GUEST BLOG POST BY CHELSEY SILVERIA, LCSW (CLEARVIEW TREATMENT PROGRAMS)
Has a therapist ever suggested PE therapy for you? Have you ever felt unsure about what that means and the potential impact or usefulness of this therapy? PE stands for Prolonged Exposure. Prolonged Exposure therapy is an evidence-based practice; meaning there is research that demonstrates this type of treatment is effective at reducing an individual’s symptoms.
Most likely a therapist has discussed the option of beginning PE therapy if you have a history of trauma or have recently experienced something traumatic. Individuals who experience trauma and develop symptoms often meet the criteria for the diagnosis of PTSD (Post-Traumatic Stress Disorder). PE therapy is effective at reducing symptoms of PTSD because it enables you to begin addressing certain feelings, thoughts, or situations that you have been avoiding because it reminds you of the trauma.
If you have experienced trauma, you may try to avoid feelings, thoughts, or situations that remind you of the trauma. However, this is often beneficial only in the short term and not for any length of time. People with untreated PTSD who avoid dealing with their feelings become significantly impacted in their daily lives. They avoid spending time with their friends or family due to fear that they will be confronted with their trauma. They may also stop engaging in their favorite hobbies or activities because they do not want the chance that something might trigger them. These people can be so focused on avoiding any triggers that they seem to lose the life that they once had. This also prevent people from recovering from the symptoms of PTSD.
In PE therapy, you will have the opportunity to face your fears and talk about your trauma in a safe environment. You will expose yourself to thoughts, feelings, events that remind you of the trauma. This can be very challenging. Your therapist will ask you to do the exact opposite of what you want to do – avoid dealing with those thoughts and feelings. However, after you begin to discuss the trauma in more detail and expose yourself to the things that may remind you of the trauma your distress level will decrease. You will retrain your brain to learn that you can experience certain situations and remain safe. When you experience PTSD symptoms your brain and body believe that if you experience thoughts, feelings, or situations similar to those attached to your trauma, your life or wellbeing is once again at risk just as it was during the traumatic event.
If you are considering PE, there are a couple of things to know. PE therapy is not without risk. You will have to talk about your trauma in detail. But your therapist will be there to support you and you will be able to take things at your pace.
You will be asked do things that remind you of the trauma outside of the safe environment of therapy. You will start by doing things that make you slightly distressed and then will slowly expose yourself to more and more things that may make you more distressed.
Once again this may sound overwhelming, however living with PTSD symptoms and avoiding things that you used to enjoy doing can be just as difficult. And those engaged in PE therapy report a decrease in symptoms as they continue their treatment.
10 things to know about PE:
- PE is recommended for individuals who have experienced trauma and are experiencing symptoms of PTSD.
- PE therapy is not appropriate for certain people, even if they have experienced a traumatic event. One reason PE therapy is not recommended is for those who have a difficult time remembering the trauma and several other factors.
- PE lasts approximately 8-15 weeks, depending on how many sessions are needed. It includes weekly sessions that typically last 90 minutes.
- During the first session, you will learn more about PE, you will share some information about your trauma, and you will learn breathing techniques to help when you are feeling distressed.
- In the second session, you will discuss how the trauma has impacted your life. You will also be asked to do activities outside of therapy that reminds you of the trauma. Lastly, you and your therapist will rank people, places, and things that you have been avoiding since the trauma.
- In the third session, you begin to discuss your trauma in detail.
- In sessions 4-9 (more sessions can be added if needed), you will continue to describe your trauma in detail as well as go over how you are exposing yourself to situations that remind you of the trauma.
- Homework will be given during each session and will be reviewed the following session.
- In the final session, you will discuss how your feelings about your trauma have changed and how you can continue to practice the skills you learned in therapy moving forward.
- PE is an individual therapy and is not done in a group setting.
Chelsey Silveria, LCSW, is Program Therapist at Clearview Treatment Programs. Located in Los Angeles, Clearview Treatment Programs is a premier provider of mental health treatment for women with Borderline Personality Disorder (BPD), psychiatric disorders, addictions, and dual diagnosis. Internationally known for its Dialectical Behavior Therapy (DBT) and evidence-based treatment programs including Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Prolonged Exposure Therapy (PE), Clearview Women’s Center provides treatment for mental health disorders (BPD, PTSD, depression, anxiety, bipolar disorder, eating disorders, and more) in a home-like setting for women. Since 2000, Clearview’s evidence-based treatment programs have helped hundreds of women succeed in their recovery.
Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2007) Prolonged exposure therapy for PTSD emotional processing of traumatic experiences therapist guide. New York, New York: Oxford University Press Inc.