Want to understand why exposures ACTUALLY work in anxiety treatment?

This is how I explain it to all of my clients. (Yes, it includes my dog)

I want you to think of your amygdala (the fear center in your brain involved in anxiety, panic, and OCD) like it’s your dog. Don’t worry, I’ll explain...

Your amygdala is the part of your brain responsible for detecting and storing information related to fear/danger. That’s why exposure therapy focuses on retraining it. But your amygdala isn’t logical, so that’s why talk therapy and all the self awareness in the world DOESN’T usually work for panic or OCD.

Your amygdala is kind of like a dog. It doesn’t learn through logic or conversation. It learns through behavior (or experience).

If I told my dog, “Reba, if you don’t jump on me when I get home, then I’ll give you 50,000 treats and I’ll never put you in your crate again when I go to work,” she’d just stare at me. Head cocked. Confused.

Not because she’s stupid or flawed in some way. But because we know dogs don’t learn information that way. And guess what, neither does your amygdala.

Your amygdala learns through repetition and exposure.

Just like a dog needs consistent training to understand that sitting = treat, your amygdala needs repeated experiences to realize that panic or intrusive thoughts ≠ danger.

Exposure therapy can feel tedious because it’s essentially translating for your amygdala the information that the rest of your brain already knows. Right? Because your brain is already like “I know this is irrational” or “I know it’s just anxiety”, but your amygdala is the part that’s gonna keep pumping the brakes until you loop it in too. But in a language that it understands!

You can’t rush it. You have to be willing to put in the effort consistently over time. Both for anxiety treatment and training a dog.

That’s why we take both forms of training in a step by step fashion, building on itself. And allowing time in between training sessions. But consistency and frequency are KEY FACTORS.

Just like you wouldn’t train a dog by explaining commands in detail, you can’t rewire your fear response with insight alone.

That’s why exposure therapy works. You have to give your amygdala a chance to learn the information in a way it actually understands.

I think there’s actually a lot of overlap between training a cute little gremlin puppy and training our amygdales.

When I first got my dog, I did a ton of research. I knew what all the experts said. Logically, I knew all the things, right? But behaviorally… sometimes it was a different story.

One of the big things with training a puppy is taking them out every hour for potty training because their bladder just isn’t big enough yet. Which I actually did, with the help of my husband. But I remember having moments where I was like, she should just know by now! We’d done this so many times. But literally, her body wasn’t ready yet. I couldn’t get frustrated with her for that, right? 

It was tedious, but we did it over and over again. And actually, she was potty trained in a week. But think about it…that’s at least 24 exposures per day for 7 days straight. Same behavior, same routine, every time: she went outside, peed, got a treat. If she pooped, she got two treats. Lots and lots of really good exposures to teach her in a way she could actually understand.

So many people either want to skip exposures or do the bare minimum. But you’re not doing yourself any favors.

Because here’s the thing: it doesn’t matter how smart you are…your amygdala doesn’t take in information like the rest of your brain. You have to give it the chance to truly learn in the way it understands. Otherwise, you’re just going to end up frustrated with yourself unnecessarily.

It takes time. And sometimes, you have to remind your amygdala that things aren’t dangerous, especially if you haven’t been exposed to them in a while. Just like how I sometimes have to reinforce training with my dog (luckily not potty training, because we do that every day).

So don’t skip exposures. Give your amygdala the training it actually needs. Even if it seems tedious. 

I know you get it, but your amygdala doesn’t (yet).