I’ve got two major diagnoses to deal with: ADHD-inattentive, and Anxiety. They both sprinkle generous heaps of caltrops on my daily path to extraordinary success.
Closely connected to anxiety is Fear. This article is about how to deal with both.
One form of anxiety that really stops my progress, is social anxiety. Here’s how it works. We live pretty close to a college bar. During big games or other college events, the line of kids with fake ids stretches down the block around the corner. They’re just kids to me. I have no problem interacting with college kids.
But when I try to walk down the sidewalk next to this line of party, my knees buckle, I break out in cold sweat, my breath starts getting shallow. It takes everything I got to keep my body moving normally. I almost cry!
My fears take over. “What if somebody says something to me”, “what if I’m dressed like a hobo?”, “What if…”, there’s always something that could happen that could embarrass me in front of all these people.
In the end, who cares? For some reason, I do.
But I’ve mostly gotten over this fear. The way I did it is through exposure therapy.
In this article, I’ll explain what it is, how it works, and how you can design an exposure therapy strategy that will help you overcome your own fears, crippling or otherwise.
What is Exposure Therapy?
Exposure therapy is a strategy used by psychologists skilled in Cognitive Behavioral Therapy (CBT) to handle pretty much any fear or phobia their clients are trying to overcome. Practitioners of CBT believe that you don’t change underlying cognitive disorders by just talking about them. You start by changing actual behaviors. The new behavior drives the changes in the underlying condition.
For example, let’s say you are afraid of snakes, like Indiana Jones. One glance at a snake generates massive, pants shitting fear, and an immediate urge to flee the scene to safety.
The writers of those movies actually put Indy into some exposure therapy situations. In the opening of Raiders of the Lost Ark, when he hops into Jacques’s plane, he meets Reggie – the pet boa constrictor. He’s so unlikely to get truly hurt by that snake, compared to the natives hunting him with poison darts, that he has time to experience the fear without dying.
The writers actually trapped Indy in a textbook forced-exposure scenario. In the opening of Raiders of the Lost Ark, when he hops into Jacques’s plane, he meets Reggie – the pet boa constrictor. Stuck in the cockpit with the snake, Indy can’t flee. He is forced to sit there, panic spiking, while the plane takes off. Because he can’t escape, his brain is eventually forced to realize that Reggie isn’t a threat compared to the poisoned darts behind them. That’s the core of exposure: staying put until the panic runs out of gas.
It’s that assured survival that makes exposure therapy effective.
The strategy is to put yourself into environments that you know will trigger that panic, handle it for a while, then exit. Once you exit, you reflect how you survived the interaction. You’re teaching your rat brain that you can willfully enter the threat zone, and be OK.
As you structure those interactions to become riskier and riskier, you may not totally overcome the fear, but you do learn that you can do it.
You grow your confidence.
Design Your Own Exposure Strategy
DISCLAIMER I am a writer sharing my personal experiences and research, not a licensed therapist or a medical professional. If you are dealing with severe anxiety, panic disorders, or trauma, please talk to a professional before trying to rewire your brain. Exposure therapy is a highly effective tool for everyday fears and social anxiety, but it is not a cure-all. Do not use this framework to jump off a roof, wrestle poisonous snakes, or try to navigate an active volcano. Know your limits, use common sense, and seek a qualified guide if you are dealing with the heavy stuff.
I like to think about this as programming myself. I wrote a while back about how we are really at least three beings in one: Beast, Rider, and Marshall. The fear comes from that Beast, at which the Rider wheels the steed around and rides it to safety.
We can instead wield the Marshall’s personality, and rewrite the commands executed by your Rider.
What follows is called a Fear Ladder (or, clinically, an exposure hierarchy).
- Identify the Fear
Vague fears cannot be targeted. You need to identify fears, and then identify the fears behind the fears, until you can’t go any further.
For me, it’s any environment that screams “PARTY TIME” (surface fear). I’m afraid that I will get embarrassed and that it will matter (deeper fear). Really, I’m afraid that I don’t deserve love and will be abandoned (primary fear).
