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Imaginal exposure is a repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous (despite being objectively safe). Additional procedures include processing of the trauma memory and breathing retraining.
Flooding, sometimes referred to as in vivo exposure therapy, is a form of behavior therapy and desensitization – or exposure therapy – based on the principles of respondent conditioning. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress disorder .
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory.
Wolpe's systematic desensitization "consists of exposing the patient, while in a state of emotional calmness, to a small 'dose' of something he fears" using imaginal methods that allow the therapist to "control precisely the beginning and ending of each presentation". [15] This graduated exposure is similar to the SE concept of "titration ...
There is empirical evidence that exposure therapy can be an effective treatment for people with GAD, citing specifically in vivo exposure therapy (exposure through a real-life situation), [79] which has greater effectiveness than imaginal exposure in regards to generalized anxiety disorder.
Systematic desensitization, or graduated exposure therapy, is a behavior therapy developed by the psychiatrist Joseph Wolpe. It is used when a phobia or anxiety disorder is maintained by classical conditioning. It shares the same elements of both cognitive-behavioral therapy and applied behavior analysis.
Imaginal exposure: Vividly imagining the feared situation, object, or environment. This technique is commonly used for those who have had a past traumatic experience or witnessed an event leading to their diagnosis of thalassophobia.
An abbreviated example of an exposure hierarchy is pictured in Image 1. Image 1: Exposure hierarchy example for treating public speaking fears. When exposure to an item at the bottom of the hierarchy leads to moderately reduced distress or increased tolerance, a client progresses up the hierarchy to more and more difficult exposures.