Anxiety disorders can be debilitating. Traditional therapies like cognitive-behavioral therapy (CBT) have long been the gold standard for treating anxiety disorders. One sub-approach of CBT, exposure therapy, is traditionally used in people with phobias. But does exposure therapy really work for anxiety?
What is exposure therapy?
Exposure therapy is a psychotherapeutic approach designed to help people confront their fears. Typically, exposure therapy is used in cases of panic disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), phobias, and anxiety disorders. Its underlying principle is simple: by gradually exposing a person to the source of their anxiety in a controlled and systematic way, their fear response will diminish over time.
Ultimately, the client will stop their avoidance behaviors and be able to enjoy a more fulfilling life.
How exposure therapy works
Exposure therapy has several systematic steps:
Assessment and preparation
The therapist first assesses the person’s anxiety and identifies their specific fears and avoidance behaviors. Together, they develop a list of feared situations, ranked from what causes the least to the most fear.
Gradual exposure
The client is gradually exposed to the situations, objects, or ideas they’re afraid of, starting with the least threatening. This exposure can be in vivo (real-life situations), imaginal (visualizing the feared situation), or interoceptive (inducing physical sensations associated with anxiety).
Response prevention
During exposure therapy, the person is encouraged to resist the urge to escape or avoid the situation. This is critical as it helps break the cycle of avoidance that reinforces anxiety.
Habituation and extinction
With repeated exposure, the individual’s anxiety response diminishes through habituation (getting used to the fear) and extinction (unlearning the fear response).
How exposure therapy treats anxiety
Cognitive restructuring
Exposure therapy helps people challenge and change their irrational beliefs and catastrophic thoughts associated with their fears. By confronting these fears, they gather evidence that contradicts their anxious thoughts. For example, if someone has social anxiety, their exposure therapy might involve gradual exposure to social situations (real or imagined in the therapist’s office). Over time, they’ll learn that their fears of embarrassment or rejection often have no basis.
Increased self-efficacy
Successfully confronting fears will boost a person’s confidence in their ability to manage anxiety. They will have better emotional regulation and control over how they handle stressful situations that once felt paralyzing. Ultimately, this makes a person feel more self-confident and resilient. For example, a person terrified of public speaking will feel more confident after successfully giving several presentations. This sets them up to succeed in their career and social life.
Emotional processing
Exposure therapy allows people to process their fear in a safe environment. They can replace their previous fear with new, non-threatening experiences and feelings. For example, a person with PTSD can gradually process their traumatic memories, which the emotional impact those memories have on their present life. The same goes for a person with anxiety, especially if their anxiety is rooted in some level of trauma.
Potential drawbacks
Despite its effectiveness, exposure therapy is not without challenges. One of the main concerns is that it can be distressing at first. Confronting fears head-on can provoke intense anxiety, which may discourage some people from continuing treatment. With incomplete exposure, a person might actually reinforce their fear rather than diminish it. Also, exposure therapy might not be suitable for everyone.
People with severe trauma, certain medical conditions, or co-occurring mental health issues might need a different tailored approach. This is why it’s important to have a proper evaluation and guidance from a good therapist.
Getting help
No one should live with anxiety forever. Whether you’ve tried other therapy approaches or you’re just now looking into them, consider whether exposure therapy or ERP could be right for you. Connect with a therapist who can discuss your treatment options with you and develop a plan.
To find out more about how exposure therapy can heal your anxiety, contact us to schedule a free 15-minute phone consultation.
