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Exposure Therapy: Does It Really Work?

By November 28, 2010

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A recent article in the Kansas City Star features interviews with phobia sufferers who found relief through exposure therapy. The article describes the step-by-step process used by therapists to help clients work through their fears: First, you simply imagine the feared object. Next, you watch videos or look at pictures. Only after lengthy exposure to gradually increasing stimuli do you ever come into direct contact with the object of your fear.

Yet some experts feel that exposure therapy can be dangerous, leading to a worsening of the phobia. Others feel that the chances for success are slim, although the techniques are not necessarily dangerous when performed by trained professionals. So what are phobia sufferers to do? Who should you believe?

My take: The process described in the article is known as systematic desensitization. The idea is that you gradually become comfortable with a mild stimulus, such as a picture of the object you fear. Before you move on to the next step, you should have no fear at all of the mild stimulus. It is like the process of learning to swim. First you wade into the shallow end and someone supports you as you learn to kick. Only once you master a technique do you move on to something more advanced.

By contrast, the exposure technique known as flooding is like learning to swim by jumping into the deep end. In flooding, you are fully exposed to the object of your fear right off the bat. When it works, it is much faster than systematic desensitization. But there is a lot more potential for error.

I think that either type of exposure therapy can work in the right setting, with the right mental health professional, with the right client. But I also believe that either can be misapplied. Of the two, I generally favor systematic desensitization, as it allows both client and therapist more control over the process. However, that is merely my personal preference.

What do you think? Have you undergone either type of exposure therapy? Did it work? Do you think one type is better than the other? As always, your thoughts are welcome!

December 18, 2010 at 6:25 am
(1) valsamma says:

I am afraid of dead body and house where somebody died.When I heard first about exposure I could not even imagin that. I thought I will die if I do that or go mad.Now I made up my mind to face it because my near and dear are laughing at me. they don,t understand my problem.So i decided to get out of my phobia.I tried to go to the room during day time where my close relative died.I tried when some other persons were there.I suceeded.Slowly I tried myself.That also suceeded.It is possible in a slow process.

February 22, 2013 at 4:11 pm
(2) Anonymoose says:

I have severe acrophobia affecting bridges, high places, and of course flying on a plane. It’s hard to explain these fears to most people who don’t have them, and there are lots of adds for places that guarantee a quick fix. What they don’t tell you, and have to fish for, it that:
- Phobias stemming from an event are more much more amenable to therapy.
- Phobias based in how you view the world are much more difficult
- Exposure therapy wears off. I worked my way up to driving across a high bridge – small panic attack alongside. But because I don’t live near bridges I didn’t do it again for months, and the higher level of fear had returned.
- Flooding (full sudden exposure) can kill people who are older, or have disease. I have arterial sclerosis, the odds for a stroke is higher if my pulse rate goes through the roof.
- There are fads like EMT that promise to “rewrite” negative responses but they only have been shown to work when the phobia stems from a big event. Like PTSD.
- Further, the longer you have avoided the subject of your fear, the more difficult it is to alter. I’m 57, my phobia was first evident when I was about 16 – 40 years of avoiding hights or medicating to deal with them.
- Recent discoveries suggest that acrophobia may have an organic component – in how your mind / body keep you feeling in-balance

So the sooner you do something the better, if your phobia stems from an event you are more curable, and beware any solution that claims huge recovery rates.

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