What's the best way to treat anxiety? It might be exposure therapy. Exposure therapy is a way of treating anxiety that involves systematically exposing yourself to the source of your fear. It's used to treat many different types of anxiety and phobias, including panic disorder, social phobia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), specific phobias, and generalized anxiety disorder (GAD). At Strive On Counseling our team of skilled therapists is trained to use exposure therapy to treat these mental health issues.
What is Exposure Therapy?
Exposure therapy is a type of cognitive behavioral therapy (CBT) that's used to treat all kinds of phobias and anxieties. It is based on the idea that avoidance of what we fear actually increases anxiety in the long run.
Exposure therapy is based on the principle that exposure to a feared object or situation can teach your brain and nervous system to stop producing a fear response. We have an ironic tendency to avoid what we fear. In the short term, this makes sense and will typically give us temporary relief. However, in the long term, avoidance can create a greater fear response, worsening an anxiety disorder or phobia.
Why is Exposure Therapy used?
The premise behind exposure therapy is that you can learn to overcome anxiety by facing your fears. In some cases, this may mean intentionally creating a situation where you will experience an unpleasant consequence (like speaking in front of a crowd). In other cases, it could mean confronting an object or situation that triggers fear (like spiders).
In either case, the goal of exposure therapy is to teach people how to cope with their fears instead of avoiding them. Avoidance strategies are often used unintentionally and make the problem worse over time because they don’t allow people with anxiety disorders to experience positive outcomes from confronting their fears – which reinforces avoidance behaviors. A vicious cycle often results.
How Does Exposure Therapy Work?
The goal of exposure therapy is twofold: firstly, to reduce the fear response by exposing you to the thing you fear; and secondly, to help you live life with more freedom instead of being stuck inside a very small comfort zone. Once you are no longer limited by avoiding what you fear, life can feel more satisfying and fulfilling.
The purpose of exposure therapy is not simply to eliminate all anxiety—anxiety is a normal and even at times helpful emotion—but rather to get you closer to a place where your symptoms are manageable or even absent. Studies have shown that this kind of treatment can decrease the severity of many mental health symptoms within weeks.
What is the Process of Exposure Therapy like?
The process of exposure therapy can be broken down into a few basic steps:
Building trust and rapport with your therapist, who will guide you through each step of exposure therapy
Establishing a plan with your therapist that meets your needs and goals
Learning more about how exposure works for your particular anxiety (your therapist might provide reading materials or videos to watch)
Creating a list of exposure activities that you can do, ranked in severity from 1-10 (we call this an exposure hierarchy)
Learning some basic tools for facing and coping with the anxiety that comes up during exposures
Following up with your therapist on how the various exposure activities are going
Exposure Therapy for Phobias
Therapists often use exposure therapy to treat fears and phobias. If you have a fear of heights, for example, you might be instructed to come up with a list of activities that would help you overcome that fear. These activities can be anything from looking at a picture of a tall building, all the way up to standing on the edge of the grand canyon.
Your therapist might have you rank various activities on an exposure hierarchy on a scale from 1-10. This provides a roadmap for starting to face your phobia and allows you to do so a little bit at a time. For example, let's say you have a phobia of public speaking. A one on the hierarchy might be watching a video clip where someone gives a speech, whereas a ten might be giving a speech in front of a large audience. Rather than jumping right into a ten, your therapist might have you watch the video clip in the session and learn how to sit with the anxiety that comes up. Then you might go home and watch this video clip multiple times a day until you no longer have an anxious response. You would then continue to work your way up the hierarchy doing other exposures of varying intensity.
Exposure Therapy for OCD
Exposure and response prevention (ERP) is the most popular type of therapy for OCD. When used in conjunction with cognitive behavior therapy, ERP has been shown to reduce symptoms by as much as 60%.
ERP involves exposing yourself to what you're afraid of without performing a compulsion, ritual, or "safety behavior". For example, if you typically wash your hands every time you touch any object, the goal would be to prevent that response and expose yourself to the anxiety that comes with not washing your hands. You might start by delaying the hand washing or go right to preventing it, and over time your brain and nervous system learn that the anxiety is tolerable and eventually goes away, thus eliminating the need for the hand washing behavior in the long term.
Exposure Therapy for PTSD
Prolonged exposure is the most common approach for PTSD. Prolonged exposure helps rewrite the traumatic storyline and change associations to fear stimuli by repeated telling and listening of the event and systematic exposure to triggers. For example, if you were in a traumatic car accident you might begin by telling the story in a third-person narrative form, and repeating the story until it no longer evokes a fear response. Then you might address specific triggers such as the song that was playing on the radio during the crash. You might listen to this song over and over under the guidance of your therapist until your brain no longer has such a distinct association with the traumatic event.
Is Exposure Therapy right for you?
Exposure therapy is a process, not a one-time event. It's important to have a professional who can help you through this process and make sure it's working for you. Some points to consider when deciding if exposure therapy is right for you:
Has regular talk therapy not gotten you the results you were hoping for?
Has the anxiety persisted for a long time even though you logically understand there is nothing to fear?
Are you comfortable with your therapist? You should feel like you can trust your therapist, that they have your best interests at heart, and are capable of helping you work through difficult emotions or situations. Your therapist should also be someone that makes it easy for you to open up about yourself, so that they can tailor the therapy specifically for your needs.
Are you willing to do work outside of therapy sessions to get better results?
Are you willing to be a little bit uncomfortable so that you can ultimate retain freedom from your fears?
Exposure therapy isn't about forcing yourself to face your deepest fears, it's about working with a trained professional to set up a plan that you can feel comfortable with.
The goal of exposure therapy is not necessarily to eliminate anxiety completely (although it can), but rather learn how to cope with anxiety in a healthy way so that it doesn't keep you from doing what you want or need to do in life.
Exposure therapy works by gradually exposing the person being treated to an anxiety-provoking stimulus in such a way that we can limit the amount of discomfort you have to face while doing so. We don't just dive right into the deep end with no float. Exposure therapy is thought out and tailored to each individual in a way that will achieve the best results for their particular anxiety.
Conclusion
Exposure therapy is a great option for anxiety. You don’t have to live with your fear and anxiety anymore! However, it’s important to remember that this process takes time for most people. Exposure therapy can be very effective in helping you manage symptoms of PTSD, OCD, social anxiety, and other anxiety disorders, but it may not work for everyone. If you think that an exposure-based approach might be right for you or someone close to you who suffers from an anxiety disorder, talk with us about trying exposure therapy today!
Other Mental Health Services Available at Strive On Counseling
As Asheville therapists, we understand that every individual has a unique set of mental health needs. Therefore, we offer many services and forms of therapy. More specifically, our services include individual counseling, anxiety treatment, EMDR trauma therapy, therapy for men’s issues, mindfulness, Buddhist counseling, cognitive behavioral therapy, teletherapy / online therapy. Some other resources we offer include guided meditations, supplements, a list of books and other useful resources, and online courses. If you would like more information about any of these services, please reach out today, and start doing therapy in North Carolina!