• Liam Tracey

How does exposure therapy work?

Exposure therapy is a method to offload our fears and anxieties, and the responses we have to them, in what many people call an unlikely approach. The premise is simple - face your fears, but in a managed, controlled and supported way. Let’s take a look at how it really works and the potential it has to help us move forward and leave our phobias behind.


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Exposure therapy is widely recognised as a branch of cognitive behavioural therapy. What that means is that it focuses on challenging and changing the responses, both emotional and behavioural, that are demonstrated when triggered by a specific situation. This approach to psychological therapy is one which is action orientated and supported by a professional at each stage. 


For example, if a person feared dogs, their instinctive reaction when faced with one may be intense sweating, shortness of breath, and a downward spiral of negative thoughts and emotions. From a cognitive behavioural therapy angle, the therapist will help this individual to rationalise each response, recognise that they aren’t supporting their sense of safety and control, and encourage more cognitively aware responses. For someone who may have previously thought that the dog may bite no matter what, they will begin to change their perception so that they understand the dog won’t bite unless provoked.


Therefore, exposure therapy follows a very similar path - as individuals are exposed to various experiences of things they fear, they are supported to develop coping strategies which become management techniques for their emotions and behaviours. This, in turn, will lead to a reduction in the negative responses one might have to a stimulus. 


So, with the help of a qualified therapist, exposure therapy will turn the tide on those anxiety and phobia driven symptoms, and lead to a conscious management of the responses to stimulus which was previously feared. But what is actually happening in our mind that allows that to happen?


The brainy bit


There is a small part of our brain, around the size of an almond, which is responsible for our fight or flight response. This response is what often keeps us safe, out of harm's way and, for the most part, isn’t a part of our brain which we can control in the moment. It is known as the amygdala, and while we can’t decide when to turn it on or off, we can train it to respond in certain ways. For instance, if you continually flee a situation where you are the focus of attention and all eyes are on you, your amygdala will learn that this is the response which will keep you most safe and therefore trigger a flight response when such situations may occur. The frustrating thing about this part of our brain? It only learns when it is fully activated.


This is where exposure therapy comes in. By exposing ourselves to the things which we fear or have anxiety over, we activate our amygdala and experience that fight or flight response. The difference here is that we sit with those exposures, we don’t flee. We immerse ourselves in the experience to the benefit of ‘re-training’ our response, and utilise the coping strategies which we are given and supported in by the therapist. 


How does technology help?


Today, we are seeing exposure therapy become available to patients using virtual reality technology. This is creating new opportunities for those with fears and anxiety, who will benefit from this form of treatment. 


Exposure therapy can be logistically challenging and often impractical, when supporting individuals, such as those with a fear of heights. It simply isn’t sensible to continually visit sites which are at increasingly great heights. So, how do we get around it? Virtual reality (or VR for short). Using 21st century technology, it is possible to simulate a range of exposures for patients, all within the safety of the supporting therapist's office or even the comfort of our own homes. 


With this approach, there is no limit to the phobias and anxieties which can be addressed through supported exposure therapy. Right now, the team at Ovrcome are developing exposure therapy options for fear of dogs, needles, heights and social anxiety. 



Exposure therapy offers individuals a pathway towards empowerment. Of course the idea may be daunting, frightening or even anxiety-inducing, but imagine being able to reflect on a journey to control over your phobias and anxieties. Then, consider the pride and fulfilment you might feel, knowing that you achieved that through squaring right up to the thing you feared the most? How great would that feel?