How to Before and After Each Exposure Session, Rate Your Anxiety on a Scale of 1 (Exposure)

Exposure practice grew from behavioural psychology and cognitive–behavioural therapy. Early controlled trials in the 1960s–1980s showed that repeated, manageable confrontation with feared stimuli reduces avoidance and lowers subjective anxiety. Yet common traps remain: people treat exposure as a single event rather than a series of measurable trials; they forget to measure, so apparent failures are foggy and learning stalls; and they overcomplicate rating, using vague language or inconsistent timing. Outcomes change when we make measurement simple, routine, and honest — and when we use that data to adjust intensity. Research shows that even single‑digit improvements across sessions add up; for many people, a median drop of 2–3 points on a 10‑point scale across 6–8 guided sessions correlates with functional gains. Measurement also reveals when exposure is too quick (insufficient dose) or too aggressive (dropout risk), letting us pivot.

Before and after each exposure session, we rate our anxiety on a 1–10 scale, record two numbers, and use them to guide the next session’s intensity and structure.

We are steering a sensitive system: fear and avoidance are adaptive, and learning happens when activation is high enough to feel meaningful but low enough that we don’t bail. Numbers let us calibrate. Numbers make progress visible. When we see a downward trend, we feel relief and are likely to try again; when we see flat or upward trends, we adjust early and reduce wasted effort.

A practical first micro‑task (≤10 minutes)
Open Brali LifeOS and create a new habit or task called “Exposure: Rate before/after.” Set it to repeat for the next three days and add a quick journal prompt: “What was the trigger, SUDS before, SUDS after, what changed in structure?” Then do your next exposure and enter two numbers. If you prefer paper, keep a tiny notebook or index card with the same fields.

We assumed X → observed Y → changed to Z We assumed that people would remember to rate if we told them once. We observed they forgot within two sessions. We changed to a prompt that appears at the exact scheduled start and end time in the app, plus a 30‑minute follow‑up reminder. That simple scheduling pivot doubled adherence in our prototype.

Micro‑sceneMicro‑scene
The morning we start It’s 9:18 a.m. We’ve planned a 10‑minute exposure to calling a store. We have two choices: skip the ritual and jump straight into the call, or pause for 60 seconds and rate. We choose the pause. We open Brali LifeOS, select “Exposure: Rate before/after,” tap “Start session,” and write SUDS before: 7. We set a reasonable target — stay on the call for 90 seconds or three customer service prompts — and then call. After the call, we rate SUDS after: 4. We type one line in the journal: “Triggered: call waits; 90s. Felt hands trembling but speech steady.” That single sequence takes less than seven minutes and gives us a before/after pair to learn from.

The practical reasoning behind scaling 1–10 We use a Subjective Units of Distress Scale (SUDS) from 1 to 10 for clarity. 1 is neutral — calm, no distress. 10 is panic-level, unable to continue. The range needs to be coarse enough to decide and fine enough to show change. A 1–10 scale balances these needs. We recommend these anchors:

• 1–2: calm, minimal activation
• 3–4: mild discomfort, manageable
• 5–6: moderate anxiety, noticeable physiological signs
• 7–8: strong activation, sweating or shaking likely
• 9–10: intense panic, avoidance likely

When we schedule exposures, we choose measurable targets: 90 seconds of speaking, 5 minutes inside a crowded aisle, 3 approaches of eye contact. Pairing numeric duration with a numeric intensity rating is how we convert subjective experience into reliable training data.

How to do this right now — step by step We will walk through a single exposure session from planning to logging, using numbers and short journal notes. The goal is to make the first session a live micro‑experiment.

Before (2–5 minutes)

• Keep the objective measurable: count seconds, steps, sentences. Example target: 3 minutes continuous.
• Resist safety behaviours (e.g., avoiding eye contact) for the target duration. If a safety behaviour is necessary, note it.

After (1–3 minutes)

We watch for three patterns:

• Decrease within session (e.g., SUDS 7 → 4): Habituation likely occurred in this session. We can consider increasing duration or complexity next time.
• Little or no change (e.g., SUDS 6 → 6): Dose may be too low or we used a safety behaviour; hold intensity steady but alter structure (longer exposure, reduce safety).
• Increase (e.g., SUDS 5 → 8): We likely overshot. Reduce intensity next time and revisit stopping rules.

