Wednesday, April 29, 2009

PTSD Treatment: Exposure Therapy

One of PTSD’s most extreme symptoms is our tendency (devotion!) to avoid anything and everything that reminds us of our trauma. However, avoidance only feeds our traumatic feelings and encourages us to continue to embrace and act upon them. Exposure therapy aims at ending that cycle once and for all. According to an article on Medical News Today exposure therapy has proven to actually intercept the progression of trauma survivors from Acute Stress Disorder to PTSD. Now that’s something to think about.

Very popular with all kinds of trauma and particularly the military, PTSD Facts For Health defines exposure therapy this way:

Exposure therapy is based on the principle that we get used to things that are just annoying and not truly dangerous. This is called habituation, and it occurs naturally in over 95% of people.... Exposure therapy is based on the idea that this kind of habituation must occur in the person who has been traumatized if they are to overcome PTSD. Exposure therapy asks patients to confront, in a safe way, the very situations, objects, people and memories they have attached to the trauma (and are probably very consciously avoiding).

Exposure therapy is the opposite of the typical, self-prescribed avoidance approach. Because while avoidance may provide temporary relief, it just doesn't last. Facing these triggers is the key to reducing the frequency and severity of PTSD symptoms.

Exposure may be done in vivo (in real life) or in imagination. In vivo exposure is more effective than imaginal exposure. While anxiety or other discomfort may get worse in the first few minutes of in vivo exposure, it is important to continue exposure until the discomfort has diminished. Escaping discomfort only reinforces avoidance as a coping tactic, and produces all the limitations associated with avoidance—like avoiding safe places or situations that might be fun, beneficial or essential for a career and a full family life. It also increases the likelihood that the anxiety might spread, first to similar triggers and eventually to triggers that have little or nothing to do with the original anxiety. Examples of exposure in vivo are resuming driving after being in a traumatizing accident or returning to a now-safe site where an assault once occurred.

Exposure in imagination involves the person recounting traumatic memories until they lose their sting. This can be done by saying them aloud repeatedly, writing, reading and rewriting a biography of the events or recording them on a tape and playing them over and over until they are no longer distressing.

For further investigation, some interesting links:

A Soldier’s Mind: Exposure Therapy For Treating PTSD

If you’ve experience imaginal or in vivo exposure therapy leave a comment, share your thoughts so that we all can learn.

(Photo: EOS boy)

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