Exposure Therapy Advice/ Tips?


Gimme all you've got... throw it at me... I'm a horrible person and everything's awful and always will be and
Perhaps a middle ground - acknowledging the thoughts for what they are, but then giving your brain something else to focus on.

So instead of "Bring it on, Brain", it's more like "Oh, there's the I'm Useless story again, which I've heard before a thousand times...back to what I was doing...".

Thought diffusion. Takes persistence, because your brain's circuitry has these thoughts on repeat. But, eventually, your brain does give up. The spaces between the thoughts get longer, the thoughts themselves get less overwhelming.

It's an ACT strategy. Usually you couple it with some kind of value-driven behaviour that your brain will really sink it's teeth into.

Whatever - the point is your brain is doing this because that's it's current wiring pattern. But that doesn't mean you need to listen to the "I'm Useless" story every time your brain starts playing it to you. It's not like these stories change, right? Same old, same old. If anything, listening just makes them go on longer.

"Thanks Brain, but I don't need to hear that story out again, because I'm watching my favourite movie right now."


My thinking feelings are where most of my symptoms are created. That’s not to say I can control it. I read the OP. Idk what exposure therapy is really. I know I’m having the same symptoms. I don’t mind being home though. I am trying to get out of the house part time . That’s not what I’m resisting. I like doing the dishes. I got a new vacuum, I love cleaning the house . I can’t deal with people. I don’t want to go out of the house for work not because I mind work. I like work actually and I’m pretty good at it but I just can’t deal with people. It sets off all my stuff. I am having trouble doing anything though it’s probably tied to everything going on in the world it’s such a mess. I think everyone is having a harder time right now. I hope you feel better. I’m just thinking I need to be nice to myself and everyone around me if I do the dishes or not.
By running and avoiding, I'm giving the depression monster ten times more power over me than if I just sit still and mutter resignedly "Gimme all you've got... throw it at me... I'm a horrible person and everything's awful and always will be and we're all going to die and life is pointless and yadayadayada... Heard it all before... Haven't you got anything more impressive than that? Come on up the ante, let's settle this once and for all..."
So I'm doing this... And it's working... It's making me hyper-aggressive tho.
I knew there would be emotional fallout from it, tho aggressiveness isn't what I was expecting.
But oh well, it is what it is.
I'm able to handle it... Don't want to have the cops called cos I've punched some random person in the face just for existing.
So being more functional and pushing through the depression and just seething with massive irritability.
Managing to cut through the avoidance, managing to face shitty emotions head on.
I don't think I would have/ could have done this at the beginning of my trauma therapy journey... the fallout would've been too intense/ too hard to handle.
But at the end of my trauma therapy journey, I'm finding the fallout is significant but manageable.

I actually try and do this "as much as possible" but with this current bout of superf*cked depression, it's been having zero impact. Which is why I'm looking for different approaches, like just staring the mofo thoughts down and refusing to be intimidated by them.
Also, I think one "issue" with the reframing thought thing is that for me, it can quickly (and sneakily) turn into a type of avoidance...
A negative thought will arise and I'll be so desperate to "get rid of it" that I'll reframe the living daylights out of it... And I suspect it kinda turns into a situation where I'm scared of the negative thought and hurling as many positive thoughts at it as I can.
I dunno if that makes sense? But it feels avoid-y to me.
I'm sure there's a better/ correct way of doing it... but my brain seems to instinctively slip into that ^^ kind of pattern with it.


Avoidance is a symptom, and also a coping mechanism. You avoid because it reduces the thoughts. Distraction is also a tool - but it seems like for some of us that struggle with dissociation, like me, there is a distraction level that is basically a form of mild problematic dissociation. It’s not recognizing the thought or feeling and containing it, but just a plain old avoidance shut out.

