What is Worry Exposure? Tools Used in Anorexia Recovery

rtor guest blog featured image Overcoming Any Fear Using Exposure and Response Prevention Techniques to Cope with Anxiety and Related Mental Health Disorders

There are a multitude of various approaches, methods and treatment currently available used to treat mental health conditions such as eating disorders. This article aims to focus on one such tool with key areas to be explored listed below.

  • What is worry exposure?
  • Worry exposure scenarios in anorexia
  • Worry exposure hierarchy
anorexia bulimia
Anorexia can be treated with worry exposure tool – image by writechoice.com

What is Worry Exposure?

Worry exposure is pretty much exactly what it sounds like; it involves a process of imagining one’s worst fear. For example, a person with a fear of spiders might imagine having a spider crawling on them or a person with a fear of heights might imagine being stuck at the top of a very tall building.

Worry exposure involves a process of imagining one’s worst fear – image by etuttor.com

The primary idea behind such an approach is that it is often far better to one’s mental health and psychological well-being to face one’s fears head on and confront them rather than running away which only serves to keep the anxiety cycle going round.

fear experience vs behavior
It’s better to face the fear than run away from it – image by scotthyoung.com

Worry Exposure Scenarios in Anorexia

When undertaking worry exposure it is important that the patient first thinks about the most frightening scenarios he or she can imagine and ones that are likely to lead to the patient getting well as opposed to remaining ill. In the case of anorexia the worry scenarios are often associated with gaining weight.

Verkehrte Selbstwahrnehmung Immer mehr Jugendliche sind og
The worry scenarios of anorexia are often associated with gaining weight – image by pinterest.com

Samelson highlights the following scenarios as effective in worry exposure: gaining 10 pounds, being labelled as fat, being unable to wear normal sized clothes and being unable to stop eating. Scenarios within worry exposure are described as if they were occurring in them here and now, for example: “I am so obese that I can’t fit in this chair.”

Imagine the fear of being fat and face it – image by iowalum.com

Each scenario is written down and after is given an anxiety rating with one representing the least anxiety and five representing the most anxiety.

Worry Exposure Hierarchy

Following the recording of an anxiety rating, each scenario is then written in order depending on the level of anxiety associated with each one. This is known as a worry exposure hierarchy where the scenario causing the individual the least amount of anxiety is placed at the bottom of the list and the one causing the most anxiety in placed at the top.

avoidance hierarchy
Write down the anxiety as level – image by psychologytools.com

Next, each one is worked through in turn, beginning with the one that causes the least amount of anxiety and gradually building up to the one that causes the most amount of anxiety. Following this a story of what is happening behind the scenarios may be of further benefit.


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