Why it can feel overwhelming —
and why you don’t have to face it alone
By Shaun Hodgkiss, CBT Psychotherapist
When people hear the word exposure in Cognitive Behavioural Therapy (CBT), it often brings up images of being pushed into frightening situations before they feel ready. For many, this alone is enough to create anxiety about therapy itself.
If that reaction sounds familiar, it’s important to know that this response is understandable, common, and expected. Exposure works directly with fear — and fear is something the human nervous system is designed to protect us from.
This blog aims to explain what exposure really is, why it can feel daunting, and why support matters — without asking you to do anything on your own.
Why exposure can feel so scary
Exposure involves gradually approaching situations, sensations, thoughts, or memories that have come to feel threatening. These are often things people have learned to avoid because avoidance brings short-term relief from distress.
UK CBT literature consistently explains anxiety as being maintained through this cycle of fear → avoidance → temporary relief → increased fear (NHS Talking Therapies, 2018; Warwick University, n.d.). From this perspective, avoidance is not a weakness — it is a survival strategy that once made sense.
When exposure is suggested, it can feel as though that sense of safety is being taken away. People commonly worry that:
- anxiety will become overwhelming
- distress will spiral out of control
- they will be unable to cope
- exposure means “forcing” themselves to suffer
NHS and IAPT materials highlight that these fears are a natural response to anticipating threat, not a sign that someone is unsuitable for CBT (TalkPlus, 2023).
One reason exposure can feel frightening is that it is often misunderstood.
Exposure is not about being forced into feared situations.
It is not about “just pushing through”.
It is not about eliminating anxiety altogether.
Instead, UK CBT guidance describes exposure as a collaborative, planned, and supported process, usually carried out with a trained therapist (NICE, 2013; NHS Talking Therapies, 2018). The focus is on helping people feel safer engaging with life again, rather than on enduring distress for its own sake.
Letting go of the idea that anxiety must disappear
Many people begin therapy hoping to get rid of anxiety, panic, intrusive thoughts, or uncomfortable bodily sensations entirely. While understandable, this expectation can unintentionally make exposure feel like a test that can be failed.
NHS CBT resources emphasise that the goal of exposure is usually not the complete removal of feelings, but rather learning that these experiences are tolerable, temporary, and less dangerous than they feel (Plymouth Hospitals NHS Trust, 2020).
Over time, many people notice that when they stop avoiding feared situations, their confidence increases and their anxiety naturally reduces — but this happens because their relationship with fear changes, not because fear is eliminated altogether.
Why support makes such a difference
Exposure is most effective when it is carefully planned and paced, taking into account someone’s history, current stress levels, and personal values (NICE, 2013). UK guidance consistently highlights the importance of delivering exposure within a structured therapeutic framework rather than as a self-directed challenge (NHS Talking Therapies, 2018).
Working with a therapist allows people to:
- make sense of their fear responses
- agree on goals that feel meaningful and realistic
- move at a pace that feels manageable
- reflect on experiences safely and compassionately
This support can be especially important for people whose difficulties are linked to trauma, panic, OCD, social anxiety, or long-standing patterns of avoidance.
A hopeful but realistic message
Exposure is not about becoming fearless. It is about becoming less restricted by fear.
Many people who engage in CBT discover that while uncomfortable feelings may still arise, those feelings no longer dictate their choices. Life begins to expand again — not because fear disappears, but because confidence and trust in oneself grow.
If exposure feels daunting, that does not mean you are “not ready” or “not suitable” for CBT. It often means you are human — and that support could make the difference.
You do not have to face these steps alone.
References
NHS Talking Therapies (2018) The NHS Talking Therapies for Anxiety and Depression Manual. NHS England. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/06/nhs-talking-therapies-manual-v7.1-updated.pdf (Accessed: [24.01.2026]).
NICE (2013) Social anxiety disorder: recognition, assessment and treatment (CG159). National Institute for Health and Care Excellence. Available at: https://www.nice.org.uk/guidance/cg159/chapter/recommendations (Accessed: [24.01.2026]).
Plymouth Hospitals NHS Trust (2020) Exposure and habituation. Available at: https://www.plymouthhospitals.nhs.uk/display-pil/pil-exposure-and-habituation-6611/ (Accessed:[ 24.01.2026]).
TalkPlus (2023) Graded exposure. NHS Talking Therapies. Available at: https://www.talkplus.org.uk/wp-content/uploads/2023/12/Graded-Exposure.pdf (Accessed: [24.01.2026]).
Warwick University (n.d.) Exposure and habituation. University of Warwick. Available at: https://warwick.ac.uk/services/dc/pgr/phd_wellbeing/exposure_and_habituation.pdf (Accessed: [24.01.2026]).
