The Power Of Exposure with Dr. Robin Zasio

Coming to you from the center for Social Confidence in Portland, Oregon, welcome to Shrink for the Shy Guy. Helping men everywhere go from social anxiety to social domination with your host, Dr. Aziz.

Hey, Dr. Aziz here. And welcome to another episode of Shrink for the Shy Guy. Today's episode is going to be focused on the single most powerful thing that you can do to increase your confidence to overcome shyness, social anxiety, fear, self doubt. The single most powerful thing that you can do to radically transform your level of confidence in your life and then therefore your entire life. Because if you think about it, if you have a higher level of confidence, if you believe in yourself more, then you're obviously going to do more. You're going to try more things, you're going to take more risks, you're going to go for those things that really matter to you, you're going to follow your dream and you're going to have a much higher quality of results in your life and a much higher quality ultimately of your life. So what is this thing? What is this one single thing that can single handedly turn you from a place of doubt to confidence? And that is exposure. Exposure. And you've heard me talk about something like this in episodes past. And if you go to my Social Confidence center website, this is a theme that runs through everything and that's because it is so damn effective. Basically, exposure means exposing yourself to the thing that you're scared of, doing the thing that you're worried about or you're frightened of, and seeing what happens. It means turning that fear of exposure. If I open my mouth, people are going to think I'm an idiot into an experiment. What happens when I open my mouth? Nine times out of ten, the vast majority of the time, the results that you are predicting, the negative results do not happen. And you know, 1, 2 times out of 10, something negative does happen. Probably not as bad as you're imagining, but something negative happens and then you have the powerful experience of learning to manage it, to deal with it. How do I handle rejection? How do I handle a no or disappointment or failure, however you define that term, which I can get into at a later date, my thoughts on the term failure. But the challenge is how do I turn this towards my advantage? Because that's often what happens, right? Is we work up the courage to try, we expose ourselves, and if it goes well, whew, alright, I made it. But if it goes poorly, what do we do? Well, often, and this is what I used to do a lot is I would implode on myself. Now that was Terrible. I shouldn't have done that. I'm never going to do that again. That was so awkward. Why did I even try that? But a lot of the time, and you might be in this situation right now, and I want you to examine your own life, but a lot of the time we don't even get to the point of trying. We have a closed loop cycle. I know it's going to happen. In my mind, I know what's going to happen if I try. I know how people are going to respond. So then I'm not going to try. And then I further reinforce that that's what would have happened. And we just stay. It's all inside of our own heads. We don't interact with the actual outside world. We don't see how people really respond. We just stay in our own predictions, expectations, and ultimately in our own fears. And so that's why exposure is such a powerful way to, to break out of this. And I can basically predict how rapidly someone is going to improve when I work with them one on one, based upon their willingness to expose themselves. And really, it comes down to two things when it comes to exposure. And this is what determines someone's progress. If it's quick or if it's a long time, if they have radical gains in a month or it takes them a year. And the determining factor is exposure. But it's these two aspects of exposure. One, it is the level of risk they're willing to take. The bigger risk that they're willing to take, the bigger the risks, the more rapidly they will increase their confidence. So if walking down the street and making eye contact with people, is there a certain level of risk there? Right. You know, they could look away, they could grimace at you, maybe even fake punch you. I've never seen that happen, but that could happen. There's a risk there. But what about going up and talking to a stranger? It's a higher level of risk, right? What about walking over to an attractive woman that you're drawn to, that you want to get to know, and you don't know her at all, she doesn't know you, and you're just going in there and inserting yourself and seeing if there's a connection? That's an even higher level of risk, isn't it? What about asking that woman out? What about volunteering to take on a new project at work that involves speaking in front of a group of people? What about approaching a superior or a supervisor with your own initiative of a project, not only, not just getting it assigned to you but actually creating something and bringing it to someone, what about creating your own business? I mean, these are all higher and higher level of risks, aren't they? And the level of risk that you're able and willing to take will determine how rapidly you succeed and how quickly you grow your confidence. The bigger the risks, the bigger the confidence boost, even if the risk turns out negatively. I've heard this so many times from clients. They say, you know what? She didn't want to talk to me, but I felt good about trying. I mean, I walked right over to her and I was bold and I started the conversation and it feels good. So the more risk you're willing to take, the better you'll feel, even if they don't turn out the way you want them to. The second element of exposure that determines how quickly someone grows their confidence, in addition to the size of the risk, is the rate of risk you're willing to experience. The rate of risk, how quickly are you willing to put yourself into another situation that is uncomfortable pushing your edge? And I had one client who we were starting to work on. He developed confidence in a number of areas. He was able to speak in front of a group, he was able to create a friendship network. And he's really progressing well. But the final frontier for most men, myself included, is women. Oh my God, you mean you want me to be assertive with women? It's terrifying. And so we were starting to work on that and he told me flat out, you know, Z, I'll try this stuff, okay, I'll do it. But if I ask a woman out and she says no to me, I can't try again for another three months. I said three months. I mean, he said it as if it was like a rule or a matter of fact, or just how the world was as opposed to a self created limitation. I said three months. Why? Why three months? Well, that's how long it would take me to get over it. So his rate, think about that. If you're going to ask a woman out once every three months, or if you're like me when I was in high school and college, it was once every six months. Once a year maybe, probably once a year on average. So what is that rate of risk? How quickly are you going to increase your confidence and really get what you want, which is in this case for me, it was dating. But it could be any goal or dream or desire that you have. The rate at which you're willing to put yourself out there and then, hence the powerful quote by Winston Churchill, which I'M going to paraphrase, which is success is going from failure to failure with no lack of enthusiasm. And that means we're able to just put ourselves out there. And if you're able to turn towards someone and she says no, and then five minutes later go talk to someone else, then the likelihood of your success, the rate of your success dramatically improves. And so I'm particularly excited today because we are actually going to an interview with a woman, a psychologist, a doctor, a teacher. She's so many things that she's done in the world, but her main, I think one of her main gifts is in helping people get to a place of exposure, of facing their fears. She's hosted several. She hosts a television show that's all about helping people face their fears. And just some of the work she's doing is incredible. And it's really teaching people that you can overcome your fears by facing them, by exposing yourself to them. And so I'm very excited. We're going to be back in just one moment and we're going to be interviewing Dr. Robin Zasio about exposure, social anxiety, her take on fear and all that stuff. So stay tuned. We'll be right back.

