Run a disconfirmation experiment without the safety behavior

Enter the feared situation without the safety behavior and observe what actually happens.

Why it works

When safety behaviors are present during exposure, any non-catastrophic outcome is ambiguous: "I didn’t faint because I held the wall." Removing the safety behavior makes the experiment interpretable: if you don't faint without the wall, the wall wasn't necessary, which is direct evidence against the catastrophic belief. The behavior's absence is what creates the disconfirmation.

How to do it

1. Choose one safety behavior from your inventory and one low-moderate-difficulty situation where you use it.
2. Enter the situation and deliberately leave the safety behavior unused.
3. Record what happened. Did the feared outcome occur?
4. Ask: what does this tell you about whether the safety behavior was actually protecting you?

Evidence

Experiments manipulating the presence or absence of safety behaviors during exposure find that dropping them improves exposure outcome; the evidence is from studies of social phobia, panic, and health anxiety. (rct)

These studies manipulated safety behaviors in single sessions or short protocols; long-term effects of safety-behavior fading across full treatment programs are embedded in multi-component evidence.

Sources

• Salkovskis et al. (1999), the role of safety-seeking behaviours in the treatment of social phobia, Behaviour Research and Therapy
• Wells et al. (1995), social phobia: the role of in-situation safety behaviours, Behaviour Research and Therapy

Common mistake

Retaining covert safety behaviors (mentally rehearsing, holding onto a reassuring thought) while dropping overt ones, which maintains the ambiguity and prevents full disconfirmation.