Exposure therapy often treats post-traumatic stress, obsessive-compulsive disorders, and phobia disorders. These conditions all have one thing in common: anxiety. Exposure therapy has also succeeded in treating generalized anxiety and other anxiety disorders.
Recent findings in the New York Times and Forbes Magazine highlight that exposure therapy had become a “gold-standard treatment” for different anxiety disorders by providing a structured plan to help people face and overcome their “fears.”
But exposure therapy is a little more complicated than telling someone to suck it up in the presence of their most powerful triggers. There is a delicate step-by-step approach and a tailored series of progressions based on an individual’s particular triggers, worries, and greatest anxieties.
Exposure therapy works best in cases where certain circumstances tend to elicit the greatest shows of emotion and anxiety in patients. In other words, when their fear comes from a very particular place, one that they are reluctant to go to.
Not all anxiety disorders work this way. Some conditions are characterized by feelings of anxiety that occur out of nowhere for no discernable reason. Other cases of anxiety may have a deeper reason or trigger, but it may be initially unknown.
Understanding how and why exposure therapy works helps people with anxiety better understand their condition and why confrontation – albeit controlled and one step at a time – can be such a powerful treatment modality for various anxiety conditions.
How Does Exposure Therapy Work?
Exposure therapy is a structured behavioral therapy program that tackles a person’s source or triggers of anxiety in a controlled environment with the guidance of a trained mental health professional. With great success, exposure therapy has been successfully studied and utilized in treating individuals of all ages for various anxiety disorders.
The idea is simple: start small, and work your way up, building tolerance to the source of the fear, anxiety, or stress until it becomes less and less of a trigger.
The difficulty lies in making informed changes on a session-to-session basis, escalating exposure in a way that does not overwhelm the individual, and ensuring that the environment and supervising elements – friends, family, or the therapist – provide reassurance and affirmation.
Exposure therapy can be applied in several different ways. In many cases, a therapist may apply different forms of exposure therapy across different sessions or try different forms to see which leads to the most consistent progress. Comfort matters here, too. Exposure therapy is not about punishment or stress – so finding ways to create calm and comfort in a distressing scenario or amidst potentially distressing stimuli is important. The different forms of exposure therapy include:
Imagined Exposure Therapy
In this type of treatment, the individual is guided through an imagined scenario, guided by the therapist’s words. These imagined scenarios can be vivid, so guidance is important; a therapist’s voice and words can comfort the individual and keep them from spiraling into deeper levels of fear or stress.
In Vivo Exposure Therapy
In Vivo Exposure Therapy involves experiencing the “in life” trigger and confronting the fear. Again, subtle progression is important. An arachnophobe is not forced to hold a spider during the first session or at any other point during treatment. In vivo exposure therapy may occur towards the latter end of a person’s exposure therapy journey. In the case of an extreme phobia, it may be learning to manage stress and remain calm in the presence of an entirely harmless trigger, such as a spider in a terrarium.
Interoceptive Exposure Therapy
Suppose a person’s symptoms result from certain physical sensations. In that case, this type of exposure therapy will rely on slowly working up to said stimuli to resolve stress and anxiety without the risk of harm. A common example is an elevated heart rate. Some people develop an unintentional association between a higher heart rate and panic attacks and begin to experience panic and severe anxiety every time their heart beats too fast; rather than just a symptom, an elevated heart rate has become a cause or trigger for distress. Interoceptive exposure therapy aims to eliminate that association over time.
Virtual Reality Exposure Therapy
This type of treatment is relatively modern, leveraging today’s Virtual Reality technology to help patients virtually interface with triggers for their fear without ever being in danger. It’s about learning to confront and manage stress in the face of certain stimuli, completely safe in knowing that none of it is real. It’s also useful for creating frequent exposure to a source of fear that may not be realistically revisited in vivo, such as flight simulations for people with a fear of flying.
Other Treatment Methods for Anxiety
Exposure therapy for anxiety disorder treatment can be a powerful tool, particularly for conditions such as obsessive-compulsive disorder, post-traumatic stress disorder, and various phobias, such as social anxiety disorder. However, there are other forms of therapy for anxiety as well. These include:
Cognitive Behavioral Therapy
Often considered the gold standard for psychotherapy, cognitive behavioral therapy melds the concepts of cognitive therapy (focusing on thoughts to influence emotions) and behavioral therapy (focusing on actions to influence mood).
Dialectical Behavior Therapy
A different form of behavioral therapy developed primarily to treat personality disorders, dialectical behavior therapy aims to help people reconcile conflicting thoughts via conversation. In cases of anxiety, a person may learn to dampen their fears and worries through rationalization, affirmations, and repeated practice.
Exposure Therapy at Amend Treatment
Exposure therapy can be delicate. Setbacks are to be avoided at all costs, which is why specific protocols and practices are in place. A therapist does not simply begin exposing a person to their greatest fears – things start off small, with something like an imagined scenario during a calm and comfortable conversation with a light mood or a picture on a desk.