Here's an example of how desensitization works in reference to practicing going out to stores.

1. To do a grocery store (or any store) practice, start by going to the store with no plan of buying anything. It's helpful to go with a support person, if possible.

   Just get comfortable being in the store itself. For example, start by going part way down the right side of the store and see how you feel physically. If you have no physical reaction (anxiety under a 3 on a scale of 1-10), go a little farther back. If you should have an "uh oh" physical reaction, retreat (go back to a place where your anxiety level goes down below a #3) to a place where you feel safe again. That could just be going to the front of the store to look out the window or going back to your car or even home. Only you know when/where you feel safe again.

   When you retreat, do some full-body muscle tensing (tense the various muscles in your body tightly and then release them) and also do some deep abdominal breathing (even pushing your stomach all the way in to get all the air out). This may take several practices to master. Just go to the store (assuming you can get to the store with relatively little anxiety) and try to get comfortable being there.

2. Buy one item going through the express line at the easiest (for you) time of day. That could be 6 a.m. or 9 p.m.. Follow the same steps, proceeding only if your anxiety is low! The goal is to keep the anxiety low, NOT to shop!
3. Slowly work your way up in the number of items you purchase in the express lane, then graduate to the regular lane, buying one item and keep working your way up. There's NO time limit for how long it will take you to accomplish this. Usually "slower is faster"!

If you wanted to practice going to the dentist, you'd let the dentist, or his secretary, know that you have an anxiety disorder. Tell them you'd appreciate it if they'd support you by allowing you to come into the waiting room before your appointment, just to sit and familiarize yourself with the office. By doing this, you're free to come and go in the office, retreating as necessary and then going back into the situation.

Be it a demand situation or a practice situation, your goal is to NEVER AVOID, and to do everything you need to do, but do it the EASIEST WAY POSSIBLE.

The one rule that always applies to all practices and demands (things you "have to do") is, always do things the very easiest way for you. Support people will often suggest, with good intention, ways you "should" do things when you practice. Only you know how you feel and whether or not you can go on, or need to retreat because you're having a physical reaction. If, for example, the easiest way for you to go to the dentist is to take your support person clear into the treatment room to hold your hand, that's how you have to do it!

In a "practice", never distract yourself with music, talking, headsets, etc.. You need to always be aware of your body so you know when to retreat (before the anxiety gets too high!). Dr. Bourne's book, The Anxiety and Phobia Workbook, has a great anxiety scale in the chapter, "Coping with Panic Attacks".

Anytime you're doing a true "practice" it's best to actually get your anxiety down to a 0-1 level, if possible, before going back into the situation again.

Note to Support People: The phobic is to be in charge of all the variables when practicing, i.e.

• Where you go to practice
• What you practice
• When/time of day you practice
• When to retreat

HAPPY PRACTICING!

next: Desensitization Awareness Letter