Updated on 4/13/2022
If you are among the quarter of people in the U.S. who experience anxiety, post-traumatic stress disorder (PTSD), or other phobias, exposure therapy is one way to help you confront and gain control over the fear and distress that may be overwhelming you. Exposure therapy targets a person’s learned avoidance of difficult situations or thoughts that trigger a frightening or anxiety-provoking response. Generally these thoughts are caused by traumatic events and the desire to avoid reliving them.
If you are exploring prolonged exposure therapy as a possible form of treatment and response prevention, here are some key considerations to keep in mind before diving in.
“Exposure therapy is one of my preferred methods to help clients with anxiety, fears, and phobias, mainly when traveling, flying, and confronting heights. Seeing them come back to their session after doing something they never imagined they could do is very rewarding. They feel empowered and more motivated to continue working on other issues.”
How Does Exposure Therapy Work?
A safe and proven cognitive-behavioral psychotherapy technique, exposure therapy is used in the treatment of chronic PTSD as well as other damaging phobias. It is a powerful means of helping a person overcome crippling fears, anxieties, a traumatic event, and the avoidance of dreaded situations. In time, exposure therapy treatment aims to improve a person’s quality of life. During exposure treatment, the therapist works with a client to determine the best possible method for the type of trauma they experienced.
While this type of effective therapy is intended to help a patient gain control, it must be done incredibly carefully by a trained therapist in order to avoid re-traumatization. While some people can confront challenging memories all at once, also called “flooding,” others need to gradually work up to these moments over time, also called “desensitization.” In instances where exposure is gradual, a therapist leverages relaxation exercises and starts with less-upsetting stressors to help clients ease in and out of repeated exposure. The therapist has to practice gradual exposure in order to promote systematic desensitization to the traumatic event or specific phobia.
“Exposure therapy can help mitigate symptoms and negative responses to anxiety, phobias and trauma, but it’s important to remember there can be limitations and drawbacks. A trained therapist and treatment plan, can help you better understand the potential for worsening or the return of symptoms but also the value in incremental change, which can help widen the scope of healing.”
Types of Exposure Therapy Treatment
The goal of exposure therapy treatment is to reduce a person’s fearful reaction to a painful memory or stimulus, and there are a few different exposure methods to enable an effective experience. You and your therapist determine the best exposure type for your particular situation, and it can include one of the following:
- In Vivo Exposure A person is exposed to a feared situation in the real-world. For example, a person who fears public speaking might be asked to give a speech in front of an audience.
- Imaginal Exposure When real-world exposure is simply not feasible, which can be because it is too difficult or hazardous (such as combat-related PTSD), a person is prompted to mentally confront a fear or situation by picturing it in their mind.
- Virtual Reality Exposure In recent years, virtual reality has been explored as an alternative to imaginal exposure, helping a person confront fears and worst-case scenarios. This is also a valuable option if real-world exposure is too hard or dangerous.
- Interoceptive Exposure This entails conjuring physical sensations that do not cause harm, but are still dreaded. If you fear experiencing an elevated heart rate, for instance, you may be asked to run in place to increase your heart rate and learn the sensation is not dangerous.
- Prolonged Exposure Serving a combination of multiple exposure methods, this entails discussing your trauma as well as experiencing it in the real-world.
Often, these exposure treatment types are conducted along with coping exercises and relaxation techniques to ensure a person is not re-traumatized during the exposure process. Additionally, therapeutic exposure pacing can vary and is best determined by your therapist. Because exposure therapy has the potential for emotional and physical harm, it is important to seek a therapist or professional who is specifically trained in administering these treatments.
Who Can Benefit from Therapeutic Exposure Therapy?
This form of effective treatment is scientifically demonstrated to be a useful means to treat a broad set of mental health conditions including:
- Panic Disorder
- Social Anxiety Disorder
- Obsessive-compulsive Disorder
- Post-traumatic Stress Disorder
- Generalized Anxiety Disorder
Numerous reports have studied the benefits of undergoing exposure therapy, with a host of positive outcomes reported for those that have a specific phobia, social anxiety disorder, or chronic PTSD. Over time, some people find their negative reactions to feared stimuli decrease or at least weaken when it comes to previously learned negative associations. Additionally, some people find a greater sense of self-efficacy after learning they are capable of confronting a fear or anxiety, finding they can now attach more realistic beliefs about feared situations.
“When I work with clients in recovery from an eating disorder, I like to use exposure therapy by teaming up with my client’s dietitian to strategically and systematically re-introduce foods that feel triggering because it supports clients with gaining their power back over food.”Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC
Taking The Next Step
While there is a large amount of behavior research that supports the benefits of exposure therapy as an effective treatment for anxiety, post-traumatic stress disorder (PTSD), and other phobias, it is essential to find a therapist who specializes in this form of treatment before getting started. While there are different phasing techniques to lessen any re-traumatization, as well as many different types of exposure, the key is to find a therapist who can implement the best treatment for your unique situation. When done effectively, the results can be life-changing.
Kaplan JS. Exposure Therapy for Anxiety Disorders. Psychiatric Times. Published online September 6, 2011. doi:https://www.psychiatrictimes.com/node/735910
American Psychological Association. What Is Exposure Therapy? https://www.apa.org. https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy. Published July 2017.
Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues in clinical neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610618/. Published September 2015. Accessed September 7, 2021.
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