The Power of Exposure Therapy for PTSD, Anxiety, and OCD: Overcoming Trauma and Mental Disorders

So recently I stumbled upon this movie called Ahaan on Netflix, a very touching story with an authentic portrayal of developmental disability.  The story is beautifully crafted and delves into disabilities that never makes to the dining table conversation. People don’t talk about mental disorders in casual conversations. And this movie does that, it talks about the difficulties and dilemmas of anxiety and exposure therapy. 

In this movie, the psychiatrist advises exposure therapy to the patient. He puts the patient through things that triggers his anxiety. He enters a stinking public toilet. Travels on a crowded local train. Visits a garbage dump. He confronts his fears to overcome them.

Experts say exposure therapies are highly effective for patients with anxiety disorders. It’s effective to the extent that some psychiatrists say it should be considered a first-line treatment. However, in clinical practice, this treatment is underutilized. It needs further training, evidence, and dissemination.

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Mental disorders

Anxiety disorders are very common these days and the worst thing is that most people don’t even realize. The ticking heart under the shirt feeling fear and anxiety on a perfect day, that’s a disorder. It’s not normal. While some live their life with this ticking heart, for others the scene is more serious. Their anxiety is so strong that it starts interfering with everything in life. Even going to a grocery store may feel like a mission impossible!

In these cases, exposure therapy can help. 

Researchers found that exposure-based therapies are effective for these disorders. But because of a lack of specialized training in exposure-based therapies, they are not much used in clinical practice. 

Another factor that makes it a lesser-used therapy is the negative beliefs around this therapy.  Because they don’t have the right training, they are skeptical about safety and efficacy. Surveys reveal that majority of the psychologists who treat patients with PTSD do not use exposure therapy. Some also believe that exposure therapy can exacerbate the symptoms. 

However, surveys also reveal that individuals with trauma and PTSD prefer exposure therapy over other treatments. Furthermore, research proves that exposure therapy does not lead to exacerbation of symptoms.

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Exposure Therapy

Exposure therapy is a treatment process for anxiety and mental disorders in which the therapists encourage the patient to confront their fear. This can be external or internal. Like facing certain objects, situations or activities is external exposure therapy. Whereas, confronting one’s thoughts and sensations is internal exposure therapy. The whole aim of this exposure therapy is to erase the perceptions of fear through an acquaintance. 

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How does exposure therapy work in anxiety?

Repeated presentations of a fear-provoking stimulus can lead to habituation. It’s like when you dip your toes in ocean tides for the first time you feel scared. But when you do it a number of times you get habituated with this. 

Exposure therapy weakens the conditioned response through repeated exposure to conditional stimuli. For example, people once bitten by dogs tend to develop a dog phobia. But gradual exposure to the fear can reduce it over time. 

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Types of exposure therapy

Graded exposure 

In graded exposure therapy, the therapist targets feared stimuli first. This involves constructing an exposure hierarchy. The therapist ranks the patient’s fears according to anticipated reaction. In this, they don’t attempt higher-level exposures until the patient’s levels of fear subside. 

Flooding exposure

In flooding exposure therapy, the most difficult stimuli are brought out of the bag first. But this is decided by a trained expert who can gauge the patient’s way of response. In clinical practice, both these methods are equally effective. But most patients and clinicians choose the graded approach.

Vivo Exposure

In vivo exposure, the patient confronts the feared stimuli in the real world. This was the therapy employed in the movie Ahaan, where the character is exposed to the fear stimuli. This is especially helpful in treating OCD, anxiety, social anxiety, and certain phobias.

Imaginal Exposure

Many times, the Vivo exposure is not feasible. It could be both difficult and hazardous. In such cases, therapists may opt for imaginal exposures. In imaginal exposure, the patient is put to confront the emotions during the combat. It’s more mental than physical.

Virtual Reality Exposure

In the recent world, virtual reality exposure therapy has become a huge hit. Thanks to artificial intelligence and technology. Patients are immersed in a virtual world that allows them to confront their fears. In other words, they go through the entire process just like in Vivo but not physically.

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Efficacy of exposure therapy – Research and Studies 

There is no dearth of evidence that proves that exposure therapy is effective. It can lead to improved symptomatic and functional outcomes for patients. The available research also suggests, it should be considered the first-line treatment for anxiety disorders.

This therapy is a tried and tested treatment for anxiety disorders. A study on Vivo exposure for patients with specific phobias revealed that 90% of the patients reported a significant reduction in fear and impairment. Further, 65% of patients reported that they no longer had a specific phobia. 

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Several other studies have also demonstrated the efficacy of this therapy for patients with Generalised Anxiety Disorders, social anxiety, and PTSD. With repeated exposures, patients experience reduced sensations of fear, develop the ability to cope, and find new meanings to previously feared stimuli. 

A 2013 study examined the effects of prolonged exposure therapy in PTSD patients. The researchers found it effective in reducing chronic PTSD and depression symptoms. Another 2013 study, examined the efficacy of this therapy in earthquake survivors. 

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Exposure therapy for SAD (social anxiety disorder)

This therapy is very helpful in addressing issues related to social anxiety. Therapists often refer it for people who struggle with stage frights and social settings. This kind of therap works best in fighting fears related to 

• Eating in public. 
• Paruresis or shy bladder syndrome — the fear of using public restrooms.
• Phone phobia – the fear of attending the phone.
• The fear of public speaking
• The fear of conflict 

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Take away

In conclusion, exposure therapy can be very effective for patients with social anxiety. However, it’s important to work with a trained professional who can guide you through the situations to overcome your fear. As we have seen, there are different types of exposure therapies and the therapist will plan the best method. 

The studies available on exposure-based therapy have concluded it’s efficacy. This is very beneficial, cost-effective and practical treatment to certain kinds of phobias. Hence, we can say that further implementation of this therapy could be instrumental in treating the rising cases of mental issues.