What is Exposure Therapy?

​

Exposure therapy is a behavioral treatment approach that involves coming into contact with the things that make us anxious, in a controlled and safe way. When we are afraid of or worried about something, our tendency is to avoid that issue. While in the short term, avoidance makes us comfortable because we do not have to face the thing that makes us fearful. However, in turn, the fear that results from it only reinforces our fear. This makes it more difficult to face. By exposing ourselves to the situations that produce anxiety, over time we can decrease our fear. This allows us to become better able to endure anxiety-provoking situations with more comfort.

 

Who is Exposure Therapy Helpful For?​

​

Exposure therapy has been shown to be helpful for a number of concerns, including social anxiety, phobias, panic disorder, OCD, generalized anxiety disorder, trauma, and PTSD.

​

How does Exposure Therapy Work?

​

Exposure therapy in Madison, WI can look a number of ways depending on the person and what their concern is. Typically, it begins with an assessment, education, and the creation of a hierarchy. A hierarchy is created in collaboration with the therapist and involves identifying the fears. We then begin rating them from 0-10 or 0-100 depending on how much fear they induce. Most often, one moves at a pace that is comfortable for them up the hierarchy toward the most feared situation. Through exposure therapy for anxiety and other phobias, one learns that the things they feared about the situation are not likely to occur.

 

Exposure therapy also works through habits, in which one’s anxiety levels naturally go down the more they are in contact with what they are afraid of. Exposure therapy can be in vivo (directly facing the feared situation or thing), imaginal (thinking about being in contact with the feared object or situation, especially when direct exposure is impossible or unsafe), virtual (such as through flight simulators), or interoceptive (creating physical symptoms that mimic panic or anxiety, such as by spinning in a chair to bring about dizziness).

 

An Example: Dog Phobia

​

Let’s imagine somebody who has a phobia of dogs, either because they were bit as a child, because of cultural reasons or any other reason. This person likely avoids dogs because they are afraid that something bad might happen, such as getting bit. This avoidance is reinforced because when they avoid dogs, they do not have to experience the fear that comes with it. When this person comes into therapy, they will make a hierarchy with their therapist. This may look something like this:

​

10- Look at picture of a dog

20- Watch a video of a dog

30- Sit in a car outside of an animal shelter

40- Be 20 feet from a small, leashed dog

60- Stand outside of the dog park

70- Go to the animal shelter and sit in a room with a dog

90- Go inside the dog park and walk up to a group of play-fighting dogs

​

​This person will start at the lower end of their hierarchy, and as they gain comfort and confidence in facing situations at the lower end, they begin to build up toward the highest point. Over time, this person will habituate to their fear, increase their confidence related to being around dogs, weaken their association between dogs and what they fear happening. The goal is to learn new beliefs about what being around dogs is like. They may even begin to enjoy dogs! Overall, exposure therapy in Madison, WI is a highly effective, highly personalized form of treatment for a number of different concerns.