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Treating PTSD Can Include 'Exposure Therapy'

A man hugging his familyAfter a traumatic event, many Veterans experience distress and symptoms of posttraumatic stress disorder (PTSD). This distress may be highest when dealing with memories, thoughts, feelings, and situations that are related to the trauma. Exposure therapy is a type of therapy that may help you decrease distress about your trauma. This therapy works by helping you approach trauma-related thoughts, feelings, and situations that you have been avoiding due to the distress they cause. Repeated exposure to these thoughts, feelings, and situations helps reduce the power they have to cause distress.

Prolonged Exposure (PE) is one type of exposure therapy that works for many people who have experienced trauma. It has four main parts:

  • Education - Prolonged Exposure therapy starts with education about the treatment. You will learn about common trauma reactions and PTSD. Education allows you to learn more about your symptoms. It also helps you understand the goals of the treatment. This education provides the basis for the next sessions.
  • Breathing - Breathing retraining is a skill that helps you relax. When people become anxious or scared, their breathing often changes. Learning how to control your breathing can help in the short-term to manage immediate distress.
  • Real world practice - Exposure practice with real-world situations is called in vivo exposure. You practice approaching situations that are safe but which you may have been avoiding because they are related to the trauma. An example would be a Veteran who avoids driving since he experienced a roadside bomb while deployed. In the same way, a sexual trauma survivor may avoid getting close to others. This type of exposure practice helps your trauma-related distress to lessen over time. When distress goes down, you can gain more control over your life.
  • Talking through the trauma - Talking about your trauma memory over and over with your therapist is called imaginal exposure. Talking through the trauma will help you get more control of your thoughts and feelings about the trauma. You will learn that you do not have to be afraid of your memories. This may be hard at first and it might seem strange to think about stressful things on purpose. Many people feel better over time, though, as they do this. Talking through the trauma helps you make sense of what happened and have fewer negative thoughts about the trauma.

With the help of your therapist, you can change how you react to stressful memories. In prolonged exposure therapy, you work with your therapist to approach trauma-related situations and memories at a comfortable pace. Usually, you start with events that are less distressing and move towards ones that are more distressing. A round of prolonged exposure therapy most often involves meeting alone with a therapist for about 8 to 15 sessions. Most prolonged exposure therapy sessions last about 90 minutes.

With time and practice, you will be able to see that you can master stressful situations. The goal is that you, not your memories, can control what you do in your life and how you feel. Therapy helps you get your life back after you have been through a trauma.

PE Therapy for Veterans

A soldier consulting another soldierProlonged Exposure therapy has been shown to be one of the most effective treatments for PTSD. For this reason, the VA's Office of Mental Health Services has rolled out a national prolonged exposure therapy training program. As a result, fully trained and certified clinicians will be available at VA's across the country to provide prolonged exposure therapy

Check out this video describing how In-Context Exposure Therapy Helps Bring Closure to Veterans.

Getting More Help

My HealtheVet offers readers a variety of resources to understand PTSD.

National Center for PTSD - A comprehensive web resource for Veterans and therapists, and includes video and other resources to explain available options

The PTSD Coach app can help you learn about and manage symptoms that commonly occur after trauma. Features include:

  • Reliable information on PTSD and treatments that work
  • Tools for screening and tracking your symptoms
  • Convenient, easy-to-use skills to help you handle stress symptoms
  • Direct links to support and help
  • Always with you when you need it

Updated/Reviewed: May 1, 2011

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