Some of my patients have brought up the concern that repeating a negative thought will have a negative effect on their psyche or “make it come true”. It's important to keep in mind that the goal of a Sentence Exposure is actually to stop having negative thoughts. The point is that, sometimes, the quickest way to get rid of a thought is by burning it out (i.e. repeating it over-and-over again until it gets boring).

Usually, this technique is used when no other technique is working. In other words, you can’t distract yourself and you can’t talk yourself out of it; so, you are going to have the thought anyway. In that case, repeat it until it gets boring because it will leave your mind faster that way.

Ideally, you are looking for a sentence that you can feel in your body. An anxious sentence should be able to make you feel tight in your chest or shoulders. A sad sentence should make you feel heavy or tearful. An angry sentence should be able to make you feel hot or like you want to punch something. Because of this rule, the technique actually works best when are already feeling bad, because then its easy to pick a sentence. You just pick whatever’s already on your mind.

This is actually the most important rule because it’s the biggest difference between a Sentence Exposure and the way that we normally feel bad. Normally, when we feel bad our brain jumps from sentence to sentence. For example, it might go from "The boss doesn't like me" to "I’m going to get fired" to “I’ll be homeless" to "My life sucks" and then you're off to the races. With a Sentence Exposure what we're saying is “No. No. Screw that. I’m just going to do one sentence at a time” so that you can finally see how the sentence gets boring. Then, you can move on to the next sentence.

This is the hardest rule to follow when you’re feeling really anxious because you’ll find that all these other sentences want to come in. But, you’ve got to be very diligent about it. "No. No. Screw you. Take a number.  I will do you, but I'll do you next after I'm done with this first sentence." 

You’ll know what I mean by this after you practice the technique a few times. When you start a Sentence Exposure at first you should feel more anxious because you are trying to feel bad, but, as long as you stay on just one sentence, it always eventually starts to sound like a song, or a chant, or a tongue twister. If you do it long enough, eventually your brain starts to get distracted or spontaneously talks back to the thought,

Another way of putting it, let’s say you were feeling really anxious right now, and I told you to focus on a mantra. “Just focus on the word ‘Om’”. You’d probably tell me I’m out of my mind. “Dr. K, I can’t focus on the word ‘Om’!”. But let’s say I asked you to focus on the scariest thing you could think of. That’s actually easy. But, if you focus on just one scary sentence, it always eventually starts to sound like the word “Om”. So, what we’re doing is, we are turning the scary sentence into the mantra.

What happened? If the sentence made you feel at least some level of anxiety, but then eventually got boring (i.e. you got distracted, it started sounding like a chant, or your brain started talking back to it) and now you feel calmer, then the technique worked well for you.

If you were unable to get into the sentence and/or it didn’t make you anxious at all, then you might want to experiment with a harder/more anxiety-provoking sentence to see if that works better. If you still can’t get anxious, then wait until the next time you are already feeling anxious and try it then. Remember though, just stay on one sentence at a time (until it gets boring). That is the hardest rule to follow when you are already feeling bad.

If the sentence made you anxious but didn’t get boring at all, that’s OK too. That usually means that you need more than 3 minutes to "finish" the sentence. I’ll discuss how some sentences can take a long time a little bit later. For now, just use the same sentence at the start of the next exercise.

If the sentence felt too overwhelming and you stopped repeating it before the three minutes were up, then you picked something that was too hard. Pick a gentler, less anxiety-provoking sentence and try it again. Remember, all exposures should start out as mild at first. You need to work your way up to the harder sentences.

If after several trials, you can’t get anxious, you can’t stay on one sentence, or the anxiety never goes down at all, then this technique is probably the wrong fit for you. Try another Berserker Style technique (or a completely different style) instead.

What happened? The results should be fairly similar to the first trial run except that you probably were able to move on to at least one new sentence.

Rarely, you might come across a sentence that takes 10-15 minutes to get boring, in which case, once you have “broken its back”, you should find that it gets boring much more quickly the next time. If a sentence takes longer than 15 minutes, then this is probably the wrong approach to that sentence. You may want to try sensation, sadness, or anger exposures, or try a different style altogether when it comes up.

If the Sentence Exposure experiments worked for you, try doing Sentence Exposures for five minutes a day for the next three days (to get the hang of it). After that, just use Sentence Exposures when you are already feeling anxious.

The normal treatment algorithm is to try the Yoga Style or Logic Style techniques first when you are anxious (because they work faster), and then switch to some form of exposure if those aren’t working. Practically speaking, most people get a sense of which technique works best for them in which situation, and they will jump correctly to the best technique.

Sentence Exposures are also particularly useful to use during Real-Life Exposures. It helps ensure that the anxiety itself is voluntary, helps you get the most out of each Real-Life Exposure, and, ironically, can help you calm down the fastest as you push outside your comfort zone.