For you, it may be something else. Maybe you’re really scared of spiders. Whatever, dig down. Use your Morning Pages to get to the root.
- Build the Fear Ladder
Write down 10-15 scenarios related to your fear, and then rank them from 0 (completely relaxed) to 100 (blind panic).
For example, in my case:
| Anxiety Score (0-100) | Exposure Scenario |
|---|---|
| Level 10 | Asking the grocery store cashier how their day is going. |
| Level 30 | Asking a stranger on the street for the time or directions. |
| Level 50 | Making 5 minutes of small talk with another parent at a baseball game. |
| Level 70 | Attending a neighborhood block party for 30 minutes without a ‘shield’ person. |
| Level 90 | Sitting alone at a crowded bar and initiating a conversation. |
- Identify and strip away “Safety Behaviors”
This one is big, and people usually miss it.
Safety Behaviors are things that we do to cushion our feelings during a scary situation, so we don’t actually have to face it. Common behaviors are: staring at a smartphone, mentally rehearsing every sentence before speaking, watching the TV, just concentrating really hard on something to pretend it’s important.
To make exposure work, you have to eliminate these safety behaviors during the exercise.
- Execute the exposure!
Start at the bottom of your Fear Ladder, and do the action.
One thing I’ve been trying at this stage is to recognize when the anxiety starts to spike, when I start to feel the need to flee. At that moment, it helps to mentally holler “CHARGE!!!”
When you’ve gotten into position, don’t leave. The golden rule here is that you have to stay in the situation until your anxiety drops by half.
If you leave the exercise while your anxiety is still spiking, you’re teaching your Rider that the only way to survive is by escaping. We need to stop reinforcing that belief.
If you stick around and let the awkward feelings wash over you, eventually your brain will get bored and realize “I’m not dying”.
- Repeat
Do that low level exposure over and over until it doesn’t spike your anxiety any more. Then, go to the next level of your fear ladder and do that exposure exercise.
Keep going until that top rung of the ladder is yours!
This process takes work, and it’s really easy to stop in the middle and think you’re cured. Or, think that you’re permanently screwed.
Both of those are fictions! Keep going, and do the work.
Bonus: Program Your Own Ladder with an LLM
If you’re staring at a blank page struggling to break your fear down into 10 or 15 incremental steps, you can use an AI assistant (like ChatGPT, Claude, or Gemini) as a collaborative architect.
The secret to getting a great clinical framework out of an LLM is providing strict constraints. If you just ask it for “an exposure ladder for social anxiety,” it will give you generic boilerplate. You need to give it a role, clear definitions, and an iterative process.
Copy and paste this exact system prompt into your favorite LLM to map out your custom regimen:
Act as an expert psychologist specializing in Cognitive Behavioral Therapy (CBT) and exposure therapy frameworks.
I want your help building a personalized "Fear Ladder" (exposure hierarchy) for a specific fear I want to conquer. Before generating the ladder, you must understand two things:
1. My surface fear, deeper fear, and the situations that trigger me.
2. The "safety behaviors" (crutches, distractions, avoidance tactics) I usually use to hide from this fear.
Do not generate the entire ladder yet. First, ask me 2–3 targeted questions to get the context of my specific anxiety.
Once I answer, you will output a clean Markdown table with columns for:
- Anxiety Score (0 to 100, graduated in increments of 10-20)
- Exposure Scenario (Highly specific, real-world actions)
- Safety Behaviors to Eliminate (The specific crutches I am forbidden from using during that step)
Acknowledge that you understand, and ask your first questions.
Why this prompt works:
- The Interactivity Gate: By telling the AI not to write the ladder immediately, you force it to interview you. This ensures the final output is tailored to your actual life, not a generic textbook definition.
- The Safety Behavior Constraint: Forcing the LLM to explicitly list which “crutches” you have to abandon at each rung removes your ability to cheat the system when it’s time to execute.
Give it a spin with your own root fears and see how sharp of a tracking matrix it builds for you.
If you’ve tried using your own exposure hierarchy, write about it in the comments. Who knows, someone with your same anxieties may read it and get inspired.
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