“But exposure works!” people yell from across the street.
Do not cite the Deep Magic to me, Witch.
In some ways, that’s my fully general response to being given Standard Advice(TM). The giver may not know the Deeper Magic.You may not either, and you may not have been there when it was written, but if it doesn’t sound right to you, you can look before deciding whether to buy into it.
In this case, that may be the layperson’s standard advice, but it’s definitely not the professional’s standard advice, which can’t be condensed to a single short phrase. Five Words Are Not Enough, because “exposure” and “works” are both so underspecified.
I’m also not a professional, so my version is also very incomplete, but at a bare minimum, exposure therapy needs to be done kinda the way building up tolerance for poisons or allergens is done—carefully, in risk-minimizing contexts, with support systems on standby if things go wrong.
To quote SSC, I think accurately despite being in a very different context:
Psychotherapists treat arachnophobia with exposure therapy, too. They expose people first to cute, little spiders behind a glass cage. Then bigger spiders. Then they take them out of the cage. Finally, in a carefully controlled environment with their very supportive therapist standing by, they make people experience their worst fear, like having a big tarantula crawl all over them. It usually works pretty well.
Finding an arachnophobic person, and throwing a bucket full of tarantulas at them while shouting “I’M HELPING! I’M HELPING!” works less well....
There are two problems with its approach. The first is that it avoids the carefully controlled, anxiety-minimizing setup of psychotherapy.
The second is that YOU DO NOT GIVE PSYCHOTHERAPY TO PEOPLE WITHOUT THEIR CONSENT.
If a person… doesn’t want psychotherapy, then even as a trained psychiatrist I am forbidden to override that decision unless they become an immediate danger to themselves or others.
Exposure therapy can also be useful for panic attacks or specific phobias. This is where they expose you to the thing you’re scared of (or deliberately initiate a panic attack) and keep doing it until you stop being scared and start being bored. According to a bunch of studies it works neither better nor worse than cognitive-behvioral therapy for most things, but my unsupported impression has always been that it’s better at least for panic disorder. Cognitive-behavioral therapy seems clearly superior for social phobia.
Do not cite the Deep Magic to me, Witch.
In some ways, that’s my fully general response to being given Standard Advice(TM). The giver may not know the Deeper Magic.You may not either, and you may not have been there when it was written, but if it doesn’t sound right to you, you can look before deciding whether to buy into it.
In this case, that may be the layperson’s standard advice, but it’s definitely not the professional’s standard advice, which can’t be condensed to a single short phrase. Five Words Are Not Enough, because “exposure” and “works” are both so underspecified.
What’s the long version of the professional’s standard advice?
I’m also not a professional, so my version is also very incomplete, but at a bare minimum, exposure therapy needs to be done kinda the way building up tolerance for poisons or allergens is done—carefully, in risk-minimizing contexts, with support systems on standby if things go wrong.
To quote SSC, I think accurately despite being in a very different context:
Although, in another SSC post: