Exposure Therapy: Types, Benefits

Exposure therapy provides a valuable therapeutic intervention for many people who experience a variety of mental health conditions. Perhaps you're wondering what this approach is. What are different types of exposure therapy, and what can it possibly do to make your life better? This article will answer these questions and more. It will also show you how to get the help you need if you feel like you would benefit from this type of therapy or from online counseling in general.

What Is Exposure Therapy?

Exposure therapy is designed to help people overcome mental health conditions that arise from fear. There are specific ways to conduct exposure therapy, so that over time you gain more experience with the fearful stimuli in situations that are neutral or positive (and multiple types, such as vivo exposure, and imagined exposure therapy) leading to increased self efficacy.

As you experience the same sounds and sights that you've previously associated with danger, you become less sensitive to them, and you experience a reduction in fear. The goal of exposure therapy is to help you become less fearfully aroused when you hear, see, or otherwise sense stimuli that you associate with life-threatening situations, especially in imaginal exposure. Exposure therapy is considered to be the first line treatment for a number of disorders, and it can change the life of the person experiencing a mental health condition and their emotional processing.

Conditions Treated With This Approach

Exposure therapy treats a wide variety of fear-based mental conditions. It has been scientifically proven to be helpful for the emotional processing with each of the following conditions:

• Generalized anxiety disorder
• Panic disorder
• Simple phobias
• Social phobia
• Obsessive-compulsive disorder (OCD)
• Posttraumatic Stress Disorder (PTSD)

In exposure therapy, you're presented with the stimuli that you associate with danger in tiny, incremental steps. References to these eventually helps you become less sensitive to them, breaking the negative associations. Each of the feared stimuli is ranked according to the intensity of anxiety you feel when you experience it, and is well-known as a treatment for posttraumatic stress disorder. This is called the fear hierarchy. Stimuli on the fear hierarchy are presented in one of three ways: graded exposure, systematic desensitization, or flooding.

Flooding. Flooding is a way of presenting a feared stimulus, beginning with those that cause you the most anxiety at the top of the fear hierarchy. As you continue this intervention, the most anxiety-provoking stimuli begin to cause less anxiety and it moves away from being a feared stimulus. (Implosive therapy is a similar approach).

Graded Exposure. In graded exposure, the fear-inducing stimuli are presented to you, starting with the ones that cause you the least fear. For example, if you feel extreme anxiety when you have to fly on a plane, your therapist might begin by taking you to sit in an empty plane on the ground. Next, they might have you sit in a plane full of people. Eventually, they'll increase your exposure until you're able to take a flight without significant fear.

Systematic Desensitization. Systematic desensitization combines either flooding or graded exposure therapy techniques with relaxation techniques and relaxation exercises. Because you are more relaxed before and during the exposure, the sights and sounds that you once associated with fear become more associated with a state of relaxation.

Types of Exposure Therapy

There are several variations of exposure therapy, each of which uses its own unique methods to help people overcome mental health challenges.

• In Vivo Exposure Therapy: Vivo exposure takes place in the actual location where you typically feel distress. The example about a fear of flying mentioned earlier is an example of in vivo exposure therapy because it happens inside an airplane that was provoking fear in the patient.
• Imagined Exposure Therapy: With this method, you're not exposed to stimuli you perceive as dangerous. Instead, you imagine being exposed to it in great detail. This helps you confront the fear and overcome it. Imagined exposure therapy is especially helpful for unusual fears or fears based on specific incidents.
• Interoceptive Exposure Therapy: Interoceptive exposure helps you have the physical experience of the feared stimuli without actually being exposed to it. In the case of panic disorder, for example, patients are asked to exercise vigorously to induce the physical sensations of a racing heart and difficulty breathing. The more they are exposed to this set of sensations, the less anxious they become when they feel similar sensations during a panic attack.
• Virtual Reality Exposure Therapy (VRET): Virtual reality exposure presents the stimuli you associate with life-threatening situations through computer-generated sights and sounds. The exposure may occur via a desktop computer display, virtual reality technology, or what is called a "CAVE environment" – a cube-like compartment where projectors and audio equipment provide the stimuli.
• Prolonged Exposure Therapy For Treating PTSD Symptoms: This has successfully helped people who suffer from PTSD (posttraumatic stress disorder) due to combat experiences and other life-threatening situations. Because the traumatic event caused great fear, avoidance of situations that are reminders of that event may cause distress. This type works to decrease avoidance.