Okay, so you're listening to Dr. Aziz and thinking, hmm, maybe there is something I can do to build my confidence. But the question is what? This podcast is a great start, but if you really want to make some headway, you have to learn two things. First, you have to learn how to transform your self esteem. You have to learn how to like who you are. Without that, true confidence is impossible. Second, you have to master some basic social skills, eye contact, body language, starting conversations, small talk, meeting women, and all the rest. In order to get the confidence you need, you have to learn these things. And there's no better place to start than with Dr. Aziz's the Confidence Code, a DVD training program that teaches you exactly how to maximize your self esteem and master your social skills. To learn more, check out YourConfidenceCode.com.

Expert interview. Welcome back. Our interview today is with a special guest, Dr. Robin Zasio. And I came across her online. I listened to a very powerful interview in which she was explaining social anxiety in an incredibly articulate and direct way. And so I was intrigued immediately. And then I started looking her up. And she's got quite the track record of ways that she's been able to increase information and awareness around all sorts of anxiety, including social anxiety. She's a licensed clinical social worker and a clinical psychologist, and she's been specializing in the treatment of anxiety for over 20 years now. She's the founder of multiple centers, including the Anxiety Treatment Center, Cognitive Behavior Therapy center, and the Compulsive Hoarding Center. She's also been involved in numerous associations and foundations, and there's a long list there. And most notably, many people know her from the hit A&E series Hoarders. And my new personal favorite, which I was just talking with her about a moment ago, her show on Animal Planet called My Extreme Animal Phobia. And many of you might have seen that, or if you have not, I highly recommend going online and checking out. So just such a wealth of experience and information. And thank you so much for joining us, Dr. Zasio.

Thank you for having me. It's a pleasure.

Great. So the first thing I want to start with, and this might be a leading question, but you believe in exposure?

