Exposure Therapy for Anxiety: A Guide to Facing Fear

Person walking on a bridge over rapids representing exposure therapy for anxiety

Sometimes, fear is your friend.

It’s what keeps you from petting grizzly bears, picking fights, and wandering down dark alleys. It’s a necessary, life-saving emotion.

But for human beings, fear is complex.

Instead of just feeling the immediate fear of a predator, we have fears that stretch out over time which we call anxiety. Anxiety can keep you locked in a constant state of worry, and seriously inhibit your life.

The good news is that psychologists have discovered that you can conquer anxiety in the same way you conquer fear: by facing it.

This is the essence of exposure therapy, and it really works.


The Power and Benefits of Exposure Therapy for Anxiety

Exposure therapy, in a nutshell, is the process of facing things that trigger your anxiety until you get used to them, or even stop fearing them entirely.

It is hailed as the frontline method for treating anxiety disorders, including panic disorders, OCD, phobias, and PTSD. You can do it in a one-on-one setting with a therapist, or in a group environment.

It heals on multiple levels. And some say that all therapy, to some extent, is exposure therapy. According to psychologist Noam Shpancer:

“…much psychopathology involves an attempt to avoid difficult thoughts and emotions. Therapy involves a guided attempt to overcome such experiential avoidance. The remedy for avoidance is exposure.”

When you face your fears voluntarily, not only do you become braver, but you learn more about yourself, your past, and how you interpret the world. Beyond just feeling better, you become wiser.

Here are the major benefits of doing exposure therapy, according to the American Psychological Association:



The more often you face a fear, and the more intense fears you face, the more accustomed to them you’ll become, and the less they will inhibit you.



You may find that over time your fears die off completely, or become so insignificant that you don’t even notice them.



Conquering fears gives you the knowledge that you can not only handle the things that scare you, but you can deal with anything that brings you stress in the future.



Once your anxiety is more under control, you can adopt more realistic perceptions of your fears and fundamentally change how you engage with life.



New research suggests that it may not matter if your anxiety lowers doing an exposure task. Instead, its important that your expectancy about what might occur is violated.

For example,  let’s say you are afraid to touch the bathroom floor for fear of getting sick. Your anxiety may not lower during an exposure task but you don’t get sick. This experience of not getting sick violated your expectancy and this new learning may help you overcome your anxiety.


Exposure Therapy Examples

Because anxiety is so specific and relative to the individual, no two treatment plans will look the same.

This means that therapists administering exposure therapy can often get highly creative with their treatments.

Regardless, exposure therapy will always fall into four basic models:



This is directly facing a fear in real life.


  • A child who fears social judgment sings in front of his classmates.

  • A patient afraid of spiders sits in a room with a spider on the wall.

  • A patient anxious about neatness deliberately makes their room a mess.



Some anxieties are more abstract, but even if they only exist in your mind, that doesn’t mean they can’t be treated.

Imaginal exposure is using imagination or visualization techniques to expose a patient to their fears.


  • A patient afraid of violence could be prompted to picture violent images in their mind.

  • A patient could use written journaling techniques and describe their worst fear in vivid detail.

  • A therapist could ask a patient to recount an anxiety-inducing situation from their past. This is most often used for treating PTSD.



Thanks to the modern age, we can now utilize VR to perform exposure therapy on patients without putting them in any actual danger.


  • VR programs that simulate anxiety-inducing situations, such as being in a crowded public place, accompanied by artificial noises and sensations generated in the therapy office.



This is exposing yourself to physical sensations that bring you anxiety, but can cause you no real harm.


  • A person with a fear of heart attacks could be asked to do exercises that raise their heart rate, which would teach them that they can raise their heart rate and still survive.


How Exposure Therapy for Anxiety Works in Practice

Let’s say you struggle with a type of anxiety that many young people struggle with: social anxiety.

After considering where these fears come from (which is also necessary to discuss in therapy), a patient doing exposure therapy for social anxiety would create their own exposure hierarchy.

An exposure hierarchy is essentially a graded tier list of fear facing. The patient will climb their exposure hierarchy one step at a time, with the most “face-able” fears starting at the bottom and their most intense fears at the top.

Here’s what an exposure hierarchy might look like for social anxiety:

  • Go outside and take a walk around the block (You don’t have to say hi to the neighbors, delivery workers, or anyone else. You just have to walk). Do this five times a week, and gauge your anxiety levels.

  • Do the same walks, but practice making eye contact and smiling at five different people.

  • Do the same walks, but start saying, “Good morning!”

  • Start going to a crowded coffee shop on your way to work/school in the morning. Just sit and take in the atmosphere.

  • Start making orders/ making eye contact with the barista.

  • Start casually asking the baristas/ staff how their days are going.

  • Give five random strangers a compliment. Do this every day for a week.

  • Strike up a conversation with someone else who frequents the coffee shop about how their day is going, the weather, their schedule, or their style.

  • Give a full introduction to someone by saying, “Hi, I’m so and so. I just wanted to introduce myself. How’s your day going?”

  • Introduce yourself to someone you’d like to ask out.

These lists can be tailored to your specific anxieties, and they can serve as a roadmap out of your fear boundaries.

Knocking out each rung of your list will make you a little more courageous, and a little more free.

You Can Beat Your Anxiety

You aren’t trapped.

No matter how daunting, unusual, or overwhelming your anxiety feels, there are ways to break it down, make it manageable, and get beyond it.

Voluntarily choosing to face your fears is a curative process. It may not happen right away, but with some diligence and raw courage, you can step into your fears until they don’t hold you back anymore.

Here’s a quote from singer Ray LaMontagne on dealing with fear:

“Well, I looked my demons in the eyes, laid bare my chest, said do your best

 to destroy me. See I’ve been to hell and back so many times I must admit

 you kinda bore me.” — Empty, by Ray Lamontage