Benefits Of This Therapeutic Method

Exposure therapy is a powerful tool to help with anxiety and fear-based mental conditions by working to decrease avoidance of the fear. For individuals living with these issues, it has many important benefits.

• Becoming Less Sensitive: The sights and sounds in your environment can cause you deep distress if they make you think that danger is near. However, when you're exposed to these stimuli, you become used to their presence in your environment.
• Weakening Fear-Provoking Associations: Another way exposure therapy helps relieve fear is that it breaks previous associations between stimuli and negative outcomes. Through exposure therapy, your mind and body begin to react to those sounds for what they usually are-normal, everyday noises.
• Learning to Coexist With Fear When Needed: Even if exposure therapy is successful, there will always be situations where it's natural to feel anxious. Sessions may include helping you learn to accept fear when it's natural and understanding how to live with fear without becoming paralyzed or panic-stricken (especially when living with a panic disorder).
• Understanding Your Power: Anxiety happens most often when you feel you have no power to protect yourself or overcome challenges. During exposure therapy, you can learn that you do have control over your thinking or thoughts, not to mention your physical reactions to your environment.
• Reducing Anxiety: After successfully completing exposure therapy, you feel far less anxious. This happens when you're faced with the stimuli you have become less sensitive to through the course of treatment.
• Improving Daily Functioning: If you're prone to obsessive-compulsive behavior, you may not be able to get to work on time because you're overwhelmed by the fear you associate with not going through a set of ritualistic behaviors. However, after exposure therapy, these self-care and survival tasks become easier and more manageable to live with obsessive compulsive disorder.
• Increasing Social Skills: Many people have anxiety in social situations because they feel they are not good at relaxing around other people or contributing to conversations in interesting ways. By learning to manage this anxiety during sessions and with relaxation exercises, you can become more relaxed.
• Decreasing Symptoms Of Mental Disorders: Exposure therapy can help you decrease the symptoms of mental disorders like panic disorder, generalized anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder (PTSD). As your symptoms decrease, you'll begin to feel more in tune with the people around you and the reality of your situation.

Can Exposure Therapy Help Me?

You can do things on your own to help lessen your fears or anxiety, such as relaxation techniques and acupuncture. But it's important that you're being safe with your body, mind, and brain in a safe environment with wellness professionals, even if it's a one session treatment. If you decide to try new treatments like this one, take it slow. You need to be able to wrap your mind around what's happening, so you will be able to process your feelings in a healthy way.

You might find that you need a little extra help from a counselor. Therapists can work with you to find an approach that works best for you and provide you with helpful information relevant to you. Research has proven treatment to be successful and is well worth looking into to help you feel better and get back into life. 

BetterHelp Can Support You

If you're still wondering whether exposure therapy is the right option for you, you can get the answers you need by talking with a counselor on BetterHelp. Online therapy is a convenient, hassle-free way to get help on your own terms, wherever you are or wherever you feel comfortable. Beyond that, evidence shows that online therapy is "effective, acceptable and practical" to improve mental health needs (see this study for more). Below are some reviews of BetterHelp counselors from people experiencing similar issues.

Counselor Reviews

"Dr. Broz is a brilliant, kind-hearted woman. She listens to everything I have to say and responds promptly. We're in contact constantly with each other. Her worksheets are very helpful and I'm starting to work my way towards being able to better handle my anxiety and panic attacks. She is very relatable and often chimes in with stories of her own that relate to what I am experiencing as well. I would definitely recommend Dr. Broz to anyone in need of help or someone to talk to."