Yes, absolutely. It's actually a scientifically proven treatment modality, which makes it just so cool to use, because when we can look at people who have been properly trained in doing the exposure therapy, who have done work with patients, and specifically social anxiety and other anxiety disorders, you can see pre and post patients, PET scans, positron emission tomography scans, where there are actual physiological changes in the brain as a result of the exposure.

Wow. So that actually leads to. I mean, there's a felt difference. People will describe, they feel different, but there's actually a literal change in the physiology of the brain. And I'd imagine that also translates into people's experience of the sensations of anxiety.

Yeah, absolutely. And, you know, from just a basic level, if you think about anything that you've ever been afraid of, if you have confronted it, well, you know that your experience is that you're no longer afraid. There are basically no more chemicals that are sort of misfiring, telling you that there's danger in that situation. So you're absolutely right that the physiological experience is so different, and then people can start to go freely into those situations without being fearful.

Hmm. So how does that work with your social anxiety clients, people who are struggling with social fear and an inability to put themselves out there?

Well, basically what I do is I always, in my first session with my patients, educate them about what's going on. And I kind of lay out the foundation as follows. We all have a fear center that keeps us safe in the world. So if you imagine you're in your home, all of a sudden you look outside and you see somebody in your backyard, you don't just sit there and go, hmm, I wonder who that is.

Right.

Immediately, there Is an instinctual response of fight or flight. Do you run and hide in the closet in a flight response or do you pick up the Phone and call 911 or Security or that kind of thing? That's kind of a fight response. You're taking a proactive response. Well, in social anxiety, it lives in that same fear system. And so what happens is, as a result of a chemical imbalance, when people are going into social situations, those same chemicals fire. Telling a person that there is danger, if you will, not that they are going to be harmed in some way, but typically that there could be criticism or judgment or negative evaluation. Because the social anxiety lives in that same system that keeps us safe in the real world. The experience of that person is that those social situations are going to produce some type of negative outcome. And so they avoid them, they flight. And with anything, the more we flight, the more fearful we get. Because as time goes by, we start developing all sorts of cognitive distortions around what they anticipate is going to happen. So that being said, what we then do is we talk to them about confronting those situations, but in a very hierarchical way. On my extreme animal phobia, and even with hoarders, because we only have a limited time, the pace runs much quicker. But in our natural treatment setting, we create a hierarchy where the person identifies as many social situations that they can that that produce anxiety. On a scale of 0 to 10, 0 is if I went into this situation, I would not have any anxiety. 10 would be complete panic, which we don't want to have them do. Five being in the middle. So it could be something like starting out with making phone calls to establishments, asking them what time they close, where they are located, that sort of thing. And then we work up to other situations whereby we start going into the community and facing those situations that are producing anxiety. And then what happens is the key here is not just going in and doing it once, is that they do it repeatedly so that the actual desensitization happens, so that they can test out their fear and see that their perceived threat is far greater than the actual threat.

And I'm sure it varies greatly from person to person and what level on their hierarchy they're they're trying, what amount they're taking off to biting off to chew. But the question I often receive and maybe how do you respond to the question of, well, how many times am I going to have to do this thing before it starts to feel not so terrifying?

You know, I wish there was a template for that, but as I'm sure. You can imagine that people who come through looking for help with social anxiety can experience different triggers at different anxiety levels. So that's why we actually work individually with people. So we have individual therapy. We can augment it with group, and then we have a partial hospitalization and an intensive outpatient where people come in and they're matched with a therapist that does the work with them. They will actually take them into the community to teach them how to confront their fears. So that being said, we can never fully anticipate what somebody's anxiety level is going to be until they actually do it. Oftentimes people have such high anticipatory anxiety and then they do it, and then they kind of go, oh, that wasn't quite what I expected. But they had been avoiding it for so long that they had built up, as I had mentioned, all these cognitive distortions around what they anticipated. So for some people, it might just be a couple times, and then they practice it for homework and they can come back the next day and move to the next step. For other people, depending on how high their anxiety is, they might have to do it repeatedly over and over again, 10, 15, 20 times. But what they will find is it will get easier over time, and it's that masked, repeated practice that really gets them the results that they're looking for.

