PTSD is not a Life sentence
If you have experienced something that was extremely horrifying, terrifying, or threatening, such as a car accident, assault, abuse, life-threatening illness, or natural disaster, you may find that your life is not what it used to be. If you find that you can’t get this event or period of time out of your head, that you keep thinking about it, dreaming about it, or finding yourself re-experiencing it, you may be suffering from Post-traumatic Stress Disorder (PTSD). If you are in the middle of this experience, it may feel like it will never get better. However, this is not the case. PTSD is often quite treatable. Many people I have worked with have recovered fully from PTSD. One way to treat PTSD is through Prolonged Exposure therapy.
What is Prolonged Exposure Therapy?
Prolonged Exposure therapy is a kind of psychotherapy specifically designed to treat the symptoms of Post-traumatic Stress Disorder (PTSD). It is based on the idea that the things that keep PTSD symptoms alive are avoidance (of memories and things in your life) and negative beliefs about the trauma, the self, and the world. In Prolonged Exposure therapy, we use exposure to fight back against avoidance and change unhelpful beliefs to helpful ones. It is designed to take 10 to 12 weeks of weekly 90-minute sessions. Some people finish sooner; others take a bit longer.
What is Exposure?
“Exposure” in this context is just what it sounds like — confronting something you are afraid of. In the case of PTSD, I don’t need to tell you that the scariest thing for most people with PTSD is facing the memory of what happened. So, that is one of the things that we use exposure for. This is called “imaginal exposure.” We do this by having you re-tell what happened in our session in great detail over and over. This sounds quite awful, and I’m not going to lie, it’s really not fun, but here’s the thing… most people report a dramatic drop in nightmares, flashbacks, and intrusive memories within the first few weeks of starting this type of exposure. If you have been struggling with these symptoms for months or years, this feels like a miracle.
Why does this work?
This works because as you talk about the event more frequently, you become more and more used to it. You start to experience the reality that the memory cannot hurt you. It even starts to become boring to you. Think about watching a scary movie. The first time you watch it, it is scary. You probably jump or even scream when the unexpected happens. This probably happens the second time you watch it, or even the third. But what do you think happens the 100th time you watch it? It’s pretty dull, right? The same thing happens with the memory of the traumatic event.
Besides reducing the symptoms of flashbacks, nightmares, and intrusive thoughts, when you are able to talk about what happened as just another event in your life, you can think about it more objectively and change your beliefs about what happened and why it happened to more rational, helpful beliefs.
In Vivo Exposure
The other type of exposure we do in Prolonged Exposure therapy is called “in vivo” exposure, which means “in life.” In this type of exposure, we work on helping you get back to doing the things you have been avoiding because of the trauma. For instance, many times people who have been in car accidents find that they don’t drive the way they used to or greatly restrict their driving, like not driving on highways, not driving at night, not driving with passengers, etc.
With in vivo exposure, we start small, and then we work up to the bigger tasks. For instance, if you have not been driving on the highway or in rush hour, we start you out driving on a busier street than you are used to, but we make sure it’s at a low traffic time of day. Once you master that task, we have you drive on that same street at a somewhat busier time. We keep working up to the end goal, which is to be able to drive wherever and whenever you need to. Sometimes these exposures involve doing things, like driving, and other times they will involve talking to people or looking at pictures of the things that make you feel scared or anxious. We’ll work together to come up with a list of exposures that makes sense for you.
As you work through these tasks, the same thing happens in this process as happens when we have you work on the memory of the trauma — you find that the more you do it, the less anxious you are. It’s a very direct way to help you experience that the things you fear are actually safe, even if your brain and body try to tell you that they are not.
Who is Prolonged Exposure for?
Prolonged Exposure is not for everyone. It works quite quickly because it involves a lot of work. It works well for people who are highly motivated to get back to their lives and have enough time to devote to the process. There is homework between sessions, usually averaging 30 minutes to an hour per day, depending on what stage of treatment we are in. If you don’t have a clear memory of the traumatic event, Prolonged Exposure would not be a good fit, but there are plenty of other ways we can work on that, such as in EMDR or clinical hypnosis.
Prolonged Exposure is a great treatment for people who want to recover from PTSD symptoms and are willing to do what it takes to get their lives back. Give me a call today at 651-998-8991 or set your appointment time by clicking the “Request Appointment” button below. I’m excited to talk with you about how we can help you get back to your life.