"Kara has provided a safe environment for me to express my fears and anxiety. She has provided me tools to help manage my anxiety and continues to support me."

Conclusion

Exposure therapy is a process that can help lessen the symptoms of many different types of conditions. When used properly, it can take fear and stress out of situations that may have troubled you in the past. If you're living with extreme fears that affect your daily life, contact BetterHelp now, so you can start to feel like yourself again. With the right tools, it's possible to have a fulfilling life that's free from fear. Take the first step today.

Frequently Asked Questions

What is exposure therapy and how is it done?

There are a few different techniques used during exposure therapy work. These include: In Vivo exposure, Imagined exposure, Interoceptive exposure, Virtual Reality exposure (VRET), and Prolonged exposure for PTSD. All of these are widely considered effective therapies for a specific phobia or long-held beliefs as well, like a spider phobia or fear. Make sure this treatment takes place in a safe environment when using exposure techniques with an exposure therapist.

Is exposure therapy a form of CBT?

Yes, this type of therapy is part of the greater cognitive behavior therapy family. Sometimes it is beneficial to talk to your primary physician or read peer reviewed studies before starting this therapy. Additionally, while there are huge treatment gains, you want to ensure a significant reduction in trauma, not having further trauma from treatment that might exacerbate symptoms of social anxiety.

How long does it take for exposure therapy to work?

Compared to other methods, exposure treatment works on a quick timeline, with results appearing within a few weeks or few months. Full treatment usually takes between five and 20 sessions, depending on a variety of factors, like the issue the client is looking to make progress on, the person's openness to change, and the person's overall self efficacy.  

Does exposure therapy help anxiety?

Yes, it can be helpful to treat anxiety disorders and social anxiety disorders. After undergoing this type of cognitive restructuring and emotional processing therapy, about 60-90 percent of people had either no symptoms or mild symptoms of their original anxiety disorders following completion of the therapy plan, according to EBBP.org. This type of exposure and response prevention could be a breakthrough when it comes to people who are overwhelmed or uneasy — or experiencing nervous thoughts, like many others who seek cognitive therapy. 

What can I expect during exposure therapy?

An exposure therapist will help the client or patient learn to create new understandings about their fears — whether those are objects, activities or situations — so they can become more comfortable confronting those fears in their day-to-day real life. This is why repeated exposure therapies for specific fears can be so effective, as it can target their fear head on. Clinical psychology has also found that approach can also be effective in targeting depression. But you should know that, without a doctor present in the process, you will not be prescribed medication specific to this approach. This is a great approach when working through social anxiety disorder, or when figuring out how social anxiety disorder impacts your life.

It's worth noting that sleep directly after a session of exposure therapy has been shown to be effective, according to this study. Studies like this one and research in clinical psychology show that this approach will play out a little differently in everyone in real life.

Can exposure therapy make anxiety worse?

The effectiveness of exposure therapy for anxiety will depend on each person's situation and existing levels of worry, but is focused around treating anxiety so often it will decrease anxiety levels. It's best to consult with a therapist to understand how this type of therapy will affect you personally, and empirical evidence shows being in a safe environment leads to the most effective treatment and progressive muscle relaxation .

What is exposure therapy called?

While many call it simply "exposure therapy," it's official name is Exposure and Response Prevention. It uses imaginal exposure and in vivo exposure to help the client move forward in life, especially when it comes to confronting fears. It targets a person's fear response to make lasting change. 

Is EMDR exposure therapy?

They are the not the same, but they do have similar elements at their core. But with EMDR therapy, the patient is not re-exposed to the original trauma or fear.

Is exposure therapy a psychotherapist?

It's a type of behavioral therapy that provides help for people experiencing fears/phobias or anxiety disorders. It can be undertaken with a psychotherapist — or specially trained exposure therapist. Not only does it aim to ease existing fears or phobias, working with psychologists can help you build important coping skills for the long term.