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The main goal of exposure therapy is to desensitize you from things that cause you anxiety but are actually in reality harmless. Exposure therapy is often used in combination with pycho-education, relaxation training and cognitive therapy to treat anxiety disorders. There are three sorts of exposure therapy:

1.Interocetive exposure: It is exposure to harmless but often fear provoking bodily sensations. Often used to treat individuals who present hypersensitivity to physical sensations (i.e. panic disorders). The experiencing of intense changes in body e.g. fast heart beat, faintness, dizziness, nausea, shaking can cause anxiety. The deliberate and repeated exposure excises help the client to gradually get used to the physical sesations and to become less distressed when experiencing these sensations.

2.Imaginale exposure:  involves repeated exposure to the traumatic memory. The client needs to narrate the trauma in great detail using present tense (i.e. I am going through….. ) and all senses( what the client smelled, saw, felt, tasted, heard during the trauma). The session is often recorded so you can keep playing it at home and continue to expose yourself to the memory in between sessions. The exposure to the detailed image of the trauma is repeated until the anxiety and distress that it provokes diminishes and the memory becomes less upsetting. The memory gradually gets integrated with other memories and as a result intrusive symptoms also get reduced. You will learn that you do not have to be afraid of your memories. The aim is to eventually be able to remember the trauma without it causing great emotional distress and anxiety.  

3.Graded situational exposure: very few people find comfort in jumping into the deep water first and confronting their biggest fear directly. Many prefer to take it slowly, step by step and to gradually built up to their biggest fear. This is exactly what gradual situational exposure is.  It reduces anxiety that everyday harmless external stimuli e.g. places, objects, sounds, smells, people, or symbolic reminders of the trauma and various situations cause. A hierarchical list of the triggers and the level of anxiety which they rise is made. Then a gradual exposure starts to the triggers from a manageable and comfortable level of anxiety to the more extreme distressing levels. It is a slow, gradual, feasible and controllable confrontation of the feared triggers. The client is in control and chooses when and what he wishes to be exposed to.  The list, which the client assembles, makes the exposure exercises seem more realistic, assessable and manageable. The avoidant coping which the individual displays diminishes as the triggers produce less anxiety and distress.     

Exposure therapy is done gradually as to not to overwhelm the client. The stages are controllable and adjustable but it is certainly not a pleasant process. It is a confrontational process of thoughts, emotions, memories and triggers, which the client quite often spends avoiding. In the first few weeks it may cause a mild increase of irritability, anxiety and nightmares but that is actually a sign that the exposure starts working. In the long term the distressing emotions and their effects will subside and the quality of life will increase.  The process will provide you with the skills to overcome problems in the present and future. The client will also come to the realization through the exposure exercises that by not avoiding the distressing situation, you cannot disconfirm your fears.

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