Mm.

Mm.

And that's actually very apparent on the shows, and particularly the Extreme Animal Phobia show, and obviously in your individual work with people. And so the question that I have for you now, and this is where I think it might relate to a lot of people listening, is, what do you say when someone says, yeah, but I don't want to do that. I don't want to go talk to that person, or I don't want to make those phone calls? And there's that.

Yeah, yeah. Well, basically, this is what I. I don't think that anybody really wants to come and see me, you know, but they come to see me because they want to feel better. And unfortunately, you have to go through this somewhat torturous treatment process to get the results. And so I really validate them and say, look, you know what? If I was in your shoes, I. I wouldn't want to do this either. I totally get that. However, what's predictable is if you keep doing what you're doing, which is avoiding. We know what that's like because you're there right now. But what's unpredictable is what your life will look like if you do this work. It really is about developing a good relationship with your client, really giving them confidence in what I do and the results that they can achieve and knowing that this is what I do and it's extremely successful. It's really interesting because there's a number out there that kind of is circulating around research saying that there is about a 30% dropout when people are doing exposure therapy. And it's not just with social anxiety, but other anxiety disorders. And we do not find that at our clinic whatsoever. 99% of the people that come into our program, it's probably higher than that overall. Of people start the treatment and end the treatment because they are feeling better and they're getting those results. And I think what's really cool also about this treatment is somebody can come in and they can say to me, I have been fearful of social situations from the moment I had sort of conscious awareness. And they can be in their 20s or 30s or 40s. And within four to six weeks of treatment, we're showing roughly on the average a 70% reduction in symptoms.

Wow.

Yeah. So it's just awesome. And you know, I can't believe I've been doing this for 20 years and I still get checked when I think about doing this work because it's so awesome to literally see people's lives transform in front of your eyes and regain their lives back. To be able to do the things that you and I take for granted. I'm doing an interview and I'm not thinking twice about it. I'm just excited about the potential that this information is going to reach one person who then realizes that their life can be different. Some people wouldn't even be able to pick up this phone and talk. The things in life that we take for granted sometimes are things that other people are really suffering quite greatly from.

I think that highlights something that is really important to underline as well. Is that what I hear often is like, well, yeah, you can do that. But there's something different about me. I wouldn't be able to get to that point. And what I often challenge people on is that I truly believe that if someone is willing to consistently apply this method, maybe beyond the initial period of just getting through day to day interactions, but if you want to do something bigger, like be able to do a phone interview or record a video or talk in front of a group of people, it's the same principles that apply. You just do it beyond getting out of negative territory and into positive territory.

Absolutely. And you know, I think that it really goes back to how important it is in that initial evaluation that when they talk to me about what's going on, that I can validate them and talk to them in a way that helps them to understand that I do get what you're saying. I don't feel what you're saying, and I'm not going to pretend that I do because I don't have social anxiety by any means. But then when we talk about the treatment, it makes sense to them, and it's just instilling that confidence that, look, no one is going to ask you to make a speech in front of 100 people today. Let's talk about what you're anxious about. Let's create a hierarchy together. This is a collaborative approach. I will never ask anybody to do anything that they feel like they can't do. And it's my job to sort of be a detective that if they're having trouble moving to the first, second, third, fourth step, whatever it is, then it's my job to figure out how I can get them to that step.

What about this one? This is getting into the realm. If someone exposes themselves and let's say it's to make eye contact with someone or to call a place, and then they do it and they find out that nothing bad happens. What about. One of the fears that lurks in social anxiety is not the obvious overt response that I'm going to get from someone, but it's what they're going to be thinking about me. And one example is what I often hear is with social anxiety, there's a great fear of that anxiety being visible, like if their hands shake or if their voice quivers in any way or there's some visible sign of it. There's this fear that if people saw this and they knew I was anxious to say hi or whatever, then they're really going to think less of me. They might not tell me that, but they're certainly not going to respect me or like me.

