Exposure Therapy (ET)
Exposure therapy is a psychological treatment that helps people confront and reduce intense fear, anxiety, or distress related to specific situations, objects, thoughts, or memories. Extensive research indicates ER is highly effective for treating anxiety disorders,including specific phobias, PTSD, and panic disorder. The therapy involves gradually exposing individuals to feared stimuli in a controlled, supportive environment, therefore allowing them to experience and tolerate their anxiety without avoidance.
The primary goal of exposure therapy is to reduce avoidance behaviors. Exposure therapy operates on the principle of habituation: by repeatedly facing feared stimuli, the person’s distress decreases naturally over time as the brain learns to downregulate the fear response.
Key elements of exposure therapy include:
- Gradual exposure from less intense to more challenging situations.
- Repeated exposure to the anxiety-inducing event, whereby the person learns that anxiety decreases without avoiding or escaping. Consistent exposure helps retrain the brain, lessening the fear response.
- The person learns that they can handle the discomfort associated with the exposure, which replaces distorted beliefs, such as, “This is dangerous,” and improves the person’s ability to manage discomfort.
Exposure therapy may entail directly facing feared situations or objects in real life, like a person with a specific phobia approaching a feared object. This is called in vivo exposure. Imaginal exposure involves imagining distressing thoughts or memories in detail, usually employing a scenario that describes a situation and reading or listening to the scenario. There are also some fears that may be initially confronted using simulations, such as video or audio recordings. Interoceptive exposure is exposure to feared physical sensations, like increased heart rate, for individuals with panic disorder.
The person works with the therapist to determine the nature and pace of the exposures and the form, i.e., in vivo, imaginal, simulated, and interoceptive. By creating a structured, safe way to face fears, exposure therapy helps individuals reduce their symptoms and build resilience, ultimately increasing freedom and quality of life.
