An Exposure, With Grace
Come along on an exposure walk with me
Exposure therapy is a type of therapy in which you're gradually exposed to the things, situations and activities you fear. There are a few different approaches to this therapy. It can help treat several conditions, like phobias, post-traumatic stress disorder (PTSD) and panic disorder. — Cleveland Clinic
An exposure walk doesn’t start when I step out my front door. It starts when I first wake up and set the intention to go outside of my comfort zone. The first few minutes I wake up are the easiest. In my morning daze, anything seems possible. I imagine myself out in the world like I was before panic disorder. Anxiety? What anxiety?
I rise, stretch my body, go to brush my teeth, and somewhere between my bedroom and my bathroom, anxiety finds me. I feel it in my body—my shoulders are tense and my thoughts aren’t as clear as they were moments ago. They begin to race and jumble.
To drown out the noise and discomfort, I put on some music and jump in the shower. Hot at first to soothe my muscles that can’t help but tense at the world around me. I remind them that there is no threat, but they don’t listen. As far as they’re concerned, danger lurks around every corner.
At the very end of my shower, I turn the heat off, and cold water blasts my body. If I can’t soothe the worry, I can shock it out of my system.
Following my shower, I throw on some comfy clothes—nothing too constricting. Then, I have a spoonful of peanut butter and fill my water bottle. By my front door, my dog, Louie, is already wagging his tail, knowing what is coming next. I wish I had his eager excitement.
I sling my mini backpack on, put on my noise-canceling headphones, attach Louie’s leash, take a breath, and open the front door. When I go on exposures, I’m supposed to track my SUDS.
Exposure therapists often use a scale of 0-10 or 0-100 to rate the amount of anxiety someone has during exposure exercises. It is like a thermometer, measuring how “hot” our anxiety gets. This is called the Subjective Units of Distress Scale or “SUDS.” —UoM
I make a mental note that my SUDS before starting my walk is at 20 (not too high— just a pinch of uncomfortable).
The sun has yet to rise. This is my favorite time to go for a walk with Louie. The world around me is quiet, perfect for someone who doesn’t want her anxiety on display. In a city like Philadelphia, it’s hard to find these quiet pockets in the day.
We start down toward the park with Yeah Yeah Yeah’s Burning playing in my headphones. We stop often so Louie can sniff where all the stray cats have been. Before, it was difficult for me to pause during an exposure. Every time Louie stopped, my heart would start to flutter and panic would rise. It was as though standing still was the most unnatural occurrence.
When my anxiety was at its worst, but I was still going about my life, checkout lines became my greatest hurdle. I’d be fine, browsing/shopping, but when I stopped and waited in line, I’d panic. Instantly, the need to flee would set in. Sometimes I was able to fight through it. Other times, I abandoned my shopping cart and bolted.
Now, when we stop, I breathe. I breathe and remind myself that we’ll be going again in a matter of seconds. We reach the end of my street and the park is in sight. There are only a few cars on the road, which is a relief. I can cross the street and head into the park without waiting for the busy traffic to die down.
With summer right around the corner, the park has become my ultimate goal. I want to conquer it and be as comfortable there as I am in my house. I want to play tennis without a care. I want to race Louie across the green field, and pop down and get water ice whenever the mood strikes me.
For the next few months, I will be visiting the park almost every day to ensure I can enjoy the park freely in the near future.
At the park, I pause and take notice of my SUDS. They’ve risen to a 40 (more uncomfortable—a jittery sensation, but no feeling of needing to flee). Here at the park and at a 40, I wait, as I’m supposed to for my SUDS to decrease. I make the decision to skip the song Climbing Up the Walls by Radiohead because—as much as I love Radiohead—the song isn’t conducive to lowering my anxiety at the moment.
I take this opportunity to switch from music altogether and put the audiobook, I Want to Die but I Want to Eat Tteokbokki: A Memoir on. I exhale, feeling the slower pace more in tune with my current wanted state.
My SUDS drop to hover between a 20 and 30, so I start up again. A few steps away from the park, panic assaults me. My feet itch to run. My mind swirls and I worry I might grow faint. On instinct, because I’ve been here before, I swing my backpack in front of me. I unzip it and dig into the already open bag of airheads. My body is slightly numb as I unwrap the lemon flavor sour candy and pop it into my mouth.
My face scrunches up like I’ve just bitten into a real lemon. The sharp sour is intense, but it does what it’s supposed to do—it distracts me from my panic. By the time the sour flavor is gone and I’m left with a sweet lemon candy, all thoughts of fleeing or fainting are gone.
Louie and I continue to walk around my neighborhood as a misty rain falls. On some of the trees, there are small buds. They tease me with spring. One day soon, the trees won’t be naked and bare. The rose bushes will be in full bloom, sidewalks will be covered in tiny, fallen pink petals, and the floral shop near my house will entice me to buy too many pepper plants.
My stomach rumbles and Louie looks back at me as though to say, “I’ve had enough.” We make our way back home and there is no panic. I think, I remember when it wasn’t always like this—when panic only came when it was actually needed. I give my head a little shake. There’s no use thinking like that. I reframe it: there are times when I don’t panic, like now. And even when I have panicked, I have gotten through it.
Inside, Louie dashes off to his bed and I hang his lease. A sense of accomplishment washes over me. A walk to the park and around my neighborhood may seem like a small accomplishment to some, but I don’t let that get me down. With an extra skip to my step, I venture into my kitchen and start preparing my breakfast. My SUDS are at a zero and I glow with the feeling that I am reclaiming my life, step by step.