Exposure Therapy: Benefits For Mental Health And Anxiety

A certain category of mental illnesses may be classified as fear- or anxiety-based, which includes everything from generalized anxiety disorder to phobias to post-traumatic stress disorder (PTSD). For conditions like these, a mental health provider may recommend exposure therapy as a way to decrease stress and/or panic when the client is exposed to the trigger. Here’s what you need to know about exposure therapy for fear. 

What is exposure therapy and how does it help with mental health?

Generally, exposure therapy helps people confront and overcome certain mental health conditions that are primarily characterized by a sense of fear and is designed to prevent further trauma. According to the American Psychological Association (APA), a therapist-guided exposure therapy treatment is performed by qualified treatment providers in which they create a safe environment where they can ‘expose’ people to feared objects, activities, and other things they avoid.

Effective approaches to exposure therapy for anxiety disorders

There are specific ways to conduct exposure therapy—which qualified exposure therapists will have learned in training—so that their participants are gradually exposed to become more acclimated to the stimuli they perceive as threatening. In vivo exposure therapy and imaginal exposure therapy are two of these specializations. 

As people experience the same sounds and sights that they have previously associated with danger or specific phobias, they may become less sensitive to them and will ideally experience a reduction in their fear through repeated exposure. Exposure therapy work is often considered to be the first line of treatment for several fear-based disorders, and this therapy can significantly change the life of a person who is experiencing one.

How exposure therapy works for anxiety disorder and fear

• Flooding is a technique where the provider will present the most intense or feared version of the stimulus or stimuli first. As participants continue with this intervention, the most anxiety-provoking stimuli will often tend to cause less intense reactions over time.
• Graded exposure therapy involves exposing the fear-inducing stimuli in order of least to most fear-inducing. For example, if a participant feels extreme anxiety when they have to fly on a plane, the therapist might begin by taking them to sit in an empty plane on the ground. Next, they might prompt the participant to sit on a plane full of people. Eventually, they'll increase the exposure until, ideally, the participant can take flight without debilitating fear.
• Systematic desensitization combines either flooding or graded exposure therapy techniques with relaxation exercises. Because participants are more relaxed before and during the exposure, the sights and sounds that they once associated with fear may become more associated with a state of relaxation.

Types of therapeutic exposure and their effectiveness in behavioral therapy

There are several types of exposure therapies, each of which involves unique methods for helping people overcome mental health challenges. These exposure therapies include:

In vivo exposure therapy and its role in behavioral therapy

This takes place in the actual location the participant fears, or with the actual stimulus, they fear, or feared object, being physically present. The scenario about the fear of flying mentioned earlier is an example of in vivo exposure therapy because it takes place inside an airplane, which is what was provoking anxiety in the individual and providing realistic beliefs about the danger present. Treating anxiety with in vivo exposure therapy is not always possible if fears are not concrete. 

Imagined exposure therapy for mental health treatment

This is exposure therapy in which the participant is not actually, physically exposed to stimuli that they perceive as dangerous. Instead, they’re guided in imagining being exposed to it—in great detail. This technique may help them confront the fear and eventually overcome it. Imagined exposure therapy is especially helpful for unusual fears or fears based on specific incidents and can be used to treat anxiety disorders.

Interoceptive exposure therapy

Interoceptive exposure therapy is effective at treating panic attacks because it helps participants have a physical experience of the feared stimuli without actually being exposed to them. In the case of panic disorder, for example, an individual may be asked to exercise vigorously to induce the physical sensations of a racing heart and difficulty breathing. The more they’re exposed to these sensations in a safe, therapeutic setting, the less anxious they may become when they feel similar sensations during a panic attack.

Virtual reality exposure therapy (VRET) for mental health benefits

Virtual reality exposure therapy presents the stimuli a participant associates with life-threatening situations through computer-generated sights and sounds which may produce a physical sensation similar to a real life situation. The may occur via a desktop computer display, virtual reality technology, or what’s called a "CAVE environment": a cube-like compartment where projectors and audio equipment provide the stimuli.

Prolonged exposure therapy

Prolonged exposure therapy has successfully helped people who experience PTSD due to past combat experiences or other life-threatening situations. Because the traumatic event caused great fear, avoidance of the situations that act as reminders of the event may cause distress. This extended and consistent exposure therapy works to decrease avoidance behaviors and speed up cognitive processing.

Exposure and response prevention therapy (ERP)

Exposure and response prevention therapy is used when treating obsessive compulsive disorder, or OCD. A therapist may begin exposure therapy by presenting a stimulus that normally triggers a compulsive behavior, the exposure therapist directs the patient not to respond the stimuli, which is the response prevention component. 

Mental health conditions that may benefit from exposure therapy

Exposure therapy can be used to treat a wide variety of these fear- and anxiety-based mental health conditions. It may be a helpful therapeutic treatment for emotional processing and symptom reduction for those with disorders such as:

• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD))
• Phobias
• Panic disorder
• Generalized anxiety disorder
• Social anxiety disorder
• Trauma

According to a recent study with an exploratory multiple baseline design, exposure therapy may also be beneficial for people who experience social anxiety disorder (SAD) that is paired with stuttering. It can help people who stutter due to social anxiety because they can have opportunities to be exposed to social situations and make a plan with their speech language pathologist on how to manage their stutter in these situations. 

Potential benefits of exposure therapy for cognitive behavioral treatment

The benefits of exposure therapy depend on factors such as the therapist's specialization, the condition being treated, and the participant’s willingness to engage in the therapy. At it’s best, exposure therapy can be a powerful tool to help with anxiety and fear-based mental conditions by working to decrease the avoidances of the fear and any symptoms associated with facing them. A recent meta-analysis shows that it can be an effective treatment for conditions involving post-traumatic stress and others. It can have many important benefits. 

First, exposure therapy can decrease the client's sensitivity to sights and sounds that can trigger them into feeling that danger is nearby, thus breaking the negative associations. It may also help an individual learn to accept fear when it’s natural and learn how to live with it without becoming paralyzed or panic-stricken (especially in the case of panic disorders). Exposure therapy can help the client build personal agency because participants often realize that they have control over their thoughts which can impact their feelings. Finally, exposure therapy can decrease anxiety and help improve their daily functioning. 

Seeking virtual reality treatment for anxiety

Fear- or anxiety-based mental health disorders such as PTD, OCD, and others mentioned here can negatively impact a person’s daily functioning and cause significant distress. While your primary care physician may be able to provide you with resources on these conditions, they do not have expertise in clinical psychology. Finding a licensed therapist that fits with your personality and needs is a good place to start. Exposure therapy is one potential treatment option that may help. If you are or suspect you may be experiencing a disorder like this, speaking with a mental health professional  can help. They can evaluate your specific situation and recommend therapy accordingly, whether that includes exposure therapy or other types. General cognitive behavioral therapy (CBT), for example, is also commonly used to treat a variety of anxiety disorders by helping the individual learn to recognize and shift flawed or unhealthy thought patterns that are causing distress. Exposure therapy falls under the CBT umbrella. Depending on your situation, various aspects of CBT may be used in exposure therapy.

Benefits of virtual reality exposure therapy for mental health and anxiety disorder treatment