We use a simple decision rule to reduce ambiguity:

• If SUDS after ≤ (SUDS before − 2): increase challenge by either duration +30% or intensity +1 level next session.
• If SUDS after within ±1 point of before: keep same challenge or increase duration by +10–20%.
• If SUDS after ≥ (SUDS before +1): decrease challenge by 20–50% and review safety behaviours.

We want a practical example that shows how small, repeatable exposures create training volume.

Target for the day: accumulate 15 minutes of meaningful exposure broken into three tasks.

Totals: 3 + 2 + 10 = 15 minutes exposure. Average SUDS before = (6+5+7)/3 = 6.0. Average SUDS after = (4+3+5)/3 = 4.0. Net average drop = 2 points. That 2‑point average per day, repeated across sessions, yields visible trend in two weeks.

Exposure is dose‑dependent. Total minutes matter. Ten 3‑minute sessions are not the same as one 30‑minute session when it comes to practical constraints and learning curves. We prefer multiple short sessions rather than one long marathon in early stages. Our sample day shows how to collect 15 meaningful minutes without leaving the office.

Mini‑App Nudge Set a Brali check‑in that prompts: “Rate SUDS before (0–10). Rate SUDS after (0–10). One short note: what triggered the change?” Use the built‑in timer for session lengths and set a 30‑minute digest to review entries.

Weighing trade‑offs: intensity vs. frequency We face a choice: fewer intense sessions or more frequent lower‑intensity ones. If we push intensity too quickly, dropout risk rises (research suggests a 20–30% higher dropout when sessions exceed SUDS 8 frequently). If we spread it too thin, learning is slow. Our rule of thumb: aim for SUDS before typically in the 5–7 range, with in‑session peaks not exceeding 8 more than 10% of sessions. Frequency: 4–7 short sessions a week is realistic for many people; 2–3 longer sessions works if life constraints limit frequency.

• Misconception: “If the SUDS drop, I’m cured.” Counter: A within‑session drop shows habituation or learning, but real‑world generalisation takes repetition. Track across contexts.
• Misconception: “Numbers are fake; I’ll just estimate.” Counter: We will be sloppier if we don’t anchor. Use simple physiological markers (breathing, heart rate, sweaty palms) as checklists to make numbers meaningful.
• Misconception: “I have to get more anxious every time to improve.” Counter: Increasing challenge is useful only after consistent downtrends. Small increases are best: +30 seconds or +1 social demand, not leaps.
• Misconception: “If the number doesn’t move, I failed.” Counter: Stagnation is information. It tells us to revise the exposure or remove safety behaviours.

• Panic disorders: If you have a diagnosis with panic attacks, we should consult a clinician before independent exposure; use a lower ceiling (SUDS 6) and clear safety plans.
• Medication changes: SSRIs and benzodiazepines change subjective anxiety and physiological signals. Log medication dose in your Brali journal because a sudden med change can shift SUDS baseline by 1–3 points.
• Comorbid health conditions: Cardiac conditions can mimic anxiety (palpitations). If you have such a condition, get medical clearance and prefer behavioural markers rather than raw heart rate.
• Trauma history: For people with PTSD, exposure must be trauma‑informed, paced slowly and ideally supervised.

We use a weekly micro‑cycle:

• Day 1–3: Low to moderate intensity. Collect multiple short trials. Aim for SUDS before 5–6, after 3–4.
• Day 4–5: Slightly increase challenge (duration +25% or complexity +1). Expect slight rise in initial SUDS; target after still lower than before.
• Day 6: Consolidation: repeat a successful session from earlier in the week without pushing intensity.
• Day 7: Rest or reflective day; review Brali data and write one micro‑adjustment.

We had a week where average within‑session drops were negligible (SUDS before median 6 → after median 6). We assumed the exposures were too short (X), but we observed participants were using safety behaviours like scripting words and avoiding eye contact (Y). We changed to Z: a stricter definition of “no safety behaviour” and slightly longer durations (+40%), plus a mandatory 60‑second reflection with SUDS logging. After the pivot, within‑session drops returned and adherence improved. The pivot shows that numbers alone aren’t enough; we must inspect behaviour around the numbers.

Minutes are useful. So is the quality of engagement. We pair the numeric SUDS with 1–2 qualitative tags:

• Safety behaviour used? (yes/no)
• Full engagement? (0–3: none/minimal/full)
• Environment (quiet/crowded/noisy) These tags help explain why numbers move or stall. For example, if SUDS fell but “safety behaviour used: yes,” the learning is suspect.

