Panic and Agoraphobia Exposure Hierarchies
Patients with panic disorder are often hypervigilant to their bodies, so they begin to avoid any activities that produce physical discomfort. They also tend to avoid any activity/situation in which they have had a panic attack before, even if it was something that they have always loved. With time, this can severely restrict their lives. The activities on the list below are meant to re-expand your comfort zone.
Rate each activity on a 0-100 anxiety scale for how anxious it would make you feel on a typical day (with "100" being the most anxious you've ever felt and "0" being totally calm). Activities currently rated between a 20 and a 60 are usually good to try as Real-Life Exposures. With repetition, you should notice that any particular activity becomes easier with time. You can then move on to a harder activity on your list. You can also re-rate the hierarchy periodically to track your progress.
Panic and Agoraphobia Exposure Hierarchies
“Safety Object” (i.e. medications, water, food, a cell phone)
Leaving the safety object nearby instead of in your pocket/purse
Leaving the safety object in your car for one hour
Leaving the safety object in your car all day
Leaving home without the safety object for one hour
Leaving home without the safety object all day
Drinking Coffee
Drinking just one sip of tea
Drinking half a cup of tea
Drinking a full cup of tea
Drinking just one sip of decaffeinated coffee
Drinking half a cup of decaffeinated coffee
Drinking a full cup of decaffeinated coffee
Drinking just one sip of caffeinated coffee
Drinking half a cup of caffeinated coffee
Drinking one cup of caffeinated coffee
Exercising
Doing 5 jumping jacks in a row
Doing 10 jumping jacks in a row
Doing 20 jumping jacks in a row
Doing 50 jumping jacks in a row
Exercising for 20 minutes
Exercising for 40 minutes
Exercising for an hour
Driving your Car
Looking at your car
Sitting in your car
Driving around the block once
Driving in your neighborhood for 5 minutes
Driving in your neighborhood for 15 minutes
Driving outside your neighborhood for 5 minutes
Driving outside your neighborhood for 15 minutes
Driving on the freeway for one exit in the slow lane
Driving on the freeway for 5 minutes in the slow lane
Driving on the freeway for 5 minutes in a middle lane
Driving on the freeway for 5 minutes in the fast lane
Driving on the freeway in traffic for one minute
Driving on the freeway in traffic for 10 minutes
Driving a medium distance away from your home
Driving a long distance away from your home
Being in a Crowd
Sitting in a park
Sitting in a coffee shop
Sitting in a mall
Going to a party
Going to a concert
Eating at a Restaurant
Drinking water alone in a restaurant
Eating a small item alone in a restaurant
Eating a meal alone in a restaurant
Eating a small item with a close friend (who knows what you are doing)
Eating a meal with a close friend (who knows what you are doing)
Eating a small item with a friend (who doesn’t know what you are doing)
Eating a meal with a friend (who doesn’t know what you are doing)
Eating a quick meal with a group
Eating a long meal with a group
Flying in an Airplane
Riding in a bus
Riding in a subway
Driving to the airport
Sitting in the airport
Taking a short flight with medication
Taking a short flight without medication
Taking a medium flight with medication
Taking a medium flight without medication
Taking a long flight with medication
Taking a long flight without medication
Watching a Movie in a Theater
Sitting in the back row near the aisle for 5 minutes
Sitting in the back row near the aisle for 30 minutes
Sitting in the back row near the aisle for the whole movie
Sitting in the middle row near the aisle for 5 minutes
Sitting in the middle row near the aisle for 30 minutes
Sitting in the middle row near the aisle for the whole movie
Sitting in the middle row far from the aisle for 5 minutes
Sitting in the middle row far from the aisle for 30 minutes
Sitting in the middle row far from the aisle for the whole movie