True/False
A trigger can be external or internal
True, a trigger can be external (something you see, hear, feel, etc.) or internal (like an emotion, thought, or image in your mind)
What is a Trigger?
Something that kicks off the cycle and causes your brain to sound the alarm.
Draw the false alarm cycle on the whiteboard
Trigger -> Perceived Threat -> Anxiety or Distress -> Urge to Neutralize -> Neutralizing Behaviors -> Confirmation of Threat
What is ERP?
Exposure Response Prevention. It involves putting yourself in situation that might make your brain perceive a threat, then resisting neutralizing behaviors.
What is the national animal of Scotland?
The Unicorn
An example of Secondary Avoidance is avoiding touching public surfaces because there may be germs.
False, this is primary avoidance. Secondary avoidance would be washing your hands after touching public surfaces until they feel clean enough.
What is a percieved threat?
Draw the OCD cycle on the white board
Trigger (not required) -> Intrusive Thought/Obsession -> Perceived Threat -> Anxiety/Distress -> Urge to Neutralize -> Neutralizing Behaviors -> Confirmation of Threat
Why is it important to randomize exposures?
You learn better when you are surprised.
Which country invented ice cream?
China
An example of Primary Avoidance is not going near sharp knives because you fear you might lose control and hurt someone.
True
What are neutralizing behaviors?
Any behavior that TRIES to neutralize a perceived threat.
Draw the SAD cycle on the white board
Trigger (social or performance situations) -> Thinking Errors -> Perceived Threat (fear of negative evaluations) -> Anxiety or Distress -> Urge to Neutralize -> Neutralizing Behaviors -> Social Skills Deficit (not required) -> Confirmation of Threat
What is a "Zing"?
A sudden jolt of anxiety or distress that is your bodies way of telling you the alarm has gone off. It is a signal that you are in the middle of an exposure and it's your chance to lean in.
What is the name for the plastic or metal tube at the end of shoelaces?
An aglet
If you frequently have panic attacks that means you have Panic Disorder.
False, Panic Disorder is the FEAR of having panic attacks, anyone can get panic attacks even without Panic Disorder.
What is SUDS?
Subjective Units of Distress Scale is the scale we use to measure how distressing an exposure was.
Draw the Panic Disorder cycle on the white board
Trigger -> Thinking Errors -> Perceived Threat (panic attack) -> Anxiety/Distress -> Urge to Neutralize -> Neutralizing Behaviors -> Confirmation of Threat -> Hypervigilance of Physical Sensations
What are primary and secondary avoidance and how can they be used to create exposures?
Primary avoidance is the thing you are avoiding altogether, so that becomes your exposure. Secondary avoidance is the thing you feel you must do when you can't avoid the situation, these are the neutralizing behaviors that you resist in response prevention.
Who created The Muppets
Jim Henson
Exposures are most effective when you treat them like experiments
True, create a hypothesis before you start, and then see what happens during the exposure. Test if the threat expectation was violated or confirmed.
What is Confirmation of Threat?
Every single time you engage in a neutralizing behavior, you learn that the trigger was dangerous, even if it is actually safe.
Draw the Body Dysmorphic Disorder cycle on the white board
Trigger (not required) -> Intrusive Thoughts (perceived physical flaw) -> Selective Attention/Over-Focusing -> Thinking Errors -> Perceived Threat -> Anxiety/Distress -> Neutralizing Behaviors -> Confirmation of Threat -> Development of Negative Core Beliefs about Self
How do we use inhibitory learning for exposures?
The process of teaching your brain through exposure that the feared outcome doesn't always happen and if the feared outcome does happen, you are capable of tolerating it.
What animal can sleep for up to 3 years without waking?
A snail