Exposure Therapy for PTSD

Adults with PTSD often will find themselves avoiding situations that are associated with the trauma they experienced. Some examples include:

  • Avoiding talking or thinking about the actual trauma including avoiding telling loved ones about what happened and trying not to think about it when the memory pops into your head
  • If you were in a car accident, you might be avoiding driving, being in cars, walking in areas where there is a lot of traffic, or being in the neighbourhood where the accident took place.
  • Avoiding general places, situations or people associated with your trauma, such as parks, crowded places, and people of a particular ethnicity, age or gender.
  • Avoiding trauma reminders such as movies, TV, conversations.

Unfortunately, as with all anxiety disorders, avoidance will only keep the anxiety going. Furthermore, many people with PTSD try to avoid thinking about the event as they believe they are either responsible for what happened in some way, that they could have prevented it, or that others would blame them if they knew “the whole story”. For example, it is not uncommon for people who have been sexually assaulted to think that they didn’t “fight back” enough, or that they acted in a careless way that invited or encouraged the attack. These thoughts of guilt about a traumatic event can lead to strong negative feelings of sadness, depression and shame.

If you have PTSD and are engaging in avoidance, you will likely require guidance from a trained mental health professional to address your symptoms of fear and avoidance related to the people, places, or things that are central to your trauma experience. Although this website outlines how to use a techniques called ‘exposure’ for various anxiety disorders, for individuals with PTSD we recommend a specific type of exposure, called Prolonged Exposure (PE). PE has four main parts: education, breathing training, live exposure, and imaginal exposure. Imaginal exposure is an important part of working with PTSD, as it allows the individual to talk about the trauma over and over again to regain control of his/her thoughts and feelings. Working with a therapist using PE allows the adult to change how s/he reacts to stressful memories, and gradually to become less and less afraid of the past trauma.