Prolonged Exposure Therapy - Achievable Ways to Overcome Trauma-Related Fears
Prolonged Exposure Therapy (PE) is considered one of the most effective therapies for PTSD.
Prolonged exposure therapy works by helping you face your fear in small steps and thereby reducing your anxiety. This allows you to meet your fear gradually and build up your confidence. This technique has helped many people with anxiety disorders, especially post-traumatic stress disorder (PTSD). This post is part of the therapies for PTSD series.
Edna B. Foa developed Prolonged Exposure. The American Psychological Association strongly recommends it for treating PTSD.
The treatment consists of two components that work in tandem:
- Imaginal exposure, the talking part
- In vivo exposure, the doing part
The essence of imaginal exposure is to talk about the traumatic memories to process them and make them more manageable.
You do this with a therapist. Together you find a specific or typical memory you want to process. A specific memory can be something very concrete that happened once. A typical memory can be something you have experienced several times. The therapist doesn't judge how "true" your memory is. The most important is that your feeling is valid.
When you are ready, you start to talk about the traumatic memory. Again, the therapist will be guiding you through the story. And when you have finished up, you might begin to tell the story one or two more times in the same session. This is called traumatic exposure.
One thing that distinguishes prolonged exposure from other talk therapies is that you record the session. Yep, you heard me right. You bring your phone or another handy recorder and record the whole session. Listening to the recording is one of the primary keys to imaginary exposure. First, you go home and listen to the entire thing once. And then you listen to the traumatic exposure part every day. In my experience, this listening is both the most challenging part and the best part of prolonged exposure therapy.
In the In Vivo part, you find something that scares you.
First, you write a list of the scary things. Then you score them on a 1- 100 scale, where 100 is so frightening that you think you will die. 1 is not scary at all. Together with your therapist, you figure out what to work on first. You may start with a 40 or 50 challenge, not the 100!
1. You start with a small step - such as facing your fear in a safe place.
2. Once you have faced your fear, you move on to challenge yourself a bit more.
3. You repeat this process until you feel comfortable facing your fear.
4. Once you have reached this point, you can move on to facing your fear in the real world.
One key point is to face your fears so long that you reduce your discomfort in half, or at least half an hour. Exposure is highly effective in treating PTSD symptoms.
When you face your fear, you will find that you can think more clearly and calmly. You will be less likely to become anxious or panicky. The more you practice facing your fear, the easier it will become.
There are several ways to help you to practice facing your fear:
* Visualize yourself being in a situation that makes you afraid.
* Imagine how you would react if you were in the situation.
* Think about what you would say to yourself if you were in the situation and then replay these thoughts in your mind.
* Talk to someone you know is supportive and will not judge you.
* Talk to a therapist or a friend.
You may find that you can face your fear in small steps, and then one day, you will be able to meet your fear in the real world.
Prolonged Exposure therapy can help you overcome your fears.
Let's take a look at what prolonged exposure therapy is:
* It does not involve hypnosis or other forms of suggestion.
* It requires that you confront your fear and practice facing it every day.
* It does involve repetition. This technique is based on the idea that you will eventually become desensitized to it if you repeat something often enough.
* It does NOT involve "cognitive restructuring." E.g., you will not try to change your thoughts about your fear.
* It does take time. Even though you can use this technique to help you overcome your fear of spiders, it is not a quick fix. It is a long-term process.
Prolonged exposure therapy is a method for helping you overcome your fear of a particular object or situation. To understand how this technique works, you must understand what happens when you experience anxiety.
When you experience extreme fear, your body goes into fight, flight, freeze, or flop mode. Your body reacts as if you are under attack. Fight and flight mode forces your heart rate to increase, your blood pressure to rise, and your breathing to become shallow. These reactions make it difficult for you to think clearly. In addition, your muscles tense up, and your body begins to sweat. All of these reactions cause you to feel uncomfortable.
Because of these reactions, you may feel afraid or anxious. However, you do not feel comfortable enough to face your fear. So instead of facing your fear, you avoid it.
As a result of avoiding your fear, you may begin to suffer from anxiety. In addition, avoiding your fears can lead to various problems, including panic attacks, depression, and substance abuse.
Prolonged exposure is a technique that helps you overcome your fear by gradually exposing yourself to the feared situation.
How does prolonged exposure work?
Let's have a look at what happens when you experience a phobia. When you experience a phobia, your body reacts as if you were experiencing a physical threat.
For example, if you fear spiders, your body responds as if you were under attack. Your heart rate increases, breathing becomes shallow, and muscles tighten up. In addition, your mind begins to focus on the danger. Finally, your mind might tell you that you will die and you have nowhere to run.
If you fear spiders, you are not likely to overcome your fear simply by avoiding it. You need to control your anxiety, not just prevent it. And this is why prolonged exposure is so helpful in treating PTSD and trauma-related fears.
Prolonged Exposure Therapy involves gradually exposing yourself to your fear. You start by facing your fear in small increments. Then you gradually increase the amount of time you spend in the situation. This process continues until you can tolerate the case for more extended periods.
As you continue to expose yourself to your fear, your anxiety decreases. Now you are learning how to control your fear.
The following steps will show you how to apply this technique to your fear of spiders.
1. Identify your fear
You need to identify your fear so that you can understand it better. For example, if you fear spiders due to a physical reaction, you should ask yourself why you are afraid. For example, suppose you have a phobia of spiders because of a panic attack. In that case, you should ask yourself what caused the panic attack.
2. Understand your fear
Once you have identified your fear, you should try to understand it. First, try to figure out why you are afraid. For example, ask yourself why you would be frightened of spiders.
3. Identify your triggers
Next, you need to identify your triggers. Triggers are the situation that causes you to feel your fear. For example, suppose you are afraid of flying because of a panic episode. In that case, you should identify what situations make you feel frightened?
4. Find a way to handle your triggers
After identifying your triggers, you should find a way to handle them. For example, if you are afraid of spiders because of a panic attack, you might want to learn how to control your panic attacks. You might also want to talk to a therapist or coach who can help you cope with your panic attacks.
5. Practice your new skills
Now you should practice your new skills. This means that you should face your fear in small increments. For example, a friend of mine didn't like a spider picture inside a book. So she took a piece of paper to cover the spider. Then she taped one of the sides. This way, she knew the spider was there. Now she could open the cover and look at the spider now and then. The next step would be to remove the cover. And the next step might be to ask someone to find a Youtube video with a tiny spider. This way, she would gradually be less afraid of spiders.
6. Get some support
Finally, it would help if you got some support. Friends or family members can be great supporters, and you might also want to see a therapist or coach.
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