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Exposure Therapy


Exposure Therapy is common treatment approach for trauma and certain types of anxiety.  In essence exposure therapy involves repeated exposure to the feared item, the theory being that with repeated exposure the anxiety/arousal will diminish.  Exposure therapy comes in two general types: in vivo and imaginal.  In vivo exposure is when you are actually exposed to the feared thing, such as a spider.  Imaginal exposure is when you think about and discuss the traumatic event.  In some cases exposure therapy uses a combination of both in vivo and imaginal exposure.


Systematic desensitization is a form of in vivo exposure that can be done with a phobia, such as fear of spiders or meeting new people.  Here the person gradually experiences increased exposure to the spider, with reduced anxiety at each exposure.  First the person might look at pictures of spiders, then videos of spiders.  Next the person might look at an actual spider that is in a cage, then watch someone holding the spider.  Finally the person is encouraged to actually hold the spider.  Eventually the person will experience considerably less anxiety when exposed to spiders.


Imaginal exposure therapy is a common modality in the treatment of trauma.  During such therapy the person is first taught how to relax in therapy.  The person then begins discussing the traumatic event in considerable detail.  In so doing the person experiences strong memories of the trauma, but while in a relaxed body.  Therefore, the person experiences less emotional distress when discussing the traumatic event.  Over time the person will begin to separate the memory from the emotional reaction to the trauma, and the emotional reaction to such memories will decrease.


Exposure Therapy is often helpful for people who have experienced sexual assaults, motor vehicle accidents, domestic violence, or physical assaults.  While the idea of talking about the traumatic event might worry some people, research and experience shows that most people can handle this process well.  It is important to remember that you control the pace of the exposure process., and that you can always stop an exercise at any time if you feel too uncomfortable to continue.

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