Exposure Therapy’s Most Common Mistake: All Eggs in the Habituation Basket
Posted by Steven J. Seay, Ph.D. in CBT, ERP, Obsessive-compulsive disorder (OCD)Many people have an incomplete understanding of exposure therapy…
…be it exposure and response prevention (ERP) for OCD, intentional mistake practice for social anxiety, or interoceptive exposures for panic disorder…
This is true for exposure newbies, seasoned exposure veterans, and even some good CBT therapists.
This limited understanding is based on the following flawed logic:
Premise 1: Anxiety disorders involve fear.
Premise 2: Fear is reduced through habituation.
Premise 3: Habituation is accomplished via exposure.
Conclusion: Habituation is the process by which individuals recover from anxiety disorders.
Note: This conclusion is only partially correct.
Exposure, when done right, is about much more than just habituation.
It’s about learning to see the world in a new way and developing a different type of relationship with your symptoms.
Exposure can help you challenge unhealthy, false beliefs about yourself and the world; learn to take risks and make choices that are consistent with what you want out of life; develop confidence in your ability to overcome challenges; and learn to tell the difference between you (the person) and your symptoms.
The next time you complete an exposure, ask yourself, “Why am I doing this exposure?”
If your only answer is “To habituate,” you might need to re-evaluate what you’re doing in therapy.
What have you learned from your exposures? How has your relationship with your symptoms changed as a consequence of challenging them? Please share below.
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