Exploring Prolonged Exposure Therapy for PTSD

“Prolonged exposure therapy targets the worst experience and allows the person to recognize that a memory can just be a memory. It allows people to increase their confidence and their competence to be able to handle the emotions associated with the traumatic event and allows them to function in world!”

Jennifer Burger, LPC: Deepwater Counseling Clinical Director trained in prolonged exposure therapy to treat post-traumatic stress disorder

It’s no secret that trauma can leave deep scars, affecting every aspect of a person’s life. Whether it’s the result of a single event or prolonged experiences, the impact of trauma on mental health can be profound. One of the most effective treatments for trauma-related conditions, particularly post-traumatic stress disorder (PTSD), is prolonged exposure therapy. A structured, evidence-based therapeutic approach, prolonged exposure therapy is designed to help individuals process their trauma and reduce the distress associated with it.

What is Prolonged Exposure Therapy?

Prolonged Exposure Therapy blends cognitive-behavioral and exposure therapy and focuses on helping individuals confront and process their traumatic experiences – from sexual assault to combat and everything in between. The objective is to gradually expose the person to trauma-related memories, feelings, and situations that they have been avoiding due to the intense fear or anxiety these triggers cause. By doing so, the intervention aims to reduce the power these triggers have over the individual, helping them regain control over their lives.

How Does Prolonged Exposure Therapy Work?

In the beginning, the therapist works to establish a sense of safety and trust, which is crucial for the client to engage fully in the exposure exercises. Over time, clients are guided through their hierarchy of fears and traumas, gradually increasing the intensity of exposure.

Prolonged exposure therapy typically involves four main components:

Psycho-education. The therapist educates the client about common trauma responses and the treatment philosophy. Understanding how trauma affects the brain and behavior is crucial for clients in order to engage fully with the therapy process.

Breathing Techniques. This phase of treatment helps clients learn to manage the physical symptoms of anxiety, such as hyperventilation, which are common reactions to remembering trauma. Learning controlled breathing techniques can provide a sense of calm and help reduce anxiety during exposure exercises.

Imaginal Exposure. In this stage, clients describe their traumatic experience in detail, repeatedly and out loud, during therapy sessions. This is done with guidance from the therapist, in a safe and supportive space. This recounting is recorded, and clients are encouraged to listen to these recordings between sessions to help further process their emotions (while practicing their breathing exercises to remain regulated). Imaginal exposure helps integrate the traumatic memory into their narrative, reducing its intensity and the distress it causes.

Real World Exposure. Also known as in vivo exposure, clients gradually confront situations, places, or objects they have been avoiding because they are reminders of the trauma. The goal during this stage is to help the client understand that these cues, or triggers, are not inherently dangerous and that avoidance only maintains fear.

Is Prolonged Exposure Therapy Effective?

Research has consistently shown prolonged exposure therapy to be highly effective in reducing the symptoms of PTSD. Numerous studies and clinical trials have demonstrated its efficacy across diverse populations, including combat veterans, sexual assault survivors, and those who have experienced natural disasters or accidents. The theory behind the therapy suggests that trauma survivors have unprocessed emotional responses to their traumatic experiences, which can be activated by reminders or triggers, which then leads to avoidance. For example, a sexual assault survivor may avoid dating or physical intimacy or a combat veteran might avoid attending a fireworks display. By confronting, rather than avoiding, these painful memories and cues in a controlled and systematic way, prolonged exposure therapy helps the brain process these emotions and reduces the automatic fear response.

Prolonged Exposure Therapy offers hope and healing for individuals grappling with the aftermath of trauma. By courageously facing and processing their traumatic memories, clients can reduce their symptoms, regain their quality of life, and move forward with renewed strength and resilience. If you’re interested in learning more or scheduling an appointment, contact us here.