Prolonged Exposure (PE)

PROLONGED EXPOSURE (PE)

RATIONALE

Those with Post-traumatic Stress Disorder (PTSD) often strive to avoid unpleasant experiences associated with their trauma. Whether the triggers they avoid are external, like shopping malls or certain areas of town, or internal, like feelings and thoughts, the avoidance itself tends to become a problem for those with PTSD. Besides the fact that the avoidance limits a person’s freedom to live their lives, it also reinforces the person’s fear, teaching the brain that experiences that are safe pose a real threat. The way to learn safety in the face of triggers is to practice being in the presence of the trauma memory or feared circumstance. As it so happens, this is the focus of Prolonged Exposure (PE).

EXPOSURES

PE involves two types of exposure: Imaginal and In vivo. With imaginal exposures, people describe parts of the trauma as if they are living through the moment again. First they record their exposures during therapy sessions and then they listen to the recordings outside of therapy. These imaginal exposures support people in learning to be in the presence of trauma memories without avoiding these internal experiences. Treatment also includes “in vivo,” or in real life, exposures. Here, people face external experiences they have avoided. Through PE work, people with PTSD learn that they are safe in the face of the internal and external experiences that they’ve been avoiding. Through systematically facing the trauma-associated circumstances, those with PTSD can process the trauma they’ve been avoiding.  Moreover, PE helps people to appreciate their capacity to learn about and deal with challenging emotional states, making internal avoidance less necessary.