What Is Exposure Therapy: Basics & Why It Works

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“Face your fears!”

Fear is one of the most natural primitive human emotions, we are all afraid of something; dare we say there’s not a fearless person on this planet! But oftentimes, fear is a negative emotion that can bring down a huge impact on someone’s life. 

Being afraid of something is a different and unique experience for everyone, and most of the time it depends on three factors: timing, coping, and intensity

While most people are experiencing the low intensity of fear which doesn’t have that much influence on their lives, there are such people that experience high-intensity fear, and coping with that kind of fear can be very challenging and lead to complete anxiety disorder

So, how do you go about it? How do you cope with the fear or even surpass it? 

Let me introduce exposure therapy.

What is Exposure Therapy?

Exposure Therapy is a psychological method that has proven to be the most successful when it comes to dealing with fear. 

Exposure therapy or widely known as behavioral therapy is a whole process of using systematic techniques exposing someone to the very thing they are afraid of. 

Is that safe? Well, it depends on the feasibility of the treatment and whether there are underlying problems with exposure therapy. 

Anxiety can be caused by many underlying situations. Whether it is trauma, fear, phobia, or some traumatic experience, once the fear is present, it is quite hard to surpass it. 

The exposure therapy of anxiety will simply make you face your fears repeatedly to help break the pattern of avoidance and the fear itself – all of this in a totally safe environment. 

How does Exposure Therapy Work?

Exposure therapy is based on various exposure therapy principles. One of the most important principles is the principle of respondent conditioning, known as Pavlovian extinction. 

Respondent conditioning, also called classical conditioning, is a behavioral method or procedure where a conditioned stimulus (anxiety symptom) is paired with an unconditioned (neutral) stimulus. 

When treating fear or anxiety disorders, exposure therapy will expose you to the conditioned stimulus i.e. the object or situation that is causing you anxiety. 

For example, if you are afraid of elevators, the therapist will expose you to the use of the elevator until you become comfortable using it. 

Types of Exposure Therapy 

There are different types of exposure therapy. 

Based on the situation and the severity of the anxiety disorder, the 7 most used types of exposure therapy include:

1. In Vivo Exposure

This type of exposure is done by directly facing the situation or object that causes the anxiety symptoms to rise. 

In-vivo exposure is real-life scenario exposure. 

For example, if you are afraid of an insect, using the in-vivo exposure the therapist will gradually make you hold the insect in your hand.

2. Imaginal Exposure

This type of exposure is used when in-vivo exposure is not feasible or suitable to perform. The imaginal exposure consists of making the patient imagine the feared object or situation in their mind and describe the scenario in detail. This technique is very popular in the treatment of PTSD

3. Virtual Reality Exposure 

Virtual reality exposure is getting more and more used by many exposure therapists around the world. Thanks to advanced technology, using virtual reality exposure means testing all kinds of situations straight from the therapist’s office. 

For example, if the patient is afraid of flying, the virtual reality exposure will have the patient virtually placed in an airplane. 

4. Interoceptive Exposure 

Interoceptive exposure focuses on the creation or simulation of physical sensations or responses that a patient might have while experiencing an anxiety disorder. 

One of the best examples is hyperventilation. A person that is suffering from an anxiety disorder is oftentimes experiencing an increase in the heart rate. The therapist might make the patient simulate running to achieve hyperventilation and teach the patient that the particular response is not harmful. 

5. Graded Exposure 

Graded exposure is the most used and common type of exposure therapy. Graded exposure means gradually exposing the patient to fear-inducing objects

Usually, when using graded exposure, the therapist uses a ladder or exposure guide. This means that first, the patient will be exposed to situations or objects that are deemed as low in intensity, and then gradually progress to the more intense ones. 

6. Flooding 

The flooding technique is used in combination with the in-vivo exposure and the imaginal exposure. The flooding technique of exposure is one of the most intense types of exposure that a therapist can use. 

Flooding means deliberately exposing the patient to objects or situations that are most frightening for the patient for a prolonged period of time.

7. Systematic Desensitization

Systematic desensitization is a combination of exposure therapy with relaxation exercises.

Therapists often use systematic desensitization to perform exposure therapy using physical or mental exercises, so the patient is more comfortable and able to manage and associate with the feared objects and situations more easily and stress-free.

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