Exposure Therapy in Milwaukee

Exposure therapy is an excellent evidence based therapy to address and confront anxiety disorders. We offer this type of therapy in Milwaukee and surrounding areas such as communities of Whitefish Bay, Shorewood, West Allis, Wauwatosa, West Bend, Waukesha and more. All of our therapists have basic fundamental knowledge in delivering exposure therapy. If you are looking to speak with a provider who may have more working knowledge of this type of therapy, we invite you to reach out to:

 

What Is Exposure Therapy?

Exposure therapy is a form of cognitive behavioral therapy (CBT) that is excellent for addressing anxiety disorders. Some anxiety disorders include panic disorder, phobias (e.g. agoraphobia), post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), social anxiety disorder and even general anxiety. It is sometimes called immersion therapy or graded therapy. Exposure therapy is sometimes also called exposure response prevention therapy.

When we encounter something anxiety provoking, our instinct is to avoid. This can reinforce more avoidant behavior and therefore the heightened anxiety of the trigger. In exposure therapy, the fear is confronted in a safe environment with a professional. The goal being that over time there will be a realization that the fear can be overcome, and we do not have to live in avoidance. As a matter of fact, lessening the avoidance improves quality of life, and this becomes more self apparent to the patient. It is important and normal to expect to feel uncomfortable during the therapy. With a large crux of exposure therapy being realizing that the discomfort will reach a peak and subside on its own with repeated exposures. With each repeated exposure, progressively the discomfort lessens until the patient is able to face that fear with the same level of discomfort as someone without the phobia and the outcome of being able to live without being confined by the avoidance generated by their anxiety.

Types of Exposure Therapy

It is important for exposure therapy to be customized to the needs of the patient. Because each patient’s fears and triggers are very unique, the heart of what determines efficacy of the exposure therapy is ensuring the exercise is sufficiently challenging for the patient (not too easy but not too overwhelming). On a scale of 1-10 in difficulty of the exposure exercise, commonly professionals will aim for a distress level of about 5. As the level 5 exposures are repeated, it becomes less distressing and becomes more of a level 3, 2 or even a 1. The exercises are customized throughout treatment and doing exposures that are too easy will not produce as large of a desired effect size, and the patient works up towards progressively challenging exercises until they achieve a level of mastery of their fears.

Exposure Therapy for OCD

Exposure therapy for OCD also involves a level of response prevention. Think of anxiety disorders this way, fire alarms serve a purpose. Where there is sufficient smoke, there may be a fire and therefore danger, that warrants notifying someone and action. But what if the alarm went off every time you burnt popcorn or cooking went awry? That is kind of like how anxiety works. With exposure therapy, you engage in an activity that will set off the alarm, but you resist the urge to respond to it. There is an increase in distress, but eventually reaching a point where we stop fighting that feeling, and it subsides on its own. This process is called habituation. The mind then realizes that engaging in a compulsion (also known as a maladaptive behavior) to reduce anxiety is actually not necessary, and riding that wave is actually more effective! Overtime, the urges to engage in responding to a false alarm, dissipate and everyday life feels less impairing.

A classic example is contamination anxieties and avoidance of touching items believed to be “dirty.” This can include things like public restrooms, dirt, etc. With a professional, sufficiently challenging exposure exercises are performed. The patient “contaminates” themselves but waits progressively longer periods of time, resisting the urge to wash their hands. Eventually, they reach the goal of washing their hands at the frequency per day that an average person does.

Exposure Therapy for PTSD

With anxiety disorders, our triggers can set off false alarms, much like a smoke detector when there is no true fire. In PTSD, reminders of the trauma serve as the smoke, whether there really is danger present or not. Exposure therapy for PTSD comes in multiple forms. One of them can be in the form of prolonged exposure and there is also written exposure therapy. Other techniques used for PTSD include imaginal exposure, in vivo exposure, and virtual reality. Most patients do respond to exposure therapy. In exposure interventions for PTSD, patients approach their fears, memories, thoughts and painful experiences. There are different ways where the patient re-experiences the painful occurrence(s) but with re-processing, exposure, and habituation – the false alarm response eventually extinguishes on its own. With that, the patient learns, and it sinks in more fully that the trauma related cues are not truly dangerous and the urge to avoid dissipates.

