Exposure Anxiety: The Invisible Cage of Involuntary Self Protection Responses by Donna Williams

What can you do when compliance doesn't work?  How might you help aloof, flighty, avoidant, dependent and oppositional people to stop defending and start living?  This book shows you how.

Exposure Anxiety was first written about in Nobody Nowhere in 1991 as a syndrome of involuntary and compulsive avoidance, diversion and retaliation responses.  A large section of my first text book, Autism; An Inside Out Approach in 1996, was dedicated to setting out strategies for managing, even reversing Exposure Anxiety.  In 2003 I wrote the first full book on Exposure Anxiety.

Published in 2003, Exposure Anxiety; The Invisible Cage of Involuntary Self Protection Responses, is the first ever text book by a person diagnosed with autism specifically focusing on co-morbid anxiety and impulse control disorders effecting those on the autistic spectrum.  It offers an innovative new approach to working with some of the most challenged people on the autistic spectrum. 

Drawing on an 'Indirectly-Confrontational' approach, this 336 page book gives case studies and a wealth of strategies to reduce and progressively overcome the compulsive and involuntary avoidance, diversion and retaliation responses of Exposure Anxiety.   Exposure Anxiety is an 'Invisible Cage' that challenges the person to either side with it and identify self with their own compulsive self protection responses.

There's is considerable overlap between Exposure Anxiety and conditions such as Pathological Demand Avoidance (first diagnosed in 2008), Oppositional Defiance Disorder (first in the literature around 2002), Avoidant Personality Disorder and Dependent Personality Disorder.  With this book actually written from an Inside-Out Approach, by someone who actually lived their entire life with and ultimately managed then overcame the condition, those looking for strategies for managing and reducing these conditions may find this book extremely useful.  


  • The Invisible Cage
  • 1. The Mechanics
  • 2. Relationship to Self
  • 3. Relationship to Others
  • 4. The Development of a Social Face
  • 5. Environment
  • 6. Ways Forward
  • Index


* Those living or working with chronic fight-flight states
* Those living or working with compulsive avoidance, diversion, retaliation responses
* Those living or working with chronic anxiety disorders
* Those living or working with attachment disorders, anxiety disorders, Oppositional Defiance, Pathological Demand Avoidance, Dependent Personality Disorder
* Where directly confrontational approaches (such as ABA) are not working

What readers said:

Few other books in my autism library are as marked up with exclamations points and my daughter's name as this one. Finally, finally, I not only have tremendous understanding of many of my daughter's behaviours, but tools to help her as well. It baffles me that exposure anxiety is hardly, if at all, mentioned in the general autism literature; clearly, it is one of the major challenges that are at the core of my daughter's autism. Though not all people with autism suffer from EA, this book is a must read for all professionals in the autism field, and any parents who suspect that this issue applies to their child.



My daughter was 7 years old and unable to communicate.  She endured in-your-face, intensive, ABA therapy day in and day out because "That's What You Need to Do" said all the "experts". But she was clearly unhappy and overwhelmed.  This book explained what I felt in my bones.   Almost immediately after implementing what I learned from Donna's book, my daughter responded by coming out of her defensive shell, interacting more, learning more effectively, developing skills more readily, and we, her family, began to know her more intimately.  I am grateful beyond words for Donna's insight and her incredible ability to explain exposure anxiety so thoroughly. I would highly recommend it to anyone who suspects a loved one is uncomfortable with intensive or even moderate social interaction. - Lisa Edmond



Last year l read Donna's book on exposure anxiety and nearly had an anxiety attack of my own. For the first time is 22 years, finally, a person has found my daughter.  Please, l beg any parent who has a child with autism-exposure anxiety to read this book. Donna's journey and knowledge will truly change your childs life as well as yours and finally give your family that little piece of heaven.

-Shirley and Shannon



I found this to be a very helpful book in understanding my own "exposure anxiety" behaviours and getting words for them. Every few pages I would either cry or laugh with relief - realizing it wasn't just me, that these problems "exist". I found it a very good thing to also copy certain pages/highlight, to give to people who don't "get" me and what exposure anxiety is - after reading it, they understood a little bit more! - A Santo



You can order this book from the publisher

The current publishers for Exposure Anxiety; The Invisible Cage are listed here

If in Australia you can order this book from the distributor, Footprint Books here

If you're a publisher looking to acquire other foreign language rights, please contact JKP to discuss acquisition.