Prolonged Exposure Therapy
PE helps you approach the memories and situations you've been avoiding so what happened doesn't keep deciding how you live your life.
If your world has gotten smaller because you've stopped doing things you enjoy, going places you used to go, or spending time with people you care about, Prolonged Exposure might be a good fit for you.
What Is Prolonged Exposure Therapy (PE)?
After something bad happens, it makes sense that you'd want to avoid anything that reminds you of it. People generally don't like pain or discomfort, so when something makes you feel terrible, you naturally try to make that feeling stop. Maybe that means avoiding a particular place, a certain smell, or even a conversation you don't want to have.
And sometimes it's the memory itself. You might shut down a thought as soon as it comes up, keep yourself very busy, or do just about anything to avoid thinking about what happened.
Avoidance can work pretty well in the short term. You don't have to deal with the discomfort, and you can get on with your day. The problem is that, over time, you can find yourself avoiding more and more things just to keep that discomfort away.
Before you know it, you're planning your day around what you don't want to encounter rather than what you actually want to do. And the world you live in has gotten really, really small.
That's where Prolonged Exposure (PE) comes in.
PE is a structured trauma treatment that helps you approach the memories and situations you've been avoiding, rather than continuing to work around them.
By approaching those memories and situations in a planned, systematic way, you have opportunities to learn that remembering what happened doesn't mean you're losing control, and that situations you've been avoiding may not be as dangerous or overwhelming as you've come to expect.
The goal is to help you get back to doing things you've stopped doing because of what happened, without spending so much of your time trying to avoid reminders of it.
A Closer Look at PE
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PE is a structured treatment, so we'll have a plan for what we're doing and why. There are two main parts of treatment: imaginal exposure and in vivo exposure. Fancy names, pretty straightforward concepts.
Imaginal exposure is where we work directly with the memory of what happened. You'll talk through the experience from beginning to end, which can help you make sense of what happened rather than continuing to react to bits and pieces of the memory.
Think about watching a scary movie. The first time, you might jump at every scary scene. But by the fourth time you've watched it, you know what's coming, and those scenes probably don't have the same effect. Repeatedly approaching a trauma memory can work similarly. The memory can become less overwhelming, and you learn that you can think about what happened without losing control.
In vivo exposure is where we work on things you've been avoiding in everyday life. Maybe that's driving a particular route, going to a crowded restaurant, or being somewhere that reminds you of what happened. We'll make a plan to approach situations that are reasonably safe, and you'll practice between sessions.
Both parts of PE give you opportunities to learn something important: You can handle more than trauma has led you to believe. As you approach things you've been avoiding, you're rebuilding confidence in yourself and your ability to manage difficult memories, emotions, and situations.
The goal is to get you back to living your life without having to plan so much of it around what happened.
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Imagine driving somewhere without taking the long way around to avoid a particular road. Or going out to dinner without needing to sit where you can see every entrance and exit.
Maybe you can finally make plans with friends without spending the whole day looking for a reason to cancel. Or think about what happened without feeling like the rest of your day is ruined.
Those are the kinds of changes we're working toward with PE.
You may find that memories and reminders of what happened don't hit quite as hard as they used to. And when something does bring up a difficult reaction, you have more confidence in your ability to handle it.
The goal isn't to make sure nothing ever reminds you of what happened. It's to get to a place where those reminders don't keep deciding what you can and can't do.
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PE typically takes about 8–15 sessions, although the exact number depends on your needs and progress. Appointments generally last 60 minutes, with longer sessions available when needed.
Between appointments, you'll practice approaching situations you've been avoiding and listen to recordings of your imaginal exposure sessions. This is an important part of PE, and we'll make sure you understand what you're doing and why.
Throughout treatment, we'll regularly check your symptoms and progress. You'll know what we're working toward, what's changing, and when we're getting close to wrapping things up.
The goal is for you to leave treatment with the confidence to keep doing these things on your own, long after our appointments end.
Want to compare your options? Learn how CPT, PE, and NET differ in my guide to choosing a trauma treatment.
Wondering If PE Is Right for You?
You don't have to figure that out on your own.
Maybe some of what you've read sounds familiar, but you're still not sure whether PE is what you need. That's completely fine.
During a free 20-minute consultation, we can talk about what's been going on, what you'd like to change, and whether PE makes sense for you. And if another treatment would be a better fit, we can talk about that, too.
You don't need to have all the answers before reaching out.