What is Exposure Therapy?

Exposure therapy is a counseling technique in which one is gradually exposed to whatever triggers their phobia. Afterwards, the client may discuss their emotions with a therapist to better understand why they experience a phobia and how to overcome it. For example:

• A person afraid of germs touches different objects over time that she perceives to be dirty.  First, she touches a small object, then a doorknob, and eventually shakes hands.

• Someone afraid of crowds first spends time with two people, then 4-5 people, then a larger group, and finally a large crowd.

• A person afraid of the water stands in a puddle, then in shallow water to the ankles, then on the shallow side of a pool, and finally wades in the deep end of a pool.

These situations happen in real life, but what if it’s not always possible to get a “real world exposure experience?

Imaginal Exposure Therapy

Imaginal exposure therapy takes the concept of exposure therapy and sets it in the counseling office. The client imagines a situation where they would experience anxiety from their phobia. They would then discuss with the therapist what they were feeling and work with the therapist to come up with solutions. This can be a useful method because real-life exposures might not be practical, or too dangerous, to be a useful solution.

Examples of Imaginal Exposure Therapy

• Creating a scenario in your mind where you must touch something that is “dirty.”
• Thinking about being in a group of people for fear of crowds.
• Imagining a situation where you must be in an airplane and fly.
• Focusing on how you might be afraid of swimming pools and water.

These are not flashbacks, which are associated with people who have post-traumatic stress disorder (PTSD). In fact, these are guided scenarios that you and your therapist intentionally create.

The Worst Doesn’t Have to Happen with Imaginal Exposure Therapy

The problem with phobias is the persistent belief that performing a soothing action will calm your thoughts, and keep the worst from happening. For some, this might mean catching a disease, or even dying. However, practicing imaginal exposure therapy can actually help with beating your phobia in that if you do have these thoughts, the worst won’t actually happen. This is because you are intentionally creating the thoughts!

Taking Imaginal Exposure Therapy to New Levels

Previously, imaginal exposure therapy occurred in one’s own mind. With advances in technology, we can actually take the leap from the mind to a simulator. As mentioned above, imaginal exposure therapy can be useful in situations when it would be impractical or too dangerous to experience them in reality.  For veterans who struggle with PTSD, a simulator can recreate a combat situation that triggers anxiety, without having to return to the battlefield.  This includes the sights and sounds of war. Afterwards they can then process with a therapist.

Living with a phobia means that you are spending energy every day having to make sure that either the phobia doesn’t occur, or practicing soothing rituals if it does. What if you could get that energy back. What would you do with it? You could learn something new, spend more time with your family, and generally experience less worry in your life. Imaginal exposure therapy is another tool available to help you resolve your symptoms, and free yourself of your phobia.