Prolonged Exposure Therapy (PET) Explained

According to a report from the University of Pennsylvania, post-traumatic stress disorder (PTSD) afflicts approximately 8% of the population. However, this complex and challenging disorder can be treated. There are proven long-term treatments that can help individuals who have PTSD get their lives back.

Prolonged Exposure Therapy (PET) is an empirically-validated treatment based on cognitive behavior theory. It’s specifically designed to help patients suffering from PTSD and other anxiety disorders improve their symptoms and restore their self-esteem. 

If you or your loved one is considering undergoing PET, here are some of the things you need to know:

Exposure Therapy Methods

Exposure therapy targets behaviors, such as avoidance, that people develop and manifest in response to threatening or anxiety-provoking memories, thoughts, and situations. 

For instance, a victim of sexual assault may avoid dating because she fears being assaulted again. However, this protective response may lead to difficulties with future social interactions and relationships.

The goal of exposure therapy is to eliminate avoidance or safety-seeking behavior, reduce the person’s anxieties and fears, and increase their quality of life through active confrontation. This can be done in three different ways: 

Interoceptive Exposure

This method was initially developed to treat panic disorders. It involves letting the person directly confront the somatic symptoms associated with anxiety, such as hyperventilation or increased heart rate. The therapist will create a safe and controlled environment to induce these symptoms and reduce the person’s fear of physical sensations.

Imaginal Exposure

This method involves letting the person vividly imagine their feared thoughts or memories. For example, a combat veteran suffering from PTSD may be asked by their therapist to imagine a previous combat situation. Imaginal exposure is typically used when it’s not possible or safe for the person to confront the feared situation in reality.

In Vivo Exposure

This method involves directly confronting feared situations or objects under a therapist’s guidance. For instance, a person who fears public speaking may be instructed by their therapist to give a speech in a public gathering or location.

A person who undergoes PET, a combination of all three methods, will learn how to control the physical symptoms of their trauma, imagine and discuss their fears, and practice in real-life settings and situations.

Who Is PET Appropriate for?

PET may be recommended to anyone who has witnessed or experienced a traumatic event, even if they do not have a PTSD diagnosis. Individuals with PTSD who remember at least some part of the traumatic event may also undergo PET.

PET may NOT be the best choice for individuals who exhibit any of the following:

  • Unwillingness or inability to experience or face intense emotions
  • Other higher-priority or more severe problems than PTSD that may interfere with emotional exposure during the therapy
  • Self-injury tendencies
  • Imminent or potential suicidal behavior

How Does PET Work?

PET is typically conducted through one-on-one therapy. Each session lasts approximately 90 minutes and takes place once a week for three months. However, the duration is often on a case-to-case basis. Some people may only need to undergo the therapy for 8 weeks, while others may take as long as 16 weeks. PET has also been conducted in brief, intensive formats such as 5-10 day treatment programs.

During each session, the therapist may ask the person to do any of the following:

  • Make a list of the things—including feelings, sounds, thoughts, and situations—they’ve been avoiding and rank them depending on how much distress they cause upon encounter.
  • Interact with these things in real-life (i.e. in vivo exposure).
  • Write down their traumatic experience, which they’ll then read aloud during and outside the session. 
  • Process their thoughts and feelings to reduce distress and traumatic reminders when recalling their experience.

Looking for a Psychotherapist? Request a Consultation

If you’re interested in getting PET, finding the right therapist should be your first step. A good psychotherapist can make a huge difference in your treatment outcomes. Don’t suffer in silence and get the help you need today.

Stanley Wipfli is a licensed trauma therapist based in San Francisco. He has extensive experience providing therapy for entrepreneurs, technology workers, and other professionals who are experiencing symptoms associated with stress, depression, anxiety, trauma, and PTSD. 

Contact Stanley Wipfli to schedule a free 15-minute consultation today. He is available to see San Francisco patients in person and other California residents virtually.