What is exposure therapy?

Have you ever read about exposure therapy in relation to phobias and thought ‘What even is that?’ Well, to put it simply, it is proving to be one of the foremost effective approaches to overcoming fears and anxieties, and could be the pathway you have been looking for. 

At it’s core, it is a psychological, behavioural therapy which is designed to support people manage their fears and anxieties. When we are fearful of something, our instinct is to avoid it, which in the short term may alleviate our negative feelings. However, these situations will present themselves some day, and exposure therapy offers a pathway to be prepared for when it comes. It works to break the pattern of avoidant behaviour and the feelings of fear and anxiety.

To achieve this, individuals are exposed to the situation that causes distress, while in a safe and controlled environment. The exposures can vary in length, intensity and in the actions which are taken, so this approach is most commonly co-constructed with the individual and the professional. Exposure therapy is completely designed to reduce the irrational feelings assigned to a situation by an individual, through a supportive approach.

There are a few differing approaches which can be employed for exposure therapy, some of which may work for better than others, depending on the individual.

In vivo exposure is the act of directly facing up to the feared activity. There is no deliberate preparation for this, so if it is a fear of snakes, then that individual may be instructed to touch or pick up the snake. 

On the less intense side, there is imaginal exposure. This is the act of creating vivid imaginations of the thing which is feared. The control over imagining situations is key, as this will be with the patient. Recalling previous exposures and describing traumatic experiences are all part of this approach.

Then, there is an approach which is somewhere in between, which is the most favoured amoung mental health professionals. Graded exposure is where a psychologist creates a hierarchy, where the thing that is feared is ranked the highest, while things related to it are ranked less. They then begin with mild exposures to low ranked aspects and progress onto more challenging activities, before meeting the phobia head on. To learn more, read an earlier article on How exposure therapy works.

Exposure therapy has roots which can be traced back in the early 1900s, with work by behaviourists like Ivan Pavlov and John Watson. Their work looked closely at conditioning techniques to manipulate human behaviours. But the most interesting and pivotal was that of Mary Cover Jones, who managed to rid a young boy of his fear of rabbits. Using positive reinforcements and comfort food, his unwanted, learned response to a more positive, deliberate response during exposure to rabbits. From there, exposure therapy has continued to be researched and tested as a tangible approach to supporting those with a range of mental health issues, essentially desensitising their response to a wide variety of triggers.

There are a number of mental health issues which can be treated through exposure therapy; it’s versatility is one of the many positives to the approach. Those experiencing phobias, social anxiety, post traumatic stress disorder (or PTSD), obsessive compulsive disorder (or OCD) and acute stress and trauma-related issues are all currently treated with exposure therapy. While this will differ from person to person, the science demonstrates that it is a helpful component to treating patients and continues to be the preferred option, particularly for those with phobias. An article published in 2011 in the Psychiatric Times suggested that 90% of participants in a study has reported their anxiety level had reduced significantly.

Exposure therapy continues to demonstrate it’s relevance in the mental health field. It offers those suffering from phobias a pathway to overcoming their fears and taking control of their responses to their triggers. It is at the centre of the work which oVRcome is doing, and could be exactly what you need. Read more about exposure therapy through virtual reality.