Some examples of how this therapy is employed for PTSD include examples of virtual reality simulations for combat veterans. Or sometimes individuals narrate a painful memory that includes describing the 5 senses, step by step what happened and what thoughts occurred. In doing so, the individual makes more sense of what happened. They often realize they underwent an extenuating situation and tried to make the best informed decisions they could with the limitations they had. The hopes are that disproportionate feelings of self blame and shame are also lessened and realization that what has occurred is not necessarily reflective of what is going to continue to happen throughout life.

Exposure Therapy for Social Anxiety

Exposure therapy is an excellent treatment for social anxiety. Social anxiety can take on multiple flavors. This can be fear of being the center of attention, performance related anxiety, fear of conflict, general social engagement, fear of eating in front of others, and phone anxiety. The professional helps the patient devise a series of exposure exercises of gradually increasing difficulty and distress. As the less distressing exposures are mastered, the patient moves on to the more challenging exposures. The idea is that as more favorable outcomes happen in these social environments, confidence is built and future opportunities feel less daunting. In addition, the individual learns more strategies for managing the distress in the moment and these skills become more proficient, further building confidence along with favorable social outcomes.

Exposure Therapy for Agoraphobia

Individuals with agoraphobia have fear of being in settings where escape can be difficult. Situations like large crowded areas, public transportations, being in lines can be particularly anxiety provoking. In response, some individuals may engage in safety behaviors such as trying to always be near a safety point, being with someone they trust, or always carrying some sort of item. In exposure therapy, an individual seeks these anxiety provoking situations and the keys are they repeat these exposures and make sure they are given enough time. As one sits through a stressful environment, the anxiety will initially peak and then will reduce on its own with the prolonged exposure.

Common Exposure Therapy Techniques

Graduation is a common technique used in exposure therapy. On a scale of 1-10, with a 10 being the most difficult, exposure exercises are generated. Together, with a professional, the patient chooses what level of exposure difficulty to work with. The aim is to shoot for at least a moderate level of distress because the mechanism of action is the generation of distress, sitting through it, and letting it naturally subside despite remaining in the stressful circumstance. Upon mastery, the more challenging exposures are pursued until the patient feels they have reached treatment goals and that their anxiety is no longer creating impairments in day to day living.

Another technique used in exposure therapy is called over-correction. For example for social anxiety, yes, a goal is to be able to endure day to day social interactions without surrendering to the urge to avoid situations and letting the anxiety inhibit your ability to do day to day activities. An over-correction would be going to a public place and purposely doing something that could be embarrassing, such as tripping or spilling fluid on yourself. The thought behind this is that it can create a learning experience that even in these worse case scenarios, the individual is still in a safe place and no harm is actually done. Yes, it can be awkward, and some empathic bystanders may come by to help. The hope is the realization that even when an embarrassing event happens, there are not significant longstanding adverse effects and hopefully potentially some confidence building. For example, people may learn to laugh a little at life and not take things too seriously.

Examples of Exposure Therapy

At this following link, an individual named Lily disclosed that she lived with a fear of dogs for most of her life, but it was transformed by exposure therapy. By 58 years old, she worked with Dr. Shikatani. She states within just a matter of months, not only was this fear no longer an impairment, she’s even learned to enjoy some dog encounters!

“Exposure Therapy Changed My Life”

Below is another beautiful story of someone who lived with anxiety and a fear of vomiting. The anxiety manifested in the fear of going out in public, large crowds, being in unfamiliar situations. She shared that she did not find relief in medical interventions. The fear of vomiting became more impairing as she was hoping to some day start a family, but the idea of nausea of pregnancy was a lot to bear. Fortunately, thanks to exposure therapy, she was able to create a family and is now a proud mother of 3!

https://www.monamiessolutions.com/blog/how-exposure-therapy-changed-my-life-a-hopeful-story-of-courage-and-resilience 

Contact New Frontiers About Exposure Therapy Near You

If you are looking for help, we are here. At New Frontiers, we offer a number of therapeutic approaches, and our counselors will work with you to determine the right course of treatment for your particular needs. Exposure therapy can be a very effective therapy method to bring about positive changes in a person’s life. If you are looking for a mental health office that offers exposure therapy near you in Milwaukee, we invite you to contact our friendly and compassionate team so we can set up an initial visit with one of our experienced psychotherapists. Call 414-763-6910 or contact us online using our contact form.

Don’t live with the misery of depressionanxietybipolar disorderPTSDpsychotic spectrum disorders, or another mental health issue. Schedule an appointment with a female psychiatrist by calling 414-763-6910 or by Requesting an Appointment online.

We welcome patients from the Milwaukee area, including New Berlin, Waukesha, Wauwatosa, West Allis, and nearby communities.