Other writers might find the concept of the anxiety ladder useful, either in a personal sense or as something a character might use. 🙂

Confession time, everybody — I am flat-out TERRIFIED of dentists. My anxiety levels shoot off the charts just thinking about them. However, I suspect I have developed a cavity. Therefore a dental appointment is lurking somewhere in my fairly near future.

So here’s a cognitive behavioural therapy anxiety ladder which I absolutely MUST climb… the idea is to list the necessary steps to achieve a goal, with the easiest tasks at the bottom, building up to the most terrifying elements at the top. Then I need to work on each step, starting with the lowest, until it drops to a 1/10 or a 2/10 on the anxiety scale (in other words, until I habituate to the stimulus). From there I move up to the next step until I’ve habituated to that as well, and keep going until I reach the top step and accomplish the goal.

So…

GOAL: To get my teeth looked at by a dentist.

10/10: Actually having the dentist poking around in my mouth

9/10: Sit down in the dentist chair on appointment day

9/10: Walk down the hall to the dentist chair cubicle on appointment day

8/10: Sit in the waiting room on the appointment day

8/10: Look at online photos of dental procedures

7/10: Walk into the office on the day of the appointment

7/10: Make the appointment

6/10: Sit in the waiting room on NOT the appointment day, for at least 30 minutes; do this at least 3 times

6/10: Walk into the office on NOT the appointment day, talk to receptionist, walk out again; do this at least 5 times

6/10: Meet and greet with the dentist and his nurses, tour the facility, fill in a chart, NO MEDICAL TREATMENT

6/10: Look at online photos of people in dentist chairs

DONE: 6/10 (dropped to 1/10): Talk to the receptionist on phone, explain desensitization need — EMAILED INSTEAD, got a call back, arranged for “meet and greet” with the dentist and his nurses in a couple of weeks

5/10: Visualize walking into the dentist’s office, imagine the smells and the sounds and the colours

DONE: 5/10 (dropped to 1/10): Look up the dentist’s address and phone number online

As you can see, most of the steps here are fairly high-level to begin with, so this will be a long-term process of desensitization. Fortunately my local dental clinic is open to working with me on this — including letting me come and sit in the waiting room for a half hour or so, several times a week, without having an actual appointment. 🙂 I’ll be starting on that step next week, and doing the visualization stuff (including looking at photos online) in the meantime.

Also, a friend has offered to let me come with her to her dental hygiene appointment, to sit in and watch the procedure. I think this is an excellent idea, as long as it doesn’t occur too soon in the desensitization sequence (for example, I could probably handle it ten days from now, but not five days from now). So I will get back to her and see how that goes!

I’ve been in the CBT Mixed Anxiety group sessions for about five weeks now, and I must say that CBT training is already starting to make a difference both with how I cope with anxiety and in my overall anxiety levels. So hurray!