I have read about exposure therapy before and just completed the week four lesson. It describes everything very well, but I'm still left with some of the same questions I've always had about working with anxiety through exposure. If anyone can offer any insights that would be great.
1. I understand how panic works and how my body is reacting during a panic attack, thus I'm not scared during a panic attack that some harm will actually come to me. Instead, I just HATE feeling that way, and the vast majority of my fear is centered around my "fear of fear", or fear of having a panic attack. When working with exposure, you're inducing anxiety in a sense, and while I understand you don't want to put yourself in a situation that will result in a fear rating of 90-100, if I go somewhere and feel really anxious (even up to a 60-80) I feel like my fears of feeling fearful are coming true, reinforcing my "fear of fear". Does that make sense? I guess you are just supposed to witness that your fear level will come down, but when my biggest fear is feeling miserable, and I go into a situation and feel miserable (even if I'm slightly less miserable at the end) I feel like my fears are reinforced. How do I get around this?
2. As I already mentioned, most of my fear is "fear of fear", and so I have a lot of anticipatory anxiety. How do you use exposure to deal with anticipatory anxiety? I understand that if you go through exposure and realize there is less to be afraid of, your anticipatory anxiety will eventually go down, but is there any way to address this more head on? For instance, if I develop an exposure plan for the next few weeks, my overall anxiety level will be much higher 24/7 thinking about all the challenges I'm going to be putting myself through.
3. Similarly, what about when a decent number of your panic attacks occur "out of the blue" rather than in a particular situation....how do you work with exposure in this case? It's hard to nail down a particular fear that's triggering attacks in these cases, so it's impossible to come up with any exposure plan.
4. Finally, I have a specific question about developing an exposure plan for my fear of going to events such as plays and sporting events. Often when I do these activities I feel fine for much of the event, and my anxiety increases as the event goes on until I find it difficult to stay there near the end. Often my anxiety isn't at its peak until towards the end of an event, so even if I get myself to stay in the situation and endure it hoping the anxiety will eventually go down a notch, the event often ends first - so I get to leave, and of course immediately feel better, so I feel like my fear is being reinforced. How do I do exposure work when my anxiety increases the longer I'm in a situation, but I don't have control over how long the event lasts?
I got a little long-winded there, but it's helpful even just to put my concerns into words, so thanks for reading, and any thoughts you have will be much appreciated.