Flooding is a type of exposure therapy that is used in treating invasive and debilitating psychological impairments, though primarily phobias, via the use of intense and immediate exposure to negative stimuli. Whereas other types of exposure therapies may gradually build a patient up from smaller and less calamitous examples of stimuli in their treatment, flooding generally starts with the most difficult aspects from the very beginning.
Flooding works on the same principals as classical conditioning, which modifies an individual's responses to certain stimuli in either a positive or negative manner.
Examples Of Conditioning In Relation To Exposure Therapy
Many people have heard of the experiment conducted by the Russian physiologist Ivan Pavlov in which he trained his dogs to associate the sound of a metronome (the stimulus, in this case) with food. Therefore, they were conditioned to salivate upon hearing that particular tone from then on. This is a relatively neutral example of how conditioning works.
An example of conditioning in a negative context would be a situation that many individuals have unfortunately experienced at some point in the course of their lives. Imagine a person eats a certain food before unknowingly getting food poisoning or having a stomach virus. This would cause some pretty horrible digestive symptoms that are not easily forgotten. With your body going into defense mode after such an unpleasant ordeal, it would strongly want to avoid experiencing it again. In an attempt to do this, it will likely make you nauseated and repelled by the food that is associated with the resulting sickness. In this case, you were conditioned by the experience to avoid a specific food due to your mind "learning" (or being conditioned to believe) that it was associated with unpleasant sensations and results.
Positive conditioning is the desired result of flooding in therapy. In these cases, it's used to take a negative concept to an individual and re-condition them to view it in a positive or neutral light and respond accordingly. This is done to alleviate (or at least lessen) fears, triggers, and other behaviors in those seeking treatment. When receiving flooding as treatment, an individual will be exposed to what has triggered such strong negative responses in them and encouraged to practice various forms of relaxation methods throughout the process, thereby eventually calming themselves in the presence of their particularly undesirable trigger. This works to "re-wire," or positively condition, the mind to no longer react so intensely when presented with that trigger again in the future. The association of the situation is no longer one connected to fear or trauma, and the individual becomes desensitized to it to an extent. This allows them to function more normally in daily life.
This type of therapy can be done via immersive techniques, with the assistance of virtual reality, or through the use of actual images. With successful flooding treatment, the individual will experience decreased reactions to triggers, an increased sense of capability in handling their fears and anxieties, reduced associations of a negative manner regarding situations or particular stimuli, and increased emotional processing in regards to fears and the world around them.
Flooding is not a treatment appropriate for all individuals and all situations, and not all mental health professionals choose to use it in therapy.
Flooding As A Treatment Method
Flooding, as one of the many variations of exposure therapy, is sometimes appropriate in the treatment of numerous conditions involving anxiety, trauma, phobias, and obsessive-compulsive behaviors. While it may not be suitable for all individuals seeking treatment, it can greatly reduce the invasive and incapacitating responses for some in the presence of their triggering stimuli.
Flooding As A Treatment For Post-Traumatic Stress Disorder
In the treatment of post-traumatic stress disorder (PTSD), exposure therapy may need to be approached with caution due to the severity of the experiences that induced the post-traumatic symptoms in the first place. But flooding is still a viable option in reducing those incapacitating responses to negative stimuli.
With the factors of a traumatic situation generally being far too dangerous or impossible to replicate in standard exposure therapy procedures, mental health professionals will often use an alternative variation known as imaginal exposure. This method involves having the afflicted individual imagine the aspects of their trauma and replay them in their minds under the guidance of a licensed professional, while vividly describing them as much as possible. This allows them to be re-immersed into the trauma while in a safe environment and under the care of a psychologist who can provide support in keeping them calm and assisting in the re-conditioning process. Through this method, they can gradually learn to manage their reactions to flashbacks, memories, and triggers related to the event.
Flooding As Treatment For Anxiety
Exposure therapy can sometimes be an appropriate treatment for those struggling with anxiety or anxiety-related disorders. If someone were to experience social anxiety, their mental health professional might encourage them to counter this aversion head-on by going into a public place or social event. While directly stimulated by the issue that bothers them the most, they will be instructed to practice relaxation techniques and exercises until they are capable of remaining calm in the undesired circumstances.
Though there is always the possibility of risk in any situation, the person with social anxiety will ideally grow to realize they have nothing to fear in a crowded place. They may still be a bit uncomfortable in public or crowded places, but it will likely only pertain to general overstimulation in those who genuinely prefer smaller groups or solitary activities on their own. They will become desensitized to the sights, sounds, and smells around them and realize that others in public are simply going about their business.
