Handouts · Anxiety
Facing Fears: Exposure Hierarchies
Avoiding what scares you calms anxiety now but makes it louder next time. Facing fears gradually — a step at a time — is how the fear finally shrinks.
Why Avoidance Backfires
Each time you avoid, your brain learns "that was dangerous — good thing I escaped." The fear grows and your world shrinks.
Exposure teaches the opposite: stay long enough and the anxiety falls on its own, and your brain learns "I can handle this."
Anxiety Always Comes Down
Anxiety can't stay sky-high forever — the body runs out of alarm chemicals. If you stay in the situation without fleeing, it peaks and then falls. This natural drop is called habituation.
The trick is to stay until it eases, not to leave at the peak.
Build Your Ladder
- List situations you avoid around one fear.
- Rate each 0–10 for how much anxiety it brings (your SUDS score).
- Order them from easiest to hardest.
- Start near the bottom — something challenging but doable.
Climb One Rung
- Enter the situation and stay until anxiety drops by about half.
- Don't use "safety crutches" (leaving early, distraction, reassurance).
- Repeat the same step until it feels easy, then move up.
- Practice often — frequency matters more than intensity.
My Fear Ladder
Fear I'm working on:
Rung 1 (easiest) — SUDS ___
Rung 2 — SUDS ___
Rung 3 (hardest) — SUDS ___
Keep Going
- Some anxiety during exposure means it's working — that's the point.
- Use your breathing and grounding skills to stay, not to escape.
- Track SUDS before, during, and after to see the drop.
- Celebrate each rung — you're rebuilding your world.
Go at your pace, not to panic. Steps should stretch you, not overwhelm you. This works best with a clinician's guidance — especially for trauma-related fears, where exposure needs to be paced carefully.