“The only thing to fear is fear itself.” Was Roosevelt onto something in his attempts to encourage citizens to face the woes of the Great Depression? Recently, some clinicians have contended that exposure therapy can cause emotional harm to clients. Some have even asserted that prolonged exposure for PTSD can re-traumatize clients.
This is an understandable concern, especially when we want to help clients experience less anxiety. There is no doubt that exposure therapy can be difficult for clients (especially at first). But this claim has actually not been found in either clinical or research settings.
Exposure therapies are actually an effective way to reach the goal of less client anxiety (if counterintuitively)! Extensive evidence from both research studies and clinical settings have found that exposure is extremely effective for helping clients recover from anxiety disorders, OCD, and trauma.
Exposure therapies work by continually exposing an individual to what they fear. It’s classic “face your fears”. If “the body keeps the score”, exposure therapies help train the body to not try to continually engage in “score keeping”. That is, exposure therapy retrains the brain to not activate the body’s fight or flight response in response to feared situations that are not objectively threatening. And it provides a guided and safe way that actually leads to decreases in anxiety.
This helpful effect appears to be due to exposure modifying one’s set of beliefs about situations. The therapy appears to change one’s tendency to evaluate or appraise situations as threatening that are not actually threatening. Doing so actually leads to anxiety or fear decreasing more and more each time the client encounters that feared situation.
The individual comes to discover it is not necessary or even helpful to be afraid of fear or anxiety. So Roosevelt was onto something! Encountering cars after a car accident. Giving a speech. Allowing oneself to sit with obsessive thoughts. Or petting a friendly dog after a dog bite. None of these indicate impending doom or catastrophe.
Exposure also leads to large drops in anxiety in a relatively short period, improvements in functionality, improved attention when one is not weighed down by anxiety, and feeling “freed up” to be more present and enjoy current moments.
These therapies have been around for awhile. This means there are great trainings out there for exposure therapies for multiple anxiety disorders, OCD, and for exposure for trauma.
Anxiety and/or traumatic stress are constantly difficult experiences our clients with live with everyday. Exposure therapies are tried-and-true approaches. They help clients learn how to effectively navigate those experiences inside or outside the comfort of our offices.
