

I hear this quite often. Exposure is like being abused all over again. Punishment... One of my abusers is dead. Still trying to investigate my past to find out if there were others. If I ever get names, then I will find them. Not quite sure what will happen then.

Self Focus, what are somethings you've done to put the focus more on other people and less on yourself?

Part 1 -

I'm surprised this thread has so little replies and seems to be the most inactive of the treatment threads on this forum. In my opinion exposure therapy is by far the single most effective treatment you'll ever find for social anxiety, and it's also one that you can do entirely yourself without ever having to pay for any sort of therapy, as the actual process for exposure therapy is very very simple.

I think the somewhat sub-par reputation exposure therapy seems to have here is probably due to some misunderstandings about how it works, and also due to the fact that there are different approaches to exposure therapy and some of them work better than others.

First of all, in my experience, the thing you expose yourself to is exactly what you'll feel better with. So if you do some kind of group exposure therapy where you speak in front of a group, you might feel better speaking in front of a group in therapy, or speaking in front of a group in general - but it's probably not going to make you feel any more comfortable leaving the house, or socialising at a bar or whatever. You have to exposure yourself to those things to become comfortable with them.

A lot of people also seem to think that exposure is about feeling those negative feelings so much that they stop affecting you. I even saw people above mentioning that exposure therapy felt like being abused all over again, which really sounds like exposure therapy being conducted all wrong - since if someone has PTSD or a history of abuse, then their approach to exposure therapy should really to get comfortable in situations that give them irrational fear because of their abusers (like, someone might have anxiety when laying in bed at night because that's when their abuser would come home drunk - so they might expose themselves to laying in bed enough times to start to subconsciously realise that they're safe there now) - it should NOT be about picking at an old wound and traumatising yourself.

The first thing to realise about exposure therapy with regards to social anxiety, and perhaps the most important thing I realised that helped me fight mine:

EVERYONE experiences social anxiety. A FEW people have social anxiety disorder.

Social anxiety is actually a very normal thing and even the most confident people experience it in some situations. In our cases, we experience it to extreme levels that negatively impact our lives, hence we have a disorder, but the actual symptoms of social anxiety etc - aren't something that we're the only people who get, we just 1) get them a lot more intensely than others, and 2) turn to avoidance behaviour because of them.

The reason I bring this up is because we can learn a lot from those who are confident and outgoing. I actually spent some time speaking to one of my outgoing friends about my anxiety, and was surprised to find out that despite being one of the calmest people I know in social situations - I was surprised to find out that it's not that he never experienced anything like social anxiety symptoms, it's just that he did but he acted in spite of them, didn't let them prevent him from socialising, and because he was constantly socialising, the symptoms became very minor as he got so used to socialising. He explained to me that what I was experiencing was normal to some degree, but that the severity of my symptoms had a lot to do with the fact that I was avoiding socialising. We all fear the unknown, and so if you never do something that scares you, your anxiety and fear surrounding it just gets worse and worse, and builds up to the point of being unbearable.

I quickly realised he was right. He ended up coming all the way to my country (I moved from my original country) and helping me leave the house (I feel way less anxious if I'm with a friend I feel comfortable with than going out and trying to socialise alone with people I don't know) regularly for about a week. After that, it was true, my anxiety was significantly decreased. I'd been house-bound for 2 years, but because I'd socialised every day for a week, while I felt anxiety about going out again, it wasn't so severe that it stopped me this time. So after he left, I did it again, I went back out to a bar etc, and soon I'd made some friends there and was able to start going there regularly.

I was essentially doing exposure therapy, without realising it, as I didn't even know such a thing existed at the time. Within a couple of months of going out regularly, I noticed something astonishing. My anxiety was more or less gone. Now, I have to really emphasise the more or less gone part. You don't cure anxiety permanently or make it disappear completely, but what happens is it's like the volume dial drops all the way from like 90%, to like 2%. Like there's still that vague hint in the back of your mind that this activity makes you a little nervous, but it's no longer a bad nervous, in fact it can almost become a little exciting. I think this is what my friend meant by saying he experienced social anxiety symptoms, i.e. there were still some symptoms there but I no longer had a disorder because I was no longer turning to avoidance behaviour.

For the next 2 years, I became a social butterfly. I was going out and socialising literally every day. I still had notable anxiety in certain high pressure situations, but I was so much better I genuinely stopped saying or believing I had social anxiety anymore.

Unfortunately, another thing a lot of people don't realise about exposure therapy, is that just as exposure reduces your anxiety/fear response to activities over time, lack of exposure increases your anxiety/fear response over time. I had some other issues in my life, namely I had been using drugs on and off for years already, and about a year into my social butterfly period I ended up becoming an addict. I was using morphine daily and quickly went from the best year of my life to the worst 2 years of my life.

