Exposure Therapy & ERP Therapy
Expert Exposure and ERP Therapy in New York City
Exposure Therapy is a technique used to effectively treat issues of anxiety.
Like CBT, Exposure Therapy is an effective treatment for fears and anxieties. It has been scientifically demonstrated to help individuals suffering from GAD, phobias, Panic Disorder, SAD, OCD, and PTSD.
In Exposure Therapy, a therapist might recommend a program of graduated exposures (e.g., exposing an individual to the thing that they fear) in order to help break the pattern of avoidance and live a more satisfying life. The exposure to the feared objects, activities or situations in a safe environment helps reduce fear and decrease avoidance over time.
Note on practices due to COVID-19: While we are currently meeting our clients remotely, we are currently offering in-person meetings for in vivo exposures facilitated by a therapist.
Types of Exposure Therapy
There are different types of Exposure Therapy, each involving a different approach in exposing individuals to their fears and anxieties. Some key types of Exposure Therapy include:
In vivo exposure
In vivo means “in life,” and this type of Exposure Therapy will involve an individual directly facing a feared object, situation or activity in real life. For example, someone with a fear of small, close spaces (claustrophobia) might be instructed to enter a very small space, like a closet or elevator. A person who has intense anxiety about social situations (Social Anxiety Disorder) might be instructed to give a speech in front of a group of people.
Virtual reality exposure
When in vivo exposure is not possible, in some cases, virtual reality (VR) technology may be used. For example, someone with a fear of flying might take use VR flight-simulating technology in order to experience what it would like to be on a plane.
Imaginal exposure
Imaginal exposure takes place in the mind: an individual will vividly imagine the feared object, situation, or activity. An example of this is someone with Post Traumatic Stress Disorder (PTSD) being asked to recall and describe their traumatic experience. By recalling the experience and speaking about it, over time the fear becomes less intense as the individual becomes more accustomed, or habituated, to it.
Interoceptive exposure
Interoceptive awareness is the ability to identify and respond appropriately to the patterns of internal signals. In Interoceptive exposure, physical sensations that are harmless, yet feared, are deliberately brought on. For example, someone with Panic Disorder, who experiences overwhelming physical reactions to anxiety (a racing heart, shaking, feeling dizzy, chest pains) might be instructed to run in place in order to make their heart speed up in a way that is similar to when they have a panic attack. By doing so, the individual can learn that this sensation is not dangerous.
Exposure and Response Prevention (ERP or EX/RP) therapy is a considered the ‘gold standard’ treatment for OCD.
In ERP, clients expose themselves to the feared situations, thoughts, or objects that prompt their obsessions while also refraining from acting out their compulsions. The client and therapist first complete these exposures in session, then develop a plan for the client to begin regularly practicing exposures outside of sessions. ERP cognitive behavioral therapy requires a strong commitment from the client to confront their triggers (which can be an uncomfortable or scary experience), but over time, the obsessions fade away and the compulsions are no longer necessary.
You can read more on ERP from the International OCD Foundation here.