Anxiety-based treatment via in-person or online therapy can also be beneficial for those with a fear of speaking in front of others, those dealing with self-image issues, or even people overly affected by something like being stuck in traffic. All of these are issues that can have resulting anxieties reduced by flooding, exposure, or another form of conditioning. Mental health professionals can help individuals remain calm and collected when faced with the situations that trigger these high levels of anxiety.
Flooding For The Treatment Of Phobias
Phobias are the most recognized condition treated with flooding or exposure therapy. There have even been television shows dedicated to showing the process of reducing reactions in the presence of fear-inducing stimuli.
A graded approach to treating phobias is often taken, building up from smaller triggers to those of most significance. However, flooding starts at the opposite side of the spectrum. If someone reaches out to a mental health professional due to an extreme fear of dogs to the point that they are unable to go on a walk, they may likely be instructed to expose themselves to dogs in a safe environment. This could be petting or holding a dog (and one possibly belonging to a friend or relative to ensure confirmation of good temperament) and "enduring" the interaction until their anxiety and adrenaline calm down and pass. This helps them to realize the lack of risk involved with encountering dogs and additionally grow accustomed to the interaction. This exposure will help condition the individual to associate positive or neutral reactions in response to coming across dogs in less familiar settings. If this is achieved, they may be able to overcome their fears entirely.
For other (non-animal) phobias, such as being in a moving vehicle or being afraid of the dark, individuals can easily and immediately be placed safely into these situations and required to remain in them until the appropriate calming techniques are applied.
One of the key problems with flooding is that it can fail to work the first time. The patient can quickly remove themselves from the stimuli before the exposure therapy has had time to re-condition their responses to their specific fears. If this occurs, they have been exposed to their harshest symptoms and still must work to heal.
Flooding As A Tool To Overcome OCD
The ritualistic behaviors displayed by someone with obsessive-compulsive disorder (OCD) are often due to underlying fears. A person may feel the repetitive and often specifically-numbered actions may resolve or prevent something unwanted from happening.
Flooding in this context allows the individual in treatment to be fully immersed in a situation that would trigger their compulsive behaviors. Their mental health professional will guide them in not engaging in any of them while experiencing distress. This can be anything from coming into contact with "contaminated" surfaces (whether truly contaminated or not) to addressing certain thoughts that provoke obsessive-compulsive behaviors.
In OCD, these disruptive and compulsive behaviors are often an avoidance tactic to circumvent experiencing certain fears. The individual has usually convinced themselves that the behaviors are somehow preventative actions against the particular negative stimuli. OCD becomes an issue when these behaviors begin affecting an individual’s life. By not allowing themself to indulge in these ritualistic activities, yet still being exposed to whatever it may be that triggers them, this form of exposure therapy helps the person to learn that their obsessive-compulsive actions have no significant impact on the outcome of the situation at hand. This also allows them to realize that they can handle the amount of anxiety induced by a situation without always relying on their ritualistic behaviors.
Further Information Regarding Flooding
Though flooding is a successful tool in treating numerous psychological conditions, it may not be for everyone. Not every mental health professional, furthermore, will be willing to engage in this method for therapeutic purposes. Symptoms successfully treated with exposure therapy are very likely a component of other psychological conditions that may require further treatment.
While this is true, therapists who practice flooding are more available than you might think. Researchers are increasingly exploring techniques by which they can deliver various forms of exposure therapy to patients online. One study launched in 2018 (which is still ongoing) is testing the effects of treating eating disorders and other forms of anxiety with imaginal exposure therapy delivered online. This treatment asks patients, via remote counseling, to face their anxiety source through imagination exercises. While flooding and exposure therapy are often considered in-person techniques, psychologists continue to find new and creative ways to apply them to individuals who cannot access help.
If you believe you might be able to benefit from flooding or another form of exposure therapy, you should get in touch with a mental health professional. Online counselors at BetterHelp are available to answer your questions, administer treatment, and direct you to further resources. Remote counseling is both accessible and affordable. Read what others have to say about their experiences with BetterHelp counselors below.
“I’m so thankful to be working with Melissa. I felt a positive connection with her during our first session. Melissa listens and validated that my concerns are real. I’m now starting to understand how my stress or fears might be linked to some childhood trauma. I look forward to each session and learning more about myself along with new ways to cope.”
“Most times in my life I have seen therapy as a four-letter word. I find myself, for a change, looking forward to my appointments with Amanda. Often times I find myself questioning the process but Amanda is always there with kind words and ways to challenge my fears. Her work is priceless and too is the clear personal connection she forms. I am so happy I gave BetterHelp a change and was blessed to be matched with Amanda.”
For more information regarding exposure therapy, other mental health concerns, or any of the conditions listed above, contact your local mental health care professionals or reach out to the readily available support and resources via BetterHelp's online therapy professionals.