Prolonged Exposure

PE Treats PTSD

If you’ve experienced trauma, you may find yourself going out of your way to avoid anything that triggers memories of the experience. For example, if you were in a serious car accident or your combat vehicle ran over an explosive device you might feel anxious or frightened to drive or even to travel in a car or truck. Prolonged Exposure (PE) teaches you to gradually approach the trauma-related situations, memories, and feelings you’ve been avoiding. By confronting your avoidance, you can reduce PTSD symptoms and improve your quality of life.

What is PE?

PE is a psychotherapy for people with PTSD or history of trauma. It is a type of Cognitive Behavior Therapy (CBT). For more than two decades PE has been used to treat PTSD related to combat, rape and other assaults, child abuse, motor vehicle accidents, natural disasters, or other traumatic experiences. It is based on the idea that avoiding situations you fear keeps you from recovering. It is designed to build your confidence by gradually and safely exposing yourself to thoughts, feelings, and situations you’ve been avoiding. This process of facing your fears can give you back control of your life. PE is an evidence-based, gold-standard treatment for trauma/PTSD. This means there is substantial evidence supporting its effectiveness as an intervention for people with PTSD or history of trauma.

What to Expect with PE

PE consists of a series of weekly, one-on-one sessions occurring across about three months. During your initial appointments, you will learn about PTSD and trauma, how its symptoms impact your everyday life, and how and why PE can help. You will create a list of situations that you avoid and rank them from least distressing to most distressing. For homework throughout treatment, you’ll practice doing the things you have avoided, starting with less distressing ones and gradually working up to more distressing ones. This is called in vivo, or real-life, exposure. Over time, these exposures help you learn that situations you have avoided are not as dangerous as you feared and that you can handle being in such situations.

After a few sessions, you’ll start talking about the traumatic event. This element of PE is called imaginal exposure, because you’ll imagine reliving the experience. You’ll be asked to recall details of the trauma, as well as what you thought and felt – emotionally and physically. You will usually be asked to speak in present tense, as if the event were happening now. Your sessions will be recorded and you’ll be asked to listen to the recordings between sessions. This revisiting of the traumatic event in a safe environment is designed to help you begin to realize you can cope with the uncomfortable feelings associated with your trauma memories.

This video, produced by the National Center for PTSD, can be helpful in better understanding PE and the benefits of using it to address PTSD or trauma.

Gaining Courage

As you revisit the memories of your past trauma and face your current fears in a structured way, you can use controlled breathing to help remain in situations that generate anxiety for you. The gradual exposure process can help you complete the emotional processing of your trauma and reduce fear, anger, sadness, and other upsetting feelings. Facing the safe situations you have been avoiding and making it through successfully, can help decrease symptoms of PTSD and increase your confidence in your ability to live your life more fully going forward.

PE is an effective treatment for people with PTSD or history of trauma. Its benefits usually last long after you complete treatment. If you are considering working with a psychologist, therapist, or counselor to address PTSD or your trauma history, be sure to ask if your provider is experienced in the delivery of one of the evidence-based, gold-standard treatments for trauma/PTSD (PE, CPT, or EMDR).

As an experienced psychologist specializing in the treatment of PTSD and trauma, I have years of experience with all three evidence-based, gold-standard treatments for PTSD – PE, CPT, and EMDR.

If you are struggling with your trauma history and interested in taking back control of your life, I invite you to call or email me to get started working together.