Those with anxiety often have their fear take hold of them. When this occurs, it can cause them to shut themselves off from the outside world. Paranoia can be isolating and cause the sufferer to withdraw from daily life, thus worsening the problem. However, there is a way out and that is through a psychological technique called exposure therapy.
Exposure therapy helps patients become aware of their fears and find ways to overcome those fears in a safe space. We’re going to explore exposure therapy and understand how it might be beneficial for those with panic disorders.
What are the Types of Exposure Therapy?
While it was common in the past for exposure therapy to be an incremental increase in subjecting the patient to experiences and places that trigger anxiety, now these experiences occur in the safety and security of a therapist’s office.
Certain kind of exposure therapy now doesn’t have to occur in the actual world, but rather in the minds of the patients as well as utilizing technology. ¹ The four techniques are:
1.) In Vivo Exposure
In vivo exposure is an approach to exposure therapy that involves the patient facing their fears directly in reality. That may mean that the patient is approaching the thing that they fear most in their day-to-day life.
Oftentimes this occurs in the real world, without any limitations holding them back. Of course, with any treatment option, there are drawbacks.
In vivo exposure has a particular drawback, which is facing the fears without a safety net. In vivo exposure, therapy occurs in stages, with the fear being exposed gradually. It may be too overwhelming to directly face fears and feel safer for a patient to gradually be exposed. ²
For example, for those that are claustrophobic, an in vivo method may be subjecting the patient to a crowded elevator ride. Or for a patient that is fearful of heights, it may require the patient to experience rock climbing.
In vivo exposure is a direct way for those to overcome that particular fear.
2.) Imaginal Exposure
Trauma is often experienced at the moment and buried for the end of time. However as it lays there, the remnants of the memories come back to haunt us months and years later.
Trauma morphs and manifests itself into anxiety and paranoia. When left untreated for too long, it can result in devastating stagnation.
Imaginal exposure may seem like making up stories to try and get over the pain, but it’s actually digging up trauma. Sharing such trauma in detail with a trusted mental health professional can create a real change.
Imaginal exposure gets its name from reimagining the traumatic experience and airing it out either in a verbal or written form. They are then expected to reread these experiences. By rereading, the patient confronts the very thing that they are fearful of. Most times what this accomplishes is a recontextualizing of fears. By recontextualizing, the patient comes to terms with what these fears are. From there they are able to take charge against the paranoia. ³
3.) Interoceptive Exposure
Another approach is interoceptive exposure. This method manifests physical panic symptoms that occur during a panic attack. This allows the patient to experience and learn to work through these symptoms. ⁴
Interoceptive exposure can be intimidating for a patient who has suffered from their disorder for a long time as they often don’t want to willingly manifest their symptoms on a whim.
However, this form of exposure therapy can be very therapeutic. Coming to terms with these sensations and overcoming them in a safe space can make it easier later on when an actual panic attack occurs.
For example, if a patient often experiences shortness of breath during a panic attack, they may be shown certain breathing exercises that can simulate hyperventilation while also controlling said experience for the patient.
4.) Virtual Reality Exposure
One of the more recent innovations in exposure therapy techniques is utilizing virtual reality (VR) to simulate triggering situations or occurrences in order to place the patient in a place that is uncomfortable while still physically being in a safe space. VR has revolutionized the way in which triggers are explored and treated.
VR exposure therapy has been extremely helpful for those struggling with military PTSD. The VR environment can simulate a battlefield, an ambush, or even just the villages where veterans have had traumatic experiences. Recreating these memories through photorealistic depictions, forces those veterans with PTSD to relive these moments and recontextualize them while also actively discussing their reactions in real-time with a counselor they trust. ⁵
What Disorders Can Exposure Therapy Help With?
Exposure therapy is an effective treatment option for those with post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and agoraphobia. By identifying specific triggers and forcing the patient to confront them head-on, the process can create coping mechanisms.
For patients who have experience as first responders or veterans, exposure therapy can recontextualize past situations. Exposure therapy allows those that often ignore or avoid dealing with past trauma and anxieties opportunities to place themselves back in the mindset of those triggering experiences or situations and gain control.
What are the Benefits of Exposure Therapy
Those that have undergone exposure therapy have shared the benefits they believe they have gotten from the various different approaches. Many share an ability to have more control over their anxiety, an awareness of how a triggering event or place affects their mind and body, and specific coping techniques they have created to utilize in real time whenever a trigger comes about.
Those with anxiety, paranoia, or trauma find that they understand themselves better and are able to adequately recontextualize a situation that might’ve been uncomfortable in the past. The largest benefit that is widely shared by patients is having better confidence in themselves to not only face their fears but also to have the ability to not have their fears control them.
What Does the Research Say?
Exposure therapy has shown great promise for those suffering from anxiety disorders and panic disorders. Its been a revolutionary therapeutic approach for those with PTSD, especially in those with combat or military PTSD and certain specific socialization disorders, like social anxiety or agoraphobia. ⁶ ⁷ ⁸
By confronting and recontextualizing anxieties and panic-related triggers, a patient has better outcomes in gaining control over their lives, socializing with others, and modifying behaviors.
There is also evidence that exposure therapy allows those to eliminate anxieties altogether. Success rates of exposure therapy options have shown that it should be utilized as a first-line treatment for most anxiety and panic-related disorders as it can help those who are isolated from their worries to lead healthier and more fulfilling lives. ⁹
Things to Consider
Exposure therapy is not always the best approach to confronting anxiety. In certain cases, exposure therapy could be detrimental to the development of a patient’s ability to cope with certain anxiety and panic-related issues. Exposure therapy can be an overwhelming and burdensome experience and can actually be the antithesis of strengthening one’s own ability to create coping mechanisms in an environment that is panic-inducing.
For those patients that are experiencing difficulties with exposure therapy, another therapy option might be necessary. Specific options could be Utilizing medication, group therapy options, or cognitive behavioral therapy, an approach that creates coping mechanisms without subjecting the patient to an environment that could be triggering.
Each and every patient is different, their treatment path will differ, and their avenues to therapeutic success also very. The best thing for patients is to be open and honest with mental health providers as well as support teams to find the best avenue for success possible.
Anxiety can be consuming, it can swallow you whole and cause you to close yourself off from the outside world. If you find yourself a prisoner in your own life, drowning in anxiety and paranoia, exposure therapy may be the right avenue to explore in order to find health, happiness, and a new lease on life.
No matter what approach works for you, finding the right treatment plan with the right support group can make a world of difference. if you or someone you love is struggling with their mental health, the time to reach out is now. The longer one waits, the longer one suffers.
Do you still have questions about what exposure therapy is?
We invite you to ask them in the comments section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.
¹ American Psychological Association: What is Exposure Therapy?
² American Psychological Association: In Vivo Definition
³ OCD Center of Los Angeles: Imaginal Exposure Definition
⁴ PsychTools: Interoceptive Exposure Therapy Understood
⁵ BrainLine: Virtual Reality Exposure Therapy Explained
⁶ ResearchGate: Review of Exposure Therapy – A Gold Standard of Treatment
⁷ American Psychological Association: Exposure therapy for social anxiety disorder
⁸ National Library of Medicine: Coping Skills and Exposure Therapy in Panic Disorder and Agoraphobia
⁹ Psychiatric Times: Exposure Therapy for Anxiety Disorders