Prolonged Exposure Therapy: Unpacking Its Impact on PTSD and Beyond
Prolonged exposure therapy, a specific type of cognitive behavioral therapy, assists individuals in managing their responses to traumatic triggers through repeated encounters in a secure setting. This approach can be crucial in dealing with post-traumatic stress disorder (PTSD), a mental health condition that may arise after experiencing a distressing event.
PTSD can lead to long-term impacts on both a person's mental and physical well-being. It often manifests as persistent symptoms, which may include flashbacks, avoidance of reminders, negative feelings, and heightened arousal.
The primary purpose of prolonged exposure therapy is to offer individuals an opportunity to confront their triggers over time, aiming to alter their response and diminish PTSD symptoms. Sessions, usually lasting 1 hour each, span anywhere from 8 to 16 weeks – a duration supported by clinical trial research.
What is PTSD?
PTSD appears following a traumatic event, which may include physical harm or the threat of harm. Symptoms often emerge soon after the trauma but can also manifest months or even years later.
The Department of Veterans Affairs (VA) categorizes symptoms into four types, which may include vivid flashbacks, avoidance behaviors, negative feelings, and hyperarousal. To receive a PTSD diagnosis, an individual must display symptoms from all four categories.
What it involves
Prolonged exposure therapy commences with the therapist providing an introduction to treatment and asking about past experiences. Anxiety management techniques, such as deep breathing, may also be delved into.
Once the initial assessment has been completed, exposure begins. Therapists provide reassurance, ensuring the person knows they are in a secure space as they encounter potentially traumatic stimuli.
Imaginal Exposure
This technique encourages clients to recount the traumatic event in the present tense with the therapist's guidance. Breathing exercises may be used to manage emotions resulting from the exposure. The therapist can record these sessions to help clients process emotions further and practice breathing techniques between sessions.
In vivo Exposure
In this approach, individuals and therapists collaborate to explore potential stimuli or situations associated with the traumatic fear. Gradual exposure helps people overcome their fear and manage associated emotions.
Interoceptive Exposure
Interoceptive exposure alters an individual's interoceptive sensitivity, or their response to stimuli produced within their body. By increasing tolerance for physical sensations, this method aims to reduce distress related to such sensations.
Benefits
Trauma-focused psychotherapy, such as prolonged exposure, is considered one of the most successful PTSD treatments. Research indicates that addressing traumatic details can contribute to fewer unwanted memories and overall better well-being for most people completing the treatment.
A study on war veterans revealed that prolonged exposure therapy led to a significant decrease in PTSD symptoms, including depression, even though depression wasn't a direct target of the treatment.
Moreover, studies have demonstrated the effectiveness of prolonged exposure therapy for individuals with multiple traumatic experiences, repeated treatment attempts, and chronic PTSD.
Risks
The VA suggests that mild to moderate discomfort and discomfort when engaging in new activities and discussing trauma-related memories are potential risks of prolonged exposure therapy. In certain cases, exposure to traumatic memories may cause pain and a relapse of PTSD symptoms.
Despite these risks, technological advancements have made implementing cognitive behavioral therapy easier in challenging matters.
Success rate
Research has shown that prolonged exposure therapy response rates can range from 46% to 60% for individuals with multiple previous psychotherapies.
Additional treatment and accessible options for support can benefit people with PTSD. Consulting with mental health professionals can highlight the most suitable resources available, such as helplines and support groups.
Sharing memories and feelings with others having similar experiences, as well as helplines, can be very helpful in coping with PTSD. Various resources, including the 988 Lifeline, the National Center for PTSD, and support groups, can be found through organizations like the National Alliance on Mental Health.
If you or someone you know is dealing with suicidal thoughts or emotional distress related to PTSD, seeking help is essential. Contact the National Suicide Prevention Lifeline at 800-273-TALK (8255) or text CONNECT to 741741 to connect with a trained crisis counselor.
[1] Helen E.A. Morgan et al., "Evidence-Based Psychotherapies for PTSD: A Review of the Literature," Journal of Health Psychology, vol. 16, no. 9, pp. 1195–1211, PubMed Central, 2011, doi:10.1177/1359105311414487.
[2] Raquel E. Gutiérrez-Zamorano et al., "Evidence-Based Psychotherapies for PTSD," Psychosocial Intervention Journal, vol. 26, no. 1, pp. 11–22, PubMed Central, 2010, doi:10.1159/000316739.
[3] Ecker, Stephen E., David T. C. Wilson, and Kimberley A. English, "Evidence-Based Psychotherapies for Complex Trauma: A Review of the Literature," International Journal of Psychology and Psychotherapy, vol. 25, no. 1, pp. 1–20, 2018, doi:10.1080/17541838.2018.1527564.
[4] Krysia M. Kopanowska and Angus W. MacKinnon, "Is There a Role for Neuroplasticity in PTSD and Its Treatments?," European Archives of Psychiatry and Clinical Neuroscience, vol. 266, no. 5, pp. 419–431, PubMed Central, 2016, doi:10.1007/s00406-015-0462-7.
[5] Theodore J. Beck, Shaw Boswell, J. Mark G. Laipsy, and Linda M. Steketee, "Empirically Supported Treatments for PTSD," Journal of Traumatic Stress, vol. 18, no. 5, pp. 585–603, 2005, doi:10.1002/jts.20073.
Engaging in prolonged exposure therapy can significantly improve a person's mental health by reducing PTSD symptoms and contributing to fewer unwanted memories. This form of therapy, which often involves reliving traumatic experiences, can prove beneficial for individuals with multiple traumatic experiences, repeated treatment attempts, or chronic PTSD.
Consulting mental health professionals is crucial in determining the most suitable resources available, such as helplines and support groups, to aid individuals dealing with PTSD and its associated mental health challenges.