I was lucky enough to get clean at the start of 2015, and in a spectacular way as I also completely lost any desire to get high (as my motivations in life changed) - so it was actually extremely easy to stay clean. The thing is, despite the fact it felt easy, I wanted to avoid being in any triggering locations or running into any triggering people for at least 6 months, just to be safe. So, I stayed at home, for 6 months. Didn't leave the house once. (Living with family, so didn't even have to go to the shops)

You can already guess what happened as a result of that. My anxiety came back, at full force. When I was ready to start socialising again, I realised.. I couldn't. My anxiety was so terrible again that just leaving the house was too much.

In the entirety of 2015 and 2016 I only really managed to improve to the point of feeling comfortable going to the shops if I went with a family member. That was it, I couldn't comfortably leave the house alone, and I certainly couldn't go to anywhere social like a bar or party etc. My anxiety over leaving the house alone was like a 7/10 or 8/10, and anything worse than that was a 10/10 and absolutely impossible to even consider.

Now unfortunately, like I said earlier, the friend that helped me overcome my social anxiety last time lives in another country, so I can't just be like "Oh hey fly over here and help me socialise again", so this time I have to do exposure therapy by myself.

When starting from step 0, and having no crutch like a friend or daily medication etc to help you, you need to start exposure therapy with small steps. I suggest creating an exposure hierarchy. List 10-15 activities related to your fear that make you anxious, like: going outside alone, going for a walk at night, talking on the phone, approaching a girl, public speaking, etc.

Once you have your list, rate them all from 0-10 or 0-100 in terms of how anxious they make you, with 10 or 100 being the most anxious you can imagine, and 0 being no anxiety whatsoever.

Now order them from least anxiety to most anxiety. If you don't have any activities on there that are a 5/10 or less, and it's all higher than that, then think of some activities that are less than 5/10. For example, if even leaving your house is like a 7/10, you can pick an activity like: making a forum post, or, going outside but only to your garden, etc.

Now what you do is you expose yourself to that easiest activity on your list repeatedly and rate how anxious it made you each time. Once the anxiety level is 2/10 or 20/100 or less, then you can consider that step conquered, and move on to the next step.

A lot of people do exposure therapy with a therapist, and so only do it once a week or something. I don't think that works really. I think exposure needs to be regular if you want to see good results. If you can expose yourself every single day though, man is it effective.

Part 2 - (Hope it's okay for me to double post like this, but I couldn't see any way to shorten my post without losing important information from it - so I had to split it in two due to the 10,000 character limit!)

On the 13th of this month (December 2017) I decided to suck it up and start doing exposure therapy again myself. I started an exposure therapy/social anxiety journal. In the journal, I write down the following things:

- Steps taken (This is what I've done to face my anxiety)
- Results (How did it go? How anxious did I feel? Was it as bad as I expected? etc)
- Medication taken (I'm prescribed Alprazolam and Propranolol to take as needed - so I thought it helpful to note down if I take those on any particular days, as if my anxiety is particularly low, it's helpful to know if it was due to getting comfortable in a situation, or just because I was medicated at the time)
- Notes (Other general notes I might have, like if my medication dose was sufficient if I took any, what I should do tomorrow to face my anxiety, any cognitive distortions I noticed, etc)

Every day I force myself to do at least one thing, no matter how small, to face my anxiety. I started with the lowest thing on my exposure hierarchy, which was going to the shops alone. It was about a 5/10 when I started, since I'd managed to do it a handful of times over the prior months thanks to a supplement called Ashwagandha reducing my anxiety.

I've forced myself to face it every day and leave the house every day, and after 10 days of doing this, it worked. My reported anxiety was now 1.5/10, or less than the 2/10 needed to cross off that activity and move up to the next step on my exposure hierarchy. I expected this to be a slow gruelling process that took months just to move from step to step, but it isn't. I think the important thing is facing your fears EVERY day, no exceptions, because this rapid repeated exposure is what gets quick and meaningful results.

I've now moved on to the next step, night time walks, which are currently about a 5/10 for me, or about the same as going to the shops was 11 days ago when I started this process. I will keep going on them until they too are a 1.5/10, and then I will move on to the next step, and so on. So far it's been going fantastic, and I know without a doubt now that I will once again conquer my anxiety to the point of being able to lead a normal social life. I honestly think it'll happen a lot quicker than expected too, because I had no idea I could make progress this fast!

I'll be sure to post an update in here further along in my exposure therapy trials.

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If you are considering exposure therapy, or have done it before but had bad experiences, make sure you do it right. I suggest creating an exposure hierarchy, and EVERY SINGLE DAY, no exceptions, facing the lowest thing on the hierarchy, until it gets to 2/10 on the anxiety scale and can be crossed off, and you move up to the next one.

