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  • Exposure-Based Therapies

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    Exposure-Based Therapies

    Exposure-based therapies are a specialized set of interventions that have roots in Cognitive-Behavioral Therapy (CBT). Examples include Exposure and Response Prevention (ERP) and Prolonged Exposure (PE), among others. The core concept of exposure-based therapies is that we can decrease our distress and increase our distress tolerance through facing our fears. This is done in a controlled and purposeful manner. Through approaching and staying in the situations that trigger anxiety, we learn that we can tolerate the situation and the emotions that we experience.

    Exposure has a strong basis of evidence to show it effective in treating:

      • Obsessive-Compulsive Disorder
      • Posttraumatic Stress Disorder
      • Anxiety Disorders, including:
        • Phobias
        • Panic Disorder
        • Agoraphobia
        • Social Anxiety Disorder
        • Generalized Anxiety Disorder

    Anxiety is actually maintained and worsened by our attempts to avoid it. When we try to avoid something we feel anxious about, we frequently feel temporary relief. However, we quickly become dependent upon that relief. This results in trying more and more desperately to never feel anxious, while still feeling worse and worse.

    Exposure works by disrupting and reversing this feedback loop. Through staying in the feared situation, we find that although it may take longer to experience relief, we don’t need it immediately like we thought. With practice, we desensitize ourselves to the trigger and the anxiety that we used to feel. We learn that our strength is in our ability to embrace and confront our fears, and that avoidance was only interfering with our discovery of that strength.

    You might be asking, “but I experience my feared situation all the time – why hasn’t that worked as exposure?” The answer is that it’s very possible to be in the situation but still be practicing avoidance! Avoidance isn’t always literally escaping the situation. Avoidance comes in many forms, including but not limited to distracting oneself from the situation, engaging in superstitious behaviors, and seeking repeated reassurance. In OCD, these behaviors are called “compulsions.” In anxiety disorders, they are frequently called “safety behaviors.” They can be overt and obvious, and they can be so subtle that we might not even be aware that they are happening. These kinds of in-situation avoidances are usually a major player in what keeps us from getting used to our anxiety triggers. The process of giving up and or preventing compulsions/safety behaviors is often called “response prevention” and is an important part of successful exposure therapy.

    Because of its powerful efficacy, we incorporate exposure techniques into most of the therapy that we provide. Rest assured, however, that we do not take a one-size-fits-all approach. The nature, pace, and style of exposures we engage in are completely customized to your needs. Furthermore, all exposure plans are made in collaboration with you to ensure that you feel ready to take on each therapeutic challenge.

    We would love to help you use exposure to take back your life from OCD or anxiety. If you’re interested, or if you have questions about how this type of therapy might work for you, please contact us to schedule a phone consultation.