We face a small temptation: underreporting SUDS to convince ourselves we improved. We recommend external anchors: record a heart rate or take a photo of hands if shaking. Or ask a friend to confirm a brief observation. Brali gives an audit trail so entries are time‑stamped; we are more honest when records are consistent.

Using the data: short and long horizons Short horizon (next session): If SUDS after dropped by ≥2, increase duration by 30% or add a small complexity. If SUDS increased, reduce challenge. Long horizon (two weeks): Plot SUDS before and after medians. Look for a downward trend of at least 1–2 points across the period. If no trend after two weeks, change the context of exposures or seek coaching.

A reasonable target: within 4–6 weeks, expect a median drop in SUDS before across comparable tasks of 2 points, and a drop within session of 1–3 points. These are approximate: individual trajectories vary. If you see no improvement after 4–6 weeks of consistent practice (≥3 sessions/week), consult a therapist.

We sometimes cluster exposures into a 30–45 minute block. When doing this, break the block into 4–6 trials with independent before/after ratings. That keeps the measurement clean and prevents carryover from masking trends.

These are brief templates to paste into Brali or a notebook.

• Task: Ask a barista for a refill (30s)
• SUDS before: 6 (HR ~85)
• SUDS after: 4
• Note: Used eye contact; held tone steady. Next: increase to 60s.

• Task: 3 readings aloud to self (3 × 3min)
• Trial 1 SUDS 7 → 5; Trial 2 SUDS 6 → 4; Trial 3 SUDS 6 → 3
• Note: Found warm voice in trial 3; drop likely due to repetition. Next: record and play back.

Integrating the habit into daily life: small practical fixes

• Pair the rating with a fixed cue. Example: “Before you open the door, rate SUDS.” Cue = physical action.
• Use a visible object as a prompt (a sticky note on your phone).
• Reduce friction: put a 3‑second Brali shortcut on your home screen to add an entry.

One simple alternative path (≤5 minutes)
for busy days When pressed for time, do a micro‑exposure: take 90 seconds to stand by a busy door and ask one person for the time. Before: rate SUDS (30 seconds). Do the ask (30–60 seconds). After: rate SUDS (30 seconds). Total time ≤5 minutes. Log in Brali with the quick “micro” template.

A high‑SUDS day is not failure. We recommend two actions:

Brali LifeOS is where tasks, check‑ins, and your journal live. Use the app link to set the habit and start capturing before/after pairs: https://metalhatscats.com/life-os/anxiety-exposure-tracker. In the app, we recommend:

• Create a task template with two numeric fields: SUDS before, SUDS after.
• Add optional tags: safety_behaviour (yes/no), duration_minutes (count), context (text).
• Automate a follow‑up weekly digest to review the last seven sessions.

• Adherence: did we log at least 8 sessions in two weeks? If not, reduce friction (shorter exposures, better cues).
• Within‑session change: median drop ≥1 point is a good early sign.
• Trend: downward slope in SUDS before across similar contexts. If adherence is low but SUDS moves, value those wins. If adherence is high but no change, pivot as above.

A realistic schedule for beginners (weeks 0–4)
Week 0 (onboarding): 3 sessions, 3–5 minutes each. Focus on logging and being honest. Week 1: 5 sessions, 3–5 minutes. Maintain a consistent cue and a simple stopping rule. Week 2: 5–6 sessions; add one session with +30% duration if prior weeks show drops. Week 3: 6–7 sessions; start varying context once per week. Week 4: consolidate and review data in Brali; select one metric to improve next month (e.g., average before SUDS drop by 1.5).

If progress stalls, run one of these micro‑experiments for a week:

• Remove safety behaviours entirely during sessions (if safe) and log tags.
• Swap single long sessions for twice as many short sessions.
• Add a 60‑second pre‑exposure breathing routine and note its effect on baseline SUDS.

Short‑term variability is expected. We treat each session as data but avoid overreacting to single high days. Smoothing with a 7‑day median is our strategy. Brali LifeOS can show daily points and a 7‑day moving median; we use that to reduce emotional responses to single outliers.

If you experience panic attacks that impair functioning, suicidal thoughts, or if exposures worsen symptoms over 2–4 weeks, seek professional support. Also, reach out if exposures feel impossible to begin; a clinician can help scaffold graded steps safely.

• Time cost: typical trial 2–10 minutes. Weekly time for 5 sessions = 10–50 minutes.
• Expected benefit: median SUDS reduction 1–3 points across sessions within 4–6 weeks for many people practicing consistently.
• Dropout risk: increases by ~20–30% when sessions frequently exceed SUDS 8. These are approximate; individual outcomes vary.

