Anxiety Disorders 259
asked to think about only one specifi c worry (this is the exposure) and to imagine
their worst possible fears about the subject of that worry, such as the possible deaths
of family members. Patients are asked to think about their worry continuously for
about 30 minutes. After this half-hour of exposure, patients then list their rational
responses to the worst outcomes they imagined. Patients’ anxiety and level of worry
should decrease both over the course of the session and across sessions. When pa-
tients can think about one set of concerns without much worry or anxiety, they move
on to use the same procedure with another set of concerns (see Figure 7.4).
Figure 7.47.4 • Worry Exposure Source: Adapted from Brown, O’Leary, & Barlow, 1993.
Worry exposure fi rst involves evoking a particular worry as
vividly as possible and trying to imagine the worst-case
scenario related to that worry.The patient then tries to stay focused on the single worry
for about a half-hour; the patient should habituate to the
anxiety caused by the worry.Once the patient has habituated somewhat to the worry, the
patient and therapist generate possible rational alternatives
to the worst-case scenario.After the patient has habituated to and developed a rational
response to a particular worry, he or she is ready go through
the same process with a new, specifi c worry.I’d like you to worry
about only a single concern. Let’s
start with your worry that when your wife
is late, it’s because she’s been in a car
accident—that she’sslumped
unconcious over the steering wheel.
Let’s try to stay focused only
on that worryyy.Okayyy...
When I think about my wife being
late and possibly in an accident,
after a while I feel anxious.Are there alternative
explanations or why your wife
might be late other than some
tragedy has befallen her?Hmm... I suppose she could have
gotten stuck in traffic and didn’t
want to take her eyes off the road
to call me. Or she could be driving
around looking for a parking
place.Okayyy, I can think about my wife
being late and not get so anxious. If
I start to worry about her being late
because of an accident, I can
remind myself about alternative
reasons why she’s late. I am ready
to go to the next worry.Okay...
When I think about my wife
being late and possibly in an accident,
after a while I feel anxious.Okay, I can think about my wife
being late and not get so anxious. If I
start to worry about her being late because
of an accident, I can remind myself about
alternative reasons why she’s late. I am
ready to go to the next worry.I’d like you to worry
about only a single concern. Let’s start
with your worry that when your wife is late, it’s
because she’s been in a car accident—that she’s
slumped unconscious over the steering wheel.
Let’s try to stay focused only
on that worry.Hmm... I suppose she could
have gotten stuck in traffi c and didn’t
want to take her eyes off the road to call
me. Or she could be driving around
looking for a parking place.Are there alternative
explanations for why your wife
might be late other than that some
tragedy has befallen her?