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Overcoming anxiety with graded exposure

By Emma Reilly, co-founder of Myndr

 

My name is Emma and I’m the co-founder of Myndr. Before moving into the startup world I had been a freelance designer for around 5 years. I had started my business with the support of The Prince’s Trust and went on to become Young Ambassador of The Year in 2015. This role meant I was required to do a lot of public speaking to raise the profile of the Trust.

One of the perks was getting to attend big events where I would get to chat with celebrities like Helen Mirren and Rod Stewart. It was a very fast-paced and public facing experience. One week I’d be on the cover of a National Newspaper with Simon Cowell, the next I’d be on the News or day time TV. It was a role I thoroughly enjoyed and relished.

However, none of this would have happened if I’d never learned to combat my Social Anxiety.

Rewind back to the year 1999 when I had just left school and started a media degree at University. I had already suffered silently with depression and anxiety since the age of 13, but just months into my new course I suffered a complete mental breakdown. I remember talking to my mum, telling her how I couldn’t cope being around other people. Just someone looking in my direction would trigger a debilitating panic attack. Thankfully she was massively supportive and helped me withdraw from University and seek help from my GP.

This was my first experience of a psychiatric hospital and my first time really opening up to how bad my situation was. Just a year previously I had secretly tried to take my own life because I couldn’t cope with the average 15 panic attacks I was having every day. Now, I couldn’t even open the door of our house to someone, instead preferring to hide under the bed whilst the panic took hold. I was just not able to carry out any type of basic human functioning and now my mind had imploded with the weight of anxiety.

My first doctor quickly told me that I had a severe social phobia (or Social Anxiety Disorder as its now known). Unfortunately, there wasn’t much understanding of it as there is now.

“Take these pills for the depression” he said. “You’ll soon grow out of the social phobia”.

That was as much treatment I got at that time. 

I would come to spend the next 5 years at home as a recluse, only ever really talking with my parents and sister. I didn’t go out and I didn’t engage with anyone who came to visit. I tried of course to get treatment, most of which was very generalised anxiety workshops and meditation classes. I remember one therapist made me listen to whale song for 60 minutes whilst laying on a couch.

“How do you feel now?” he would ask me.

“Very relaxed” I would reply, “just don’t make me go outside where the people are!”

Eventually I would start to read up more and more about Social Anxiety on the internet. Recovery via CBT (cognitive behavioural therapy) was much more developed in the US, so I had many ‘internet friends’ passing me over tips about how I could do it on my own.

One of the first things I learned was that Anxiety is a lifesaving response to danger. Back in the time when humans were being chased by bears and hunting for food, our brains adapted to create a fight or flight response in order to stay alive. Its triggered by two almond shaped parts of the brain called the Amygdala (am-migdil- a). The Amygdala, amongst other things, is responsible for processing emotion. It was rather useful when deciding whether to run from the bear or fight the bear. Fear conditioning meant the Amygdala would learn when to trigger the Anxiety response so that it was always one step ahead of danger. Another bear would come along and boom… we’re ready to respond. Fortunately for most of us there aren’t too many bears running around today. In fact, many of us will be very lucky to never face a true fight flight scenario more than a couple of times in our lives. Instead, this pesky little Amygdala has learned to pick the wrong battles, believing it is doing us a good life saving service. It is essentially a switch which is being flicked at the wrong times.

The positive I came to learn is that the Amygdala is highly re-trainable through processes like CBT and Anxiety can be significantly reduced, if not cured.

When I first started out on my own DIY CBT journey, I came to realise that in order to get where I wanted to be, I had to put myself through some really hard and difficult situations. CBT after all, is about changing behaviour in response to negative thoughts… or doing the opposite of what your mind is telling you to do.

Facing fears is a tough process. We wouldn’t be in this situation if we found it so easy to change how we behaved to a thought. This is why the best way to overcome a fear is to break it down into manageable chunks. This is called graded exposure. Its breaking down your fear into small tasks so that you take on and complete each part before moving on to something a little more challenging.

The first thing I did was grabbed a notebook and wrote down what my end goal was; or the thing that was motivating me to break free of my Anxiety.

“I want to start my own business and be free to go out and talk to all kinds of people and be confident in who I am”. It was a simple statement, but for me it helped to visualise that goal.

The next thing I did was write down a list of things I could do but didn’t usually do because of Anxiety.

  • Meet someone for coffee
  • Go on a date
  • Stay in the room when people come to the house
  • Answer the door when it rings
  • Use a telephone Go to the shops

My list went on for pages because there were just so many things I avoided.

The next thing I did was reorder my list from the easiest to the most difficult. Not that anything on this list was easy for me, but there was a definite order to how intense I felt any anxiety.

The first thing on my list was to go to the local post office and ask to buy a stamp. It was something my mother was always asking me to do but even just muttering a few words to a stranger would make me panic. It was a small enough step to get my heart racing, but not to throw me in at the deep end (something which is referred to as ‘flooding’).

The next day I ventured out, anxiety in tow, to the Post Office. I got as far as the door before it all became too much and I ran home. I beat myself up for a little while eventually told myself it was ok. I just had to pick myself up and try again.

My second attempt was much better. I asked for the stamp and although I felt like I probably appeared like an idiot, the lady herself didn’t seem to notice. She gave me the stamp and moved on to the next customer. I left that shop shaking, but elated! I had done it. Step one on my list complete!

However here comes the bad part.

Just like teaching a puppy to sit or stay, that Amygdala needs to have new behaviours repeated over and over before it learns that it is not in any way life threatening. A therapist would later tell me to “Face your fears until you’re bored to tears”. So that post office got a visit from me every day for two weeks. Then after two weeks I went to a new Post Office AND the corner shop for a lottery scratch card. Each time the anxiety would fade more and more until I was just going through the motions.

Once I felt like I’d really achieved my first step and it wasn’t giving me anxiety, I’d move on to the next step on my list and the process would begin again. Sometimes it would take days to beat the anxiety down; sometimes months. There were times I felt like giving up when it seemed to go badly wrong and there were days where I felt I was doing so well I could skip over so many steps. The key was just about keeping at it and being consistent.

One of the things I learned on my journey was that I didn’t have to fit a certain mould and that I was not going to be the same as others around me.

Being in my early twenties and single, I felt like I needed to be going out drinking and attending clubs like those in my peer groups. There was a point where I did start meeting friends on nights out in the city and I would beat myself up that I didn’t enjoy myself and was super anxious all night. It took me a long time to realise that a) I hated loud places like clubs and b) It just wasn’t my cup of tea. These places still give me anxiety but I know that I’m not missing out if I don’t go to them.

My graded exposure process took about 4 years (because of the severity and complexity of my anxiety). But at the end of that time I was able to pick up the telephone to make an appointment with a Prince’s Trust Advisor and then attend a 4 day workshop with 7 other people. Had I not changed my behaviour through graded exposure those simple steps would have been impossible.

Do you suffer from Anxiety? Is graded exposure something you would like to try in a collaborative way?

I’m starting a Myndr group to help those experiencing any form of Anxiety, to support, work on challenges and share information.

If you would like to join please email me.

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