The exposure technique It basically consists of gradually or directly confronting the stimuli that we fear or that cause us anxiety with the aim of reducing this anxiety. It is a technique that is used in numerous clinical conditions, from phobiasfor which it was originally conceived until the obsessive compulsive disorder (OCD), the stress post-traumatic, addictions wave bulimia.
There are several types of exposure techniques. One of the key authors when we talk about them is Joseph Wolpe. This author introduced and developed systematic desensitization, a specific type of exposure in imagination. When the exposure occurs in front of the real stimulus (rather than in imagination or virtual reality) we speak of live exposure.
Live exposure is a classic technique within cognitive-behavioral therapy. Its basic foundations are found in conditioning and the principles that explain its effectiveness They would be habituation at a physiological level, extinction at a behavioral level and changing expectations from a more cognitive or mental perspective.
When talking about exposure it is essential to keep in mind the concept of avoidance of anxious stimuli. This can occur either because we do not face it or because we appropriate elements that give us security. What type of elements? Well, for example, if they give me afraid of airplanes and I only allow myself to go on one if I carry a benzodiazepine in my pocket in case I have a panic attack, that pill would be working as an avoidance. Despite taking the plane, I don’t give myself the opportunity to experience what happens if I leave the pill at home. With it in my pocket I have the peace of mind or mental security that if something bad happens I can take it, with which I am not truly exposing myself to the fear that the plane gives me.
The studies by Mathews and collaborators showed that, although long exposure sessions were more effective than short ones, once exposure occurred habituation. It is important to keep in mind that, in addition, if an exposure is not long enough it could be sensitizing instead of therapythat is, producing more fear or anxiety than there was at the beginning.
Another factor to take into account in the exhibition is the graduation with which the patient is exposed to the anxious stimulus. Both graded and abrupt exposures have been shown to be effective. Each one has its advantages; While the gradual ones are more tolerable for the person, the abrupt ones are more immediate. Generally the guideline is that the degree of exposure The patient’s tolerance will determine it.
Live exposure is one of the most effective techniques in cognitive-behavioral therapy, but due to how aversive it can be, it will be very important that there is a good therapeutic alliance and that a good gradation of anxiety stimuli is carried out, since otherwise it is very likely that therapeutic abandonment could occur.
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