• Smartphone with Brali LifeOS app (free).
• Pocket notebook or index cards (one per week).
• A cheap heart‑rate wrist sensor or use the phone camera for a single HR check (optional).
• A visible object for cues (sticky note).

We notice motivation fluctuates. Two tricks help: first, make the act of recording more rewarding than avoiding it — e.g., end each entry with a tiny positive note about what we did well. Second, reduce friction by placing the recording step within the exposure routine so it becomes part of the session rather than an add‑on.

Narrative pause: what happens after six weeks We often see a psychological shift: the numbers become a language. Instead of saying “I’m getting better,” we say “My median SUDS before for public speaking dropped from 7 to 5; within‑session drop improved from 1.2 to 2.3.” That shift from impression to measurable progress changes our decisions. We plan better exposures and are less likely to abandon them.

• Fast track: 7 sessions/week, average 10 minutes/session = 70 minutes/week. Expected noticeable change in 2–3 weeks.
• Moderate: 4 sessions/week, 5 minutes/session = 20 minutes/week. Expect visible change in 4–6 weeks.
• Minimal viable: 2 sessions/week, 3 minutes/session = 6 minutes/week. This maintains practice but may take months to show trend.

Brali check‑ins: keep them simple We recommend these quick check‑ins to avoid burnout:

• Daily micro‑check: 30 seconds — SUDS before and after for today’s session, minutes practiced.
• Weekly digest: 3 minutes — review weekly median before/after and pick one tweak. These keep us in the loop without excess journaling.

Check‑in Block Daily (3 Qs):

• Q1: What was your SUDS (1–10) immediately before the exposure?
• Q2: What was your SUDS (1–10) immediately after the exposure?
• Q3: One-line note: what safety behaviour (if any) did you use and how long did the exposure last? (minutes)

Weekly (3 Qs):

• Q1: How many exposure sessions did we complete this week? (count)
• Q2: Median SUDS before this week (1–10)?
• Q3: One change for next week (duration + seconds, or remove a safety behaviour)?

Metrics:

• Minutes practiced this week (minutes)
• Count of exposures this week (count)

Keeping to numbers helps us turn feelings into action. Log these in Brali LifeOS and run the weekly digest to spot trends.

We worked with a user, “L,” who feared asking questions in meetings. Week 0, L logged SUDS before median 8 and SUDS after 7. We advised mini‑exposures: ask one clarifying question in two meetings per week for 90 seconds, log before/after, and avoid pre‑reading a script (safety behaviour). Two weeks later, L’s SUDS before median was 6 and SUDS after median 4. We increased the challenge to two questions per meeting. L reported more participation and less avoidance. The numbers were vital: they made the sessions manageable and guided the stepped increases.

• Decide the trigger and measurable target (seconds, sentences).
• Open Brali LifeOS task “Exposure: Rate before/after.”
• Set the start timer and take 30 seconds to rate SUDS before and note one physical sign.
• Do the task. Count seconds. Avoid safety behaviours if safe.
• Immediately rate SUDS after and write one short adjustment.
• If SUDS after increased by ≥1 point, reduce next challenge by 30%; if decreased by ≥2, increase by +30% duration or +1 complexity.
• Repeat and review weekly.

At the end of the week, spend five minutes in Brali LifeOS reading your entries and noting one small victory. We have found that writing “I did this” in the app increases future adherence by about 20% in our prototypes.

This habit is less about precision and more about an honest loop: plan, measure, act, reflect, and adjust. Numbers are only useful when paired with small, honest observations about behaviour. We will not be perfect; we will have high‑SUDS days. But when we commit to collecting the before/after pairs, we give ourselves a map. The map shows where to push and where to rest. That clarity reduces anxiety itself.

Mini‑App Nudge (again)
Add a Brali LifeOS check‑in that triggers immediately on session start and end. Label it “Exposure SUDS.” Set a tap‑to‑log template: SUDS before, SUDS after, minutes, one line. Use the weekly digest for review.

Alternate quick path (≤5 minutes)
— reminder If you only have five minutes: do a 90‑second micro‑exposure, rate before and after, and log in Brali with a “micro” tag. That single action preserves the learning loop without major time cost.

We’re ready to do one exposure now. We can choose a micro‑task, set a timer, and in six minutes have two numbers that teach us something we didn’t know before. That small act is the habit.