Exposure Treatment for Anxietyby Jerry Kennard, Ph.D. Medical Reviewer
Exposure therapy is a tried, tested and effective method for reducing anxiety. The principles are very straight forward. By gradually and repeatedly exposing the person to an anxiety-provoking situation, event or activity, anxiety gradually reduces. By starting with issues that provoke the least anxiety and gradually working up, the treatment builds on previous success.
The big problem with anxiety is that it makes us feel very uncomfortable. It is sometimes so distressing that the simplest way to reduce it is to avoid or escape the circumstances causing it. These are effective techniques but it means people never give themselves the chance to try something different. Importantly they also never give themselves the chance to overcome their anxiety.
Imagine yourself in a situation where a continued noise or smell is present. Over time you find this sensation becomes less and less noticeable. When questioned you find yourself saying 'what smell?' It's a process known as habituation and the same principles apply in exposure therapy. The more a person is exposed to an anxiety provoking situation the more they become accustomed to it. After a while, they no longer notice, or it simply fades into the background.
Exposure Therapy Approaches
There are in fact different kinds of exposure therapy. So-called situational exposure is the most common. Here the person builds towards confronting the problem that specifically affects them and has resulted in situational avoidance. But there are circumstances where entering a situation is too much to cope with. In this situation a form of exposure called imaginal exposure may be used. Imagining fears becomes the first step in confronting anxieties. A third type of exposure is particularly useful in people with health anxiety. Exposure to feared bodily sensations is a way of reducing the associated anxieties. For example the sensation of a rapid heartbeat may trigger anxiety that a heart attack is imminent. By bringing on these sensations in a systematic and controlled fashion it becomes clear that the associated fears are unfounded.
There are steps that need to be followed in exposure therapy and that will be the topic of my next post.