When you do that, don't stop facing the thing you crossed off, just don't make it a priority anymore. You still need to face it occasionally, or that anxiety number will creep up from lack of exposure - unless of course higher things on the hierarchy also encompass it (for example, if leaving the house is the bottom item on your hierarchy, then you're technically facing it when doing things higher up on the hierarchy like going to a party or a friend's house etc - since you're leaving the house there too).

If you don't have a therapist, don't wait until you get one. All you need is a pen and paper or a document on your computer, a few minutes to create a 10-15 item list, and the dedication to do at least one small thing every day to face your anxiety. I promise you, if you follow through, and do it right, this is the best treatment you'll find.

You cannot overcome any fear without facing it, period. If you do face it though, you can, and will, eventually become comfortable enough with it to at least lead a relatively normal life.

Oh and just in case anyone's curious, here's a sample from my social anxiety journal, an entry from a couple of days ago, to maybe give some of you ideas on your own journals:

Shyness/social anxiety is genetics and exposure therapy won't help you to overcome it. The fact that after spending 6 months isolated at home your anxiety has returned proves that exposure therapy only works while you're doing it. Stop doing it and you'll reverse to your natural state. Take a person who hasn't got social anxiety and is super confident. He could spend 5 years locked in a cellar without any interaction and he would be the same person after 5 years. When you're an adult it's practically impossible to alter anything that's related to your brain structure. I found an interesting comment on youtube related to shyness/anxiety. Read it below.

Shyness doesnt affect writing, because the writer is anonymous. In face to face interaction, anonymosity is not granted.Therefore you are open to judgement and shyness takes its toll.
As far as enligtenment being vastly more difficult than desensitisation, well, desensitisation is basically a form of phsycological torture which must be maintained for thousands of hours.So I hate to think what hardship "enlightenment" (a very ambiguous piece of terminology, with no widely accepted meaning) will bring. I really see no merit in "enlightenment" as it is a very obscure concept which a rational person will never understand or make sense of, since it is not based of rational thought, just spaced out phsyco babble.
In any event, twin studies prove shyness is caused by genes.If genetically identical people develop the same shyness when reared in different environments, then the genes are a major factor.There can be no other explanation.
Did you know that animals raised in identical environments can be given any set of behavioral traits just by selectively breeding them? Its the same with humans.Your behaviour can be controlled by changing your genes, and genes alone.

And to top it off, you should understand that the adult human brain has fundamentally very limited capacity for change.The type of development which occurs during childhood when shyness is usually formed, cannot be duplicated in later life.This is thoroughly researched fact.Did you know that a person never loses their native accent after the onset of adulthood, or that it is impossible to learn perfect pitch in adulthood, or that no one has ever found any method of altering general intelect in adult humans? This is because the developmental stage of the brain is OVER.Even thousands of hours training cause very minimal change in the adult brain, hence why amazing musicians and athletes always trained from a young age, as it is impossible to train the adult brain to be so skilled in some specific task.The same goes for social confidence.If you want to be good in that field, just as with any skill, you will need to be trained since early childhood to excell at it. I read a little study about how myelin around the axioms in the brain changes in response to training.The myelin( white matter) in a childs brain builds around ten times faster than an adults brain in response to piano practice.They studied 7 regions of the brain.Piano practice changed all 7 regions in the childs brain.The adult brains showed no changes at all in 4 of the 7 regions, and the 3 that showed changes were about %10 of the increase in the the corresponding region of the childs brain.So when people tell you can change as an adult, well, they are telling you a kind of half truth....

Exposure therapy.....

But it did overcome it. Yeh, obviously, if you totally isolate yourself from people then the anxiety will return. All that guy had to do is not become hooked on drugs continue living in the world and he was free from anxiety. Or free enough to be able to live his life.

A treatment isn't going to overwrite a genetic propensity, its going to allow you to function in the world, and then, if you are functioning in the world, if it doesn't return, then that is literally the definition of a successful treatment.

That is all you are going to get re mental health treatments, sorry to break it to you. There isn't a magic pill that is going to take it away (save super rare cases with MAOI's), this kind of success is all there is. If taking someone from being unable to function to be able to function perfectly well in the real world isn't a successful treatment, then what the **** is?

Exposure therapy worked big time for me.

I didn't even realize there was a term back then! I just realized from reading a lot of books on successful people and watching Youtube videos about successful people that you have to get outside of your comfort zone in order to achieve success.

I kept that mindset at all times and it was definitely key to helping me conquer my social anxiety and depression related to it.

All the best,
Jordan

Exposure definitely works. 100%. I know that being around people constantly or being exposed to stressful situations made me more resilient. But don't chew off more than you can handle! With me the biggest issue has been social skills I never learned (such as networking, reacting to a situation, or learning how to read and judge people) because I never spent time around people learning those skills. And, much like exercising, you never want to plateau!