How We Make Decisions1. Expose Yourself #Exposure #Stress

How We Make Decisions1

Expose Yourself

July 20, 2015

I am not really that ‘up to date’, on World History.  Nor, am I a Comrade of Vladimir.

Having said that, my attention was captured, by a story I stumbled across, while Googling myself, on the internet.

It was about an event during my lifetime, where the world was almost completely destroyed.

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Needless to say, I found this slightly more interesting, than stuff about me.

What captured my attention, was not only the description of this near Armageddon.  I also, had no idea this event actually happened.

This story was the seed, to new thoughts about Decision Making, resulting in a 5-part series of articles.


Part 1 will discuss the concept of Decision Making, and its relationship with STRESS and EXPOSURE.

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Part 2 will take a closer look, at the different ways we use our EXPLICIT and IMPLICIT memory, to help with Decision Making.

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Part 2.5, Just Say No To Trump, will caution you about the dangers of using your Procedural Memory to make decisions, when voting in an Election.

trump 2

Part 3, ‘The CEO’s Of Your Mind’, will focus on the brain’s Executive Functions in Decision Making.


In Part 4, I will give you the juicy details of this terrifying situation, and ask; ’Would You Have Saved The World‘?

armaged 3

In Part 5, we will explore Decision Making, through the lens of Game Theory, to further understand how people make decisions.

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We should start off with this recognition; we are all faced with hundreds of decisions every day.

Most are minor, like when to brush your teeth, or feed the goldfish.

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I don’t weigh the Pros and Cons of feeding my fish, or consider that perhaps I am making them lazier, or interfering with the Survival of the Fishiest.

These mundane tasks are essentially hardwired into my daily routine, and aren’t really ACTIVE decisions at all.

These PASSIVE decisions are less about ‘Yes or No’, and more about ‘When and How’.

You see, the brain is pretty smart. It wants to avoid stress as much as possible. For the most part, it would rather be entertained, instead of entering a math contest.

So it developed an important system, allowing us to eventually chill out, in the face of STRESS.

With repeated EXPOSURE, to almost anything imaginable, the brain eventually gets bored, and stops getting all worked about stuff.

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Instead it activates a different part of our brain, allowing us to make MUCH BETTER DECISIONS.

‘Exposure’, merely means our brain becomes aware of something; like a wild animal, chocolate Sunday, or Gym class.  Any one of these things can cause stress, in some individuals, for various reasons.

This process, where repeated EXPOSURES, eventually decreases (ACCOMODATES) the amount of stress we experience, is called HABITUATION.

Habituation is the way our brain, eventually, learns how to turn scary mountains into boring molehills.


But we should probably back up, just a little, to the beginning.

At the very start of life; brand new, naked us, lacked skills.

We were just a little twig, without a decision tree.

sapling 1

I can’t really imagine a more stressful situation, than the one faced by babies, in their first few weeks.

Sensations making little sense; save suckling and Mother’s scent.

We are basically a Blank Slate at birth, in desperate need of developing skills, to survive this challenging world.

And every new thing, or sensation we encounter, represents an indecent EXPOSURE, throughout our entire lifetimes.

New situations, decisions, or demands; can leave us feeling naked like newborns, if we lack the previous experience or skill set, to tackle the challenge.

These conflicts often cause stress, the first few times we encounter them.

Much of our ability, to gain command of these situations; starts with our ability to handle its stress, before we can ever start to make smart decisions.

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The funny thing about situations and stress, is the more we have of one, the less we have of the other.

This is just how EXPOSURE works.

The brain has an incredible ability, to eventually ‘get used to’, almost any challenging situation that it encounters.

Now I am not referring to Anaphylaxis, or other important illnesses.

I am referring to the types of situations, where people feel professionally, cognitively, or socially ‘allergic’; and avoid like the plague.

Over time, with repeated EXPOSURES, to WHATEVER situation life throws at us, the brain learns to ACCOMODATE the crisis, and HABITUATE the stress.


This concept has major implications; related to Parenting, School, Medicine; and even applies to the co-workers in your office.

The most basic way, to relieve the stress of difficult decisions, is to expose the person to them, one bit at a time, in a supportive environment.

When parenting, this would specifically apply to anxious parents, who wish to protect their children, from almost any challenging experience, for fear they may fail, or feel emotions.

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This avoidance of exposures actually has the undesired effect of creating much more stress, if that situation is encountered. An example may be a parent who ‘protects’ their child, from every dog, in essence taking all decision making away from the child.

In the future, if that child grows up afraid of dogs, when one is encountered, they will run for safety, instead of making safe decisions. Ironically, in this case, their avoidance of the exposure is actually more likely to increase the stress of the situation, not only by their initial fear.

It gets worse; if they do run, the thing they fear is more likely to chase them.


Another example, would be avoiding learning a school subject in front of an audience of our peers. Can you recall having to go ‘up to the board’, to solve a math problem?