Absolutely. And that's a really great question, because in social anxiety, it oftentimes is the fear of what people are thinking. Obviously, there's a fear also of what if they get mad at me or they yell at me? That type of thing. But basically, when we're dealing with anxiety, we're really teaching people to. To be able to tolerate doubt and uncertainty and to have a conscious awareness that you are never going to know what somebody is thinking unless they tell you. But that for all of us humans on the planet, we have to learn to tolerate doubt and uncertainty on a daily basis. Doing this interview, there may be people People that say, oh, my gosh, she's the worst person I've ever heard on the radio in my life, well, I've got to risk that. But what happens is over time, I've done, my gosh, hundreds and hundreds of interviews, countless interviews, and no one has ever come and emailed me. And probably this will be the first after I'm saying this and said, oh, my gosh, that was a horrible interview. You should go into a different profession or something. But, you know, the thing is that because there's so much positive feedback that comes back, that if you do get negative feedback, it's very tolerable, and it's getting to a place where you can actually accept that not everybody's going to like you, not everyone's going to agree with what you say, but that if the majority of the people, if you're good at what you do, and the majority of the people give you positive responses, and that's what we really build on. Not the negative, but the positive. And so in working with social anxiety, I'll tell people, we obviously can't control what people think. And there will be people in your life that may be judging you or criticizing you. However, it's probably fewer and farther between. My experience has been people with social anxiety are very, very kind. They're not typically overtly angry people to where the responses that they're fearing are actually going to happen.

Absolutely. And I really believe that if someone is spontaneously being themselves and making a joke or starting a conversation with someone they're interested in, if the responses they get are negative, then that's not going to be a good fit for. For the two of you for a relationship. And I think that the fear is often like, well, no one will like me. But then that gets into the realm of something that needs to be tested and challenged with this exposure work.

Absolutely. And that's where I really separate out what we call cognitive behavior therapy and the exposure therapy. The CBT really works on the concept of you, just of what you just said. And that is, no one is going to like me. So I'm going to go, okay, wait a minute. While it's true that some people may not like you, to say no one will like you is a cognitive distortion that is black and white, all or none thinking. And so if you're telling yourself this message of no one is going to like me, well, why would you go out in the world? Why would you risk. Because no one's going to like you.

Right.

But if we say, I'm betting That there's at least one person in the world that likes you. Then let's go test that out. Let's go ask this guy a question and see how he responds. Okay, so did that person respond in a way that identified that he did not care for you? And then the person says, no, well, let's go ask another question. Let's see how that goes. And then again, what happens is that desensitization happens, where they learn that that perceived threat is far greater. The key is perceived is far greater than the actual threat.

Yeah, and that's the thing. Consistently, that is the response. And the major hurdle is beginning the exposure and all the fears and doubts beforehand. But once you're walking down that path, it's, as you said, the apprehension is often worse than the experience. And that leads to. My next question is, you know, there's a number of people listening and obviously, hopefully they're hearing the benefit of actually working with someone and just how much you can overcome by getting help. But, you know, there's people that are saying, well, I don't know if I want to commit to that, and, well, maybe I can just do it on my own. And how would you. The people listening, how can they find the motivation and the courage to start taking that action on their own?

You know, I think you just said the key word, and that is motivation. What are the factors that are leading you to listen to this interview? Well, gosh, is it just, you're curious about social anxiety, you want to learn about it, or is it bigger than that? And going back to what you said is, gosh, you know, I really don't want to be hijacked in my house. And I really want to have better quality of life. And so start with writing down what those motivating factors are to give you the quality of life that you would like. Is it you want to go to school and get a degree? Is it that you want to get a job? Is it that you want to have more friends? What do you want those friendships to look like? And really start identifying why you want to do this hard work. Then what you can do, and anybody can email me, and I'd be happy to send them something that would help them to develop a hierarchy. Start to identify those situations that produce anxiety. Rate those triggers on a scale of 0 to 10, 0 again, meaning no anxiety at all, 10 being complete panic, 5 in the middle. And then start with the lower level ones, the lowest level the ones, and start to put yourself in those situations and test out your fear. And again, if people want to email me at drrobinatcsac.net, that's-r r o b I n t c sac.net, i would be happy to send them a hierarchy where they can just put their anxiety level next to different triggers. So it's things like asking for a location of a restaurant, asking someone for the time, calling and asking for a specific item on a to go menu. And it has them all laid out so they don't even have to come up with their own hierarchy and they can just start that process themselves.