Exposure or stress inoculation therapy is a therapy of exposure, but isn’t a therapy of being flooded.
A negative thought will arise and I'll be so desperate to "get rid of it" that I'll reframe the living daylights out of it... And I suspect it kinda turns into a situation where I'm scared of the negative thought and hurling as many positive thoughts at it as I can.
Is this like how some might panic about having panic attacks? (I have done that.) I used to get this one thought in my head and panic about it, and then panic about the panic. So. Yeah, I can relate, in a different way.

There's two ways to manage a thought or emotion that feels intolerable or distressing. 1.) to recognize it, notice it's there, cope with it and move on past it - what sometimes therapists call "containment" and might show up as emotional regulation skills. 2.) to shut it out and numb it until it keeps popping back up with a truckload of symptoms.

Those who dissociate tend to be super good at #2. It's harder to do #1. (It's also really hard to explain the difference between healthy distraction/reframing and avoidant distraction/reframing.)

One thing to keep in mind as you wrestle through a better balance is the flood/numb cycle. (Numbing can be any flavor of problematic dissociation/shut out.) The more someone numbs the more likely they will later be flooded, and the more one is flooded (or experiences intense symptom spikes), the more likely one is to experience emotion as overwhelming and numb, and around it goes.

You are right to recognize a need to face the thoughts, but be careful with the draw to jump in feet first and just flood them in, fallout and all. It could set you up for numbing later on.

Mindfulness might be helpful to explore. It’s a way to experience situations and build up the skill for the thoughts to come... and go... one mindfulness strategy is to picture each thought as a leaf floating down a river. I found that not as helpful as others but for me, writing the thought down and then putting it in a box helped me have the thought, and get past it and not have it the thought, or the shut out of it, take over my mind.

Another is to notice what you feel with a certain thought, and then imagine turning a knob of a dial down. Might seem silly but works for some people. It's not about avoidance or re-framing, but turning down the volume on the distress that comes with the thought, allowing it to be there, and allowing yourself to also move on from it.

Mindfulness is different than mediation (which I don't do personally because that just makes me space out.) Mindfulness can be used in any situation with any thoughts or feelings.

It’s about allowing the thought to exist, but not flood. Exposure therapy works in the same way - it’s not about just doing something that floods, but experiencing little bits and going to offense to prevent flooding. It's not denying that the airport is there for someone that is afraid of flying, but rather "I see the plane but hey, I’m safe, the ground is below me, etc."

If re-framing is becoming avoidant, maybe consider a less positive but more neutral productive approach. For me, it helps sometimes to say a more neutral re-frame: "I feel hopeless and I want to end it all. For now, I'm going to give myself permission to recognize I'm depressed and go walk my dog and notice the weather today." not "I have hope and all is well."

Or if feeling the need to intimidate the thought.... "*@^$*(!!*@&#!!! My abusers they don't get to win in my head! I hate being depressed and I'm taking the dog for a walk anyhow" has been a valid/useful re-frame for me.

I commend you for your courage to do what you need to do to get unstuck and reduce the avoidance! Keep up the good work!
Still applying this, still yielding positive results from it, still getting significant but manageable fallout.

Feels like I'm forcing my brain to switch from "flight" to "fight" mode.

First it was avoiding "everything" as a potential threat, now I'm forcing myself to confront those threats... Kind of like a fire fighter has to run towards a fire, instead of instinctually run away from a fire.

One thing it's made me notice is that when I'm in avoidance mode, I don't actually get much "rest" when I'm avoiding and hiding.

I seem to get into this weird state that's inactive/ passive, but also a constant churning of worries and fears. So, burning through huge amounts of energy without getting anything done. For want of a better word I'm going to compare it to purgatory.

I'm trying to get myself to stay out of that state by a) forcing myself to be active and b) only allowing myself to rest/ hide/ avoid/ take breaks if I truly REST instead of just spending hours stuck in that stupid and useless purgatory state. So annoying that that's my brain's go-to state atm.

It's like both positive ACTION and positive REST are nearly impossible to access and I have to fight all of my brain's instincts to get to those two states. Stupid brain.