Exposure Therapy is the frontline treatment for PTSD.

Sometimes, talking about it only gets you so far.

Exposure Therapies are structured psychotherapies designed to reduce distress in response to whatever is feared and keeping us stuck. In trauma work, this may involve actual memories of the event(s), bodily sensations like heart palpitations, and persistently negative thoughts about yourself and others. Often, we don’t yet know what we are afraid of, or why, or we only know part of the story. Exposure therapy can help uncover the rest of the story, but ultimately it can help you rewrite the story.

Exposure Therapies

  • EMDR

    Helps process past traumatic material, build tolerance to distress in the moment, change negative beliefs, and create desired future changes.

  • Written/Narrative

    Uses writing to focus on trauma-related thoughts and emotions. Both desensitization and cognitive change may promote healing.

  • Cognitive Processing Therapy

    Addresses negative beliefs stemming from the trauma that keep us “stuck,” and teaches about their relationship with emotions. We work to reframe these beliefs and shift emotional states.

  • Prolonged Exposure

    Helps reduce fear associated with the memory and resulting stimuli by using repeated exposure in and out of session.

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FAQs

  • We will collaborate to determine the best therapy fit. There are a variety of factors that can influence this decision. Ultimately, these therapies all use some form of fear desensitization, distress tolerance building, and cognitive flexibility (e.g., changing thoughts) to create lasting change. So the right fit is less about which treatment is the best and more about which treatment is the best for you.

  • Short answer: no.

    Long answer: You will likely find a therapist willing to jump into these treatments right away with you. That’s certainly what you’ll be offered at the VA (I have worked there). These treatments are very successful - if you complete it. However, many people drop out before finishing, for a variety of reasons.

    My goal is to help increase commitment to, and build stamina for, these therapies. They’re intense! We spend time building our skillset, rapport and trust in one another, managing expectations, and establishing support outside session. As a result, my treatment completion rate is very high, and clients meet their treatment goals.

  • As long as it takes. That is not the ideal answer, I know, but it is important to set realistic expectations about therapy — and we simply cannot determine that until we work together for a little while.

    Exposure therapies are designed to be completed in about 12 sessions. This is what you’ll read online and receive in medical facilities. However, in my experience, this is also part of the reason that dropout rates are high — in private practice, there is room for flexibility. Life continues to happen while you’re in treatment, so we build in additional exposure opportunities and debriefing sessions as needed.

    Once we decide to introduce exposure therapy, the first several sessions involve specific preparations. We collaborate to determine the ideal “dose” — the minimal amount of exposure needed to optimize healing. The first several sessions are the hardest. But, truly, it does get become more tolerable, and you will notice improvements.

  • Maybe not! Think of exposure therapy more like surgery: sometimes this level of precision and invasion is necessary, but sometimes lifestyle