Exposure therapy

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When experiencing anxiety or panic attacks, exposure to the actual fears can make you be able to tolerate the fear. This is the essence of Exposure Therapy. Read more about this therapy and the different types and methods.

What is exposure therapy?

In exposure therapy, under the guidance of a psychologist, you consciously expose yourself to your specific fear. This form of therapy is used to help people get rid of their anxiety disorder. You learn that you can tolerate your fear, and that you can handle the situation.

 

How does exposure therapy work?

When you have an anxiety disorder, fear gets in the way of your daily functioning. Many people do not like the anxious feeling so they avoid the fear.
For example, someone with agoraphobia avoids large public places outside. That avoidance behavior actually perpetuates the fear. In the short run it works well: you don’t have to go to the place that is scary for you. In the long run, it results in you going out the door less often.

 

Someone with agoraphobia actually goes to the square during exposure therapy. That person will experience this as fearful. This is called a fearful association. At the same time, the person will notice that nothing bad happens. The result is a new and positive association, which is what exposure therapy is all about.

 

The more new and positive associations you experience with your fear-stimulus, the less violently you experience the original fear. This is called inhibitory learning. The fearful association does not disappear completely. You mainly notice that the positive associations become stronger. You notice this because the feeling of fear slowly fade away. You learn that you can handle the situation.

 

Response prevention

Response prevention is an important part of exposure therapy. In addition to exposing yourself to your fear, you also learn not to fall into your avoidance or safety behaviors. In avoidance, you avoid the fear completely. In safety behavior, you do engage the fear, you just have a way to evade it in the situation.

 

An example of exposure therapy with response prevention to safety behaviors:
A person has a social fear of making contact with people. Exposure therapy then consists of going to a party and talking to people. Safety behavior is, for example, drinking alcohol to calm down, or keeping yourself in the background. Response prevention is being aware of this and not drinking alcohol and staying on the couch. If u succeed in making contact, it is a positive experience that increases confidence in yourself.

 

Is exposure therapy right for me?

Exposure therapy works when you have a fear of something and avoid that fear. For example, a social phobia, as in the example above.

 

Other conditions for which exposure therapy is an effective treatment:

 

 

Depending on that particular anxiety or situation, one or more variations of “exposures” may be used.

 

Types of exposure therapy

There are four types of exposure therapy:

 

1. Exposure in vivo;

You experience exposure in real life. You actually put yourself in the situation you fear.

 

2. Imaginary Exposure

Under the guidance of a therapist, in your mind you go back to the situation in which you feel the fear. You concentrate on the feeling and explore it. This technique is used in the treatment of PTSD and can also be used for specific phobias.

 

3. Imaginary Rescripting – in Exposure Therapy

Under the therapist’s guidance, you will “rewrite” the traumatic event to create a new, more positive outcome. The psychologist helps you to feel how you wanted to react. You imagine yourself doing that. This way, it’s about the same event, but you’ve given the situation a different twist. Imaginary rescripting can be effective in treating PTSD.
It is also a technique used in schema therapy. In schema therapy the focus is on challenging and rewriting negative beliefs and emotional reactions that come from ingrained schemas.

 

4. Interoceptive exposure
In this form of exposure therapy, you expose yourself under supervision to the sensations in your body that you feel when you are anxious or panicked. This therapy is mainly used with people who suffer from panic attacks. When the anxiety is evoked, you are guided to regain control of your body through breathing. You will experience that the situation and physical sensations do not lead to the disaster scenario you imagined. Or the scenario is not as bad as you thought. You feel that you can handle it.

 

What does a treatment look like?

There are three different methods of exposure therapy. When in treatment, you and your psychologist will review which exposure therapy method is best for you.

 

  • Graded
    Together with the psychologist you determine the hierarchy of your fears. In exposure therapy, you tackle increasingly scary things, step by step.

 

  • Flooding
    You are confronted with your fear for a long period of time and at an intense level. The psychologist helps you endure the feelings and guides you by assuring that the fear you experience isn’t reality.

 

  • Random
    The situation you are exposed to in this therapy is random in terms of intensity. The advantage of the unpredictability is that it is easier to surrender to it.

 

How long does exposure therapy take?

On average, treatment at iPractice takes eight sessions in the consultation room. At iPractice we work with blended care: a method in which you receive online support in addition to treatment in the consultation room.

 

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Are you experiencing anxiety or trauma symptoms, or panic attacks? Do the anxiety symptoms affect your daily life? Reaching out to a professional can really help. Treatment can be helpful.

publish-icon Published - 25 Jan 2024
Mariëlle has extensive experience with elements of various scientifically based treatment methods such as cognitive behavioral therapy (CBT) and exposure therapy. Together with you, she ensures that your focus is on the here and now; what can you do to feel better?
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GZ-Psychologist Mariëlle van der Meer

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