Prolonged Exposure (PE) is an evidence-based practice for the treatment of anxiety disorders and post-traumatic stress disorder. It is a type of Cognitive Behavioural Therapy, meaning that the goal is to achieve a change in the way you feel by changing your thoughts and behaviours. For many people who have experienced trauma, and for people with anxiety and specific phobias, avoidant behaviours are common. For example, it is a natural response to avoid a person, object, place, and/or situation that elicits fear, or that reminds you of a trauma that occurred. When we avoid something, our distress temporarily goes down. However, when we continue avoiding, we never 'take back control'; we stay stuck in the avoidant behaviour pattern, and will more than likely continue to experience fear, anxiety, and intrusive thoughts.
In Prolonged Exposure, we do the opposite action to avoidance - we "expose." This could mean imagining the trauma that occurred while you're with your Counsellor, and examining the thoughts and feelings that arise when this happens. This is called an "imaginal exposure." Or it could mean exposing yourself to specific triggering or anxiety-inducing places, objects, or situations. This is called an "in-vivo exposure." In PE, we do this in a gradual way. We look at what is being avoided, and we build a hierarchy (i.e., a ladder) so that, as a team, you and your Counsellor can work your way up to exposing yourself to the place, object, or situation that has been avoided for so long. You'll be required to monitor your distress level throughout the exposures. The idea is that, with repeated exposures, your distress level will gradually decline and you will be able to challenge gradually more anxiety-producing places, objects, or situations on your avoidance hierarchy/ladder. Eventually, the anxiety or fear surrounding what was once avoided will be reduced, and you will be much more likely to experience comfort and safety around the once-avoided people, objects, places, and/or situations.