After the Anxiety Hierarchy is made, the real process of recovery will begin when you start exposing yourself deliberately to your lowest fears and resisting the pull of compulsions. As you get better at handling those smaller fears, you move on to the larger ones.
When you move on to the larger ones, though, it may still not be easy for you to face a large fear all at once. You might then need to make a hierarchy for each large fear too – a mini-hierarchy within the anxiety hierarchy. So that facing it does not overwhelm you into giving up. Let us go back to the example of watching the romantic movie in ROCD Type 1. If you find this extremely difficult to do, you do not need to expose yourself to this all at once. You may be able to work your way up to it by creating a mini-hierarchy within this trigger. It could look something like this –
- Look at a list of romantic movie names.
- Look at posters of romantic movies.
- Watch trailers of romantic movies.
- Watch some parts of the movie.
- Watch the entire movie.
So, while in the anxiety hierarchy, watching a romantic movie may be 8 on SUDS, breaking it down like this may help in facing the trigger eventually. These activities will obviously need to progress slowly and you will need to work your way up steadily, but with this mini-hierarchy within the anxiety hierarchy, you may find it easier to do so.
Similarly, in the case of the other example when you do not get the text immediately after you text your partner, you may get the urge to lash at your partner and demand an explanation. If this has a high SUDS score, expecting you to stop it altogether may be unreasonable. So, in order to help yourself manage it better, you can create a mini-hierarchy within the anxiety hierarchy for this trigger. The mini-hierarchy could look something like this –
- Wait for ten minutes before lashing out.
- Wait for thirty minutes before lashing out.
- Wait for an hour before lashing out.
- Do not lash out at all.
This way, you will keep putting a distance between your urge and action, thereby making progress, albeit slowly. This mini-hierarchy serves two purposes. One, it will make sure that you are making progress towards the ultimate objective of getting over this particular compulsion. Two, it is doing so by ensuring that you are expected to tolerate the anxiety in bite-sized chunks and not all at once. As explained in the last section, a little reduction at a time goes a long way in long-term progress.
In the next chapter we shall begin to understand how to schedule ERP.
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