In most Social Situations, we try to look our best.  If we feel we may look silly, or even stupid, we often ignore or avoid observed challenges. Over time, this pattern of AVOIDANCE becomes habitual, and we become significantly less skilled with associated situations.

Going up to the board to attempt to answer a question you don’t understand does risk embarrassment. At the same time, it is quite likely many others don’t know the answer as well. They probably thought you were brave for just taking the risk in the first place, and what you actually answer is less important.

And if you do get it wrong, there is a greater likelihood that you will actually learn something new, because if you already knew the answer, you really didn’t learn anything by answering.

The threat we fear, is our fantasy about how other people perceive us, such as not being smart enough, thin enough, athletic, popular, etc.

This often causes avoidance of these pursuits; leading to widening, of the curve.


It is important to remember why we go to school in the first place; students, by definition, don’t know everything.

One can reduce avoidance by recalling the purpose of class. As a student, one does not need to be perfect, as imperfection allows real learning to occur.


In Medicine, there is gathering evidence that your immune system, which is also in charge of allergies, can become deathly afraid of certain things.


In ALLERGIC REACTIONS, the immune system overreacts to something, because it has become SENSITIZED.

New research now suggests that the AVOIDANCE of things, can directly lead to sensitization of the brain, or immune system.

It seems that we are much more likely, to get asthma, or anaphylaxis, if our parents make sure we AVOID environmental allergens; including the substances of anaphylaxis themselves, in the first few weeks and months of life. 

Perhaps AVOIDANCE can kill you, even if it is years later.

Scientists also now believe that it is healthy to pick your nose, and eat it.

It is even okay, to pick a friend’s.

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If you are a Manager, or work in a team, as part of your occupation, these concepts are very important as well.

Individuals often self select for certain job tasks, using their strengths, but often neglecting their weaknesses. Some coworkers may avoid work, due to a perception of stress; that is easily modifiable, with increased training.

It is important to recognize, when your coworkers are having a stress response to the assignment at hand.  Managers need to work hard, to identify their employee’s areas, of occupational anaphylaxis.

I guarantee the time spent, in identifying professional allergens, and creating safe training EXPOSURES, will stop much of the fight or flight reaction, your colleagues may be displaying, to deadlines or assignments.

In order to be great DECISION MAKERS, we have to EXPOSE ourselves, to new situations of discomfort and responsibility, so that we no longer feel stress or anxiety.

Once the stress is gone, the brain stops worrying about how to survive, and focuses on how to solve the problem at hand.


What if I told you to imagine 3 things, in the following scenario?

The first; you are in a room alone, without any windows, and only one door.

Now imagine I tell you that you are sitting on a chair, in the middle of this room, when a huge lion strolls in and stares you in the eye.

lion 1

Evolutionarily, this would cause STRESS, by activating your Sympathetic Nervous System’s Fight or Flight response.

You would most likely panic, lose control of this morning’s breakfast, or yesterday’s dinner, and run for a corner of the room.

Now, what if I told you that you were a Lion Tamer?

Don’t avoid difficult situations.

Embrace new experiences.

Don’t be afraid of trying to learn anything.

You never know what situation you are going to be in, and the more EXPOSURES you have had, the better chance your DECISION MAKING, will save the day.

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Please tune in for How We Make Decisions, Part 2, Switching to Autopilot.

Simon Trepel, MD

Note– I should probably take a minute, to separate Psychology from Biology, and clarify a few things.

Psychology and Trauma– It is true that repeated exposures will lessen our anxiety, for example, if we continue to seek them.  We will eventually lose a fear of heights, if we skydive enough.  However, if a TRAUMATIC situation, like a rape, unfortunately occurs, repeated exposures, in uncontrolled environments like a shopping mall, or crowded bus, are unlikely to become spontaneously easier for some, over time.  In situations like these, it is important to seek professional help.  What happens in this type of therapy, is the therapist creates an exposure ladder, from ‘safe’ to ‘associated’ to ‘actual’ exposures, gradually training the brain to relax, and use rational thought, not survival based fear thinking.  If the exposure is too stressful, the person becomes FLOODED, and this is not therapeutic.

Biology and Drugs– It is true, that exposure to almost any substance over time (besides Crystal Meth), lessens the brains response to the drug, called TOLERANCE.  Many substances of abuse, however, increase stress in other ways, by creating addiction, cnacer, and other things, that reduce your ability to make good decisions.

Simon Trepel, MD FRCPC, is a practicing Child and Adolescent Psychiatrist, in Winnipeg, Canada.  He is an Assistant Professor, at the University Of Manitoba, in the Faculty of Medicine, and the Co-founder of the GDAAY Clinic.  He is, more importantly, the proud Father of 2 beautiful Daughters.  He writes in his spare time about things he knows something about, and occasionally about things he doesn’t; like Yoga, and Italian flavored coffees.  He was not referring to coffee that tastes like an Italian person.

Check out his Blog, called Simon Says Psych Stuff, at



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