“Face your fears.” It’s a piece of advice that has been passed down over and over across countless scenarios. But did you know that, in some cases, there’s science behind it? In mental health, it’s a technique known as exposure therapy.
Could this kind of therapy be an effective treatment for you and your mental health needs? Let’s dive into what exactly it is, and what you need to know.
Table of Contents
What Is Exposure Therapy?
Exposure therapy is a psychological treatment designed to treat mental health conditions in which a trigger causes a psychological reaction. Take anxiety disorders, for example. Many people with anxiety disorders have specific triggers, such as a crowded room, that trigger anxiety attacks. Phobias, anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder are common conditions that work this way.
It also helps people with these conditions by exposing them to their triggers in a safe, controlled, repeated way. This desensitizes them to the trigger and allows their brains to associate the trigger with more safe situations than dangerous or stressful ones.
How Does Exposure Therapy Work?
During exposure therapy, a trained mental health professional constructs situations that expose their patient to the specific trigger. There are many ways to do this, but in most cases, the therapy starts with mild exposures and gradually increases them to desensitize you little by little.
For example, it may be used to treat a person with agoraphobia—an intense fear of leaving their home or being in social situations. Exposure therapy may follow this type of progression:
- Standing in an open doorway
- Stepping out onto the porch or stoop
- Standing in the yard
- Stepping onto the sidewalk that is off the property
- Walking down the block
- Gradually going further and further, working their way up to going to public places
However, it’s important to note that it isn’t performed by itself. A mental health professional starts to treat the patient through talk therapy, then adds other strategies alongside exposure therapy to help the patient cope with their symptoms.
While this approach to therapy can be stressful and challenging, there’s evidence that supports it. For instance, a study published in the Journal of Rehabilitation Research and Development identified prolonged exposure therapy as the best treatment for PTSD, especially for combat veterans. Likewise, a study published in the Psychiatric Times found that in patients treated with this type of therapy, 90% reported a decrease in anxiety symptoms, and 65% reported a decrease in phobia symptoms even as long as four years after treatment.
What Conditions Does Exposure Therapy Treat?
It’s most commonly used to treat conditions in which a trigger sparks a psychological reaction. Here’s a brief list:
- Anxiety, including generalized anxiety disorder
- Panic disorders
- Obsessive-compulsive disorder (OCD)
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
Types of Exposure Therapy
Exposure therapy isn’t a singular prescriptive procedure. It’s a technique or strategy that a mental health professional customizes to suit their patient. As a result, there are many ways this treatment method can be performed.
The most common way to conduct this form of therapy is with graded exposure: starting with mild exposures and working up to more significant and immersive exposures. It’s also often performed using a technique called systematic desensitization. In systematic desensitization, during your exposures, your therapist guides you through relaxation exercises. The goal is to coach your brain to associate the relaxation with the trigger.
There are also four primary types of exposures:
- Imaginal exposure: vividly imagining the trigger, potentially through guided imagery
- In vivo exposure: directly facing the trigger in real life
- Virtual reality exposure: using virtual reality (VR) to simulate the trigger
- Interoceptive exposure: causing trigger-like circumstances that are harmless to reduce the reaction to them
Each person’s exposure therapy is designed to address their specific trigger and align with their particular diagnosis or concerns.
Benefits of Exposure Therapy
It’s important to understand that it’s not a cure for mental illness, and most mental illnesses have no true “cure” that removes the disorder entirely. Instead, it’s all about reducing symptoms so your condition has less of a negative impact on your life. With that in mind, there are several benefits that can be life-changing.
Reducing Symptoms of Mental Health Conditions
In the case of many mental health conditions, treatment focuses on symptom reduction. That’s the case with exposure therapy, too. It treats conditions like OCD, PTSD, and anxiety, can have a dramatic impact on a person’s life. They can hold you back from certain activities and positive practices, and they can intrude on your daily life severely by throwing severe symptoms your way without warning. Those symptoms affect your ability to live a fulfilled, happy, healthy life.
It doesn’t necessarily take away the hurdles that come from mental health conditions, but it can significantly lower those hurdles so you can step over them rather than jumping over them or being stopped by them entirely.
Breaking the Habit of Avoidance
Part of the problem with trigger-related mental health conditions is that they trick you into allowing them to get worse. If a certain action or situation gives you anxiety, you tend to avoid that situation. The longer it has been since you’ve safely endured that situation, the more intimidating and anxiety-provoking the situation is. This leads to further avoidance, which leads to worsening anxiety, and the cycle continues.
Exposure therapy breaks that cycle of avoidance. It allows you to start confronting those fearful situations in a safe way so that it changes the narrative that is causing you to avoid them. As a result, your anxiety about the trigger stops growing and ultimately reduces.
Teaching Symptom Management Techniques
The practice of exposure therapy doesn’t just teach your brain that the trigger is actually safe. It also gives you a controlled environment where you can practice managing your symptoms. The mental health professional guiding you can teach you breathing techniques, grounding, meditation, and other strategies to reduce symptoms when they arise.
During therapy session, you have a chance to practice those techniques in a genuinely symptomatic circumstance. This way, when your trigger appears in your daily life and your symptoms start to rise, you’ll know exactly how to reduce your symptoms.
Risks or Challenges of Exposure Therapy
While the benefits are numerous, there are also risks and challenges to keep in mind. Be aware of these top considerations before you begin your treatment.
Avoidance and Fear
To someone with a mental health condition in which a trigger causes severe symptoms, exposure therapy sounds highly uncomfortable. It’s based around purposely getting into the types of situations you’ve likely been avoiding for many years. Quite frankly, it doesn’t sound appealing.
This is why mental health professionals don’t launch directly into exposure therapy during your first appointment. You need to first learn techniques that you’ll use during the sessions, establish trust with the therapist, and feel comfortable in the environment.
In many cases, a trigger-related mental health condition was caused or worsened by past traumatic experiences with that trigger. If exposure therapy is not performed properly, it could further traumatize the person and, ultimately, make their symptoms worse.
This can happen if the exposures aren’t properly controlled and put the person in danger or if the person is pushed too far too quickly. Fortunately, though, this is highly unlikely if the treatment is performed by a knowledgeable mental health professional.
Can You Perform Exposure Therapy on Yourself?
Logistically, it seems like something anyone can do: simply approach whatever it is that scares you. That said, it’s not advisable.
You need a knowledgeable professional to teach you management techniques and guide you through the exposures so that the practice genuinely helps rather than further traumatizing you. You also need a trusted professional to plan and pace the exposures so you can feel confident that you’re safe.
In addition, it’s not a solution on its own. It should be a part of a well-rounded therapeutic treatment plan that addresses your specific needs and condition.
How to Find an Exposure Therapy Specialist
To find out if exposure therapy can help you, look for an experienced professional in your area. At SRx, our integrated health system can connect you with compassionate and expert mental health professionals who conduct their practice in a safe and effective way. Learn more and explore ways to live a life that is less encumbered by your symptoms by checking out our mental health services.