Currently there are different psychological techniques used to treat the most common anxiety disorders, such as phobias, social anxiety, post-traumatic stress or obsessive-compulsive disorder. One of the best known and best working is the exposure technique, a therapeutic method that uses different procedures to reduce the patient’s anxiety. What does it consist of? Is it as useful as suggested?
In this Psychology-Online article we are going to explain in detail what is the exposure technique in psychologywhat are its characteristics, as well as the most used variants and how it can help us overcome our anxiety problems.
What is the exposure technique?
The exposure technique is a type of therapeutic procedure used in clinical psychology to treat anxiety disorders. This technique involves confronting the patient with the feared object, context or thought to help them overcome anxiety symptoms.
This working method bases its effectiveness on the fact that the patient learns, based on prevent avoidance or escapethat the feared stimulus does not pose a real threat, which ultimately means that anxiety symptoms are reduced and end up sending. In other words, the exposure technique interrupts avoidant behaviors (which increase fear and anxiety) and makes it easier for the patient to cope with the psychophysiological and cognitive signs of the anxiety disorder.
A treatment related to this therapeutic technique is exposure with response prevention, a widely used method for the treatment of the patient is exposed to the stimulus that causes fear repeatedly, without being able to carry out any action or compulsion to neutralize his fear. This technique has also been shown to be effective in treating and some .
Objective of the exposure technique
The goal of the exposure technique is to create a safe environment in which the person can reduce anxiety, reduce the avoidance of feared situations and improve quality of life. It is believed that this technique could help patients in several ways; Let’s see how:
- Accommodation: Over time, people find that anxiety reactions to feared objects or situations decrease.
- Extinction: Exposure can help weaken previously learned associations between feared objects, activities, or situations and poor outcomes.
- Self-efficacy: Exposure can help show the client that he or she is capable of facing his or her fears and can manage feelings of anxiety. Here you will find more information about.
- Emotional processing: During exposure, the client may learn to bind new, more realistic beliefs about feared objects, activities, or situations, and may become more comfortable with the experience of fear.
Features of the exposure technique
There are several variations of the exposure technique and it is the psychologist who will determine which of them is the most effective or convenient for each particular patient. Let’s see which are the most common and their characteristics.
- Live exhibition. The live exposure technique is performed directly in front of an object, a situation or an activity that the patient fears in real life. For example, a person with a fear of cockroaches could be instructed to handle these insects with their hands, or someone with a fear could give a speech in front of an audience.
- Exhibition in imagination. Exposure in imagination, as its name suggests, involves vividly imagining the feared object, situation, or activity. For example, someone with post-traumatic stress disorder may be asked to recall and describe her traumatic experience to reduce feelings of fear and anxiety.
- Exhibition through virtual reality. In some cases, virtual reality technology can be used when live exposure is not practical or effective enough. For example, someone could take a virtual flight in the psychologist’s own office, using virtual reality equipment that provides the typical images, sounds and smells of an airplane.
- Interoceptive exposure. Interoceptive exposure involves deliberately causing physical sensations that are harmless, but at the same time feared by the patient. For example, someone who suffers from panic disorder might be instructed to run and speed up their heart, and thus learn that one’s feelings are not really dangerous and that it is nothing more than a physiological function of their body.
Additionally, exposure therapy can also be carried out in different ways. Let’s see what are the most used procedures:
- Gradual exposure: The psychologist helps the client construct a hierarchy of exposure fears, in which feared objects, activities, or situations are classified according to their difficulty. It is usually started with mild or moderately difficult exposures, progressing to more difficult exposures.
- Flood Exposure: It’s about using the exposure fear hierarchy to start the exposure with the most difficult tasks.
- Systematic desensitization: In some cases, exposure can be combined with to make the patient feel more manageable, and to associate feared objects, activities, or situations with feelings of relaxation.
Example of exposure technique
To understand better how the exposure technique is performed We are going to put an example. In our case, we will apply the technique to a person who has a panic disorder.
In these cases, the objective is desensitize the patient to psychophysiological symptoms that occur before and during a panic attack; It is also necessary to modify the beliefs and cognitive schemes that the person has about their own physical sensations through cognitive restructuring (a complementary technique to the exposure technique).
To address panic disorder, the most useful thing is to perform the interoceptive exposure technique: the symptoms of a panic attack are simulated in a controlled context in which the patient feels safe (for example, the psychologist’s office or any quiet space), so that the psychophysiological response is weakened (interoceptive conditioning) .
For 1 or 2 minutes, the patient is asked to run, move his head from side to side, or spin around in a swivel chair to make his heart race and the physical sensations and symptoms typical of an attack appear. of panic. This symptom induction It should be carried out until the patient no longer has anxiety symptoms and complete desensitization has occurred.
The exercises should be brief (between 1 and 3 minutes) and the person should assess the level and intensity of anxiety so that the psychologist can record the changes and improvements during the procedure. When the patient is already able to better control sensations In the more advanced phases of therapy, desensitization exercises can be carried out by doing more natural activities (for example, walking up the stairs in your home or playing your favorite sport).
Steps for exposure technique
To correctly perform the exposure technique, it is important to first determine what generates fear in the patient, and then a series of steps must be followed:
- First, a hierarchy from 0 to 100 (from minimum to maximum anxiety) with situations in which the presence of the feared stimulus may occur. For example, from hearing a bark from afar (the least anxiety-inducing situation) to having a dog in front of you and being able to touch and caress it (the greatest anxiety-inducing situation), in the case of fear of dogs.
- The patient is then asked to enter a state of deep relaxation. Once relaxed, you are guided to imagine scenes and situations in which the feared stimulus is present. This process is called systematic desensitization and is used to inhibit anxiety symptoms.
- In case the exposure in imagination is not useful enough, you can resort to the live exposure: confront the patient with the stimulus feared in its real form in controlled situations and ensuring that the approach is gradual (unless the flooding exposure technique is used, which abruptly confronts the person with the feared stimulus, without any option of escape).
- The number of sessions may vary from one subject to another and will depend on the intensity of the initial anxiety symptoms, as well as other psychological and contextual variables; Weekly sessions can be held between 30 minutes and 1 and a half hours, intersperse the exhibition with breaks, etc. The important thing is that the psychologist is the one who guides the procedure based on the patient’s needs.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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Bibliography
- Fernández, M. Á. R., García, MID, & Crespo, AV (2012). Manual of cognitive behavioral intervention techniques. Desclée de Brouwer.
- Marlatt, G.A., Parks, G.A., & Witkiewitz, K. (2002). Clinical guidelines for implementing relapse prevention therapy. Addictive Behaviors Research Center, Department of Psychology, University of Washington.