That's a fantastic resource. I think that getting those things out on paper can really be a big first step because sometimes it can feel like I can't do anything. And then you really start to say, oh, wait, certain things I can do. They're just mildly anxious at producing and some are extreme. Well, how about any? I know you mentioned your email. Maybe you can give that one more time. But also any way someone could follow up and learn more about what you're doing, social anxiety from your clinics or your centers, and also any other information about that partial hospitalization inpatient work that you're offering just to get some resources for people who are listening.

Absolutely. Email is drrobin tcsac.net, the ATC stands for Anxiety Treatment Center SAC for Sacramento. They can always call the office if they'd like to get more information, not necessarily about. I mean, if somebody is calling from Wisconsin and they're just maybe looking for resources, feel free to call or more information. And that number is 916-366-0647. And then I also just kind of want to give you some information about a national resource, which is the International Obsessive Compulsive Foundation. The website is www.iocdf.com. that's iocdfactually.org. i'm sorry, let me repeat that one more time. It's iocdf.org and even though they may be calling for social anxiety, this particular organization really represents all anxiety disorders. And so they can actually access a provider database and potentially find somebody in their area who can help. Now, that being said, also just to let you know that their national conference is going to be in Los Angeles this year, and they do cover different workshops and presentations on social anxiety as well, in addition to other anxiety disorders.

Great, great. Well, thank you for that information, Dr. Zasio, and for everything that you've shared today. I really think that if people hear what you're saying and really take it to heart, and the most Important thing, put it into practice that there's going to be a lot of improvement in the lives of people listening. So thank you so much for sharing.

Thanks for having me.

I hope you benefited as much as I did from talking and listening to that conversation with Dr. Robin Zasio. So much good information and I can't reinforce enough her perception on exposure and the necessity of it to overcome social anxiety. Shyness, social fear, self doubt, self criticism, all that stuff, all those negative predictions about how people are going to respond. The most powerful and effective way to overcome that stuff is to do it. And the only obstacle that's primarily stopping you is not wanting to take that first step. And for some people it's, yeah, I don't want to, I'm scared, maybe it won't work. I just don't really want to. Whatever your reasoning and story is really catching that, challenging that and then just walking on that path, even if it's slow, just taking those steps one by one. Checking out, emailing her, getting that fear hierarchy. You can also check out my book the Solution to Social Anxiety. You can find it on Amazon.com or on my website and that will we map out a hierarchy in the action section of that book. So there's so many ways that you can make this a reality for you and I love that. In fact, that's going to be your action step for today. Time for action. Your action step for today is going to be to take action immediately on what you heard in the interview with Dr. Zasio. And that is remember when she was talking about motivation and she said she has people write out why they what they want in their life and it gives them a motivation to do the uncomfortable exposure work. So why do I want to do this? What is it going to give me? What do I really want in my life? And take a moment, just write a paragraph about that. I really want friendships where the people are calling me to hang out and not just me pursuing people. I want a group of friends that makes me laugh and I love hanging out with where I feel like I can be real and talk with them about what's going on. But we can also just watch a movie and be stupid or whatever. Or maybe you're thinking, I want to meet a woman or a man. If you're a woman listening, maybe you want to meet someone to connect with, to build a relationship with. Maybe you want to feel more comfortable at a party or a gathering. Maybe you want to. You're sick and tired of feeling anxious when you're in a class or you go to the supermarket and you just want to feel bold and strong and determined and out in the world being your full, spontaneous self, whatever those things are. Your action step is to write a paragraph about what you want to get that motivation. And, you know, bonus extra credit. If you want to get a fear hierarchy going, by all means. And then start working on that. Thanks for listening. That's our show for today, and we'll be back next week for another episode of Shrink for the Shy Guy. And until we speak again, know that you're awesome.

Thanks for listening to Shrink for the shy guy with Dr. Aziz. If you know anyone who can benefit from what you've just heard, please let them know and send them a link to shrinkforthshyguy.com for free blogs, ebooks and training videos related to overcoming shyness and increasing confidence, go to Social Confidence center dot com.