All About Prolonged Exposure Therapy

What Is Prolonged Exposure Therapy?

Prolonged exposure therapy is a structured, evidence-based treatment designed to help people recover from trauma and post-traumatic stress disorder (PTSD). It helps individuals gradually confront distressing memories, emotions, and situations they’ve been avoiding due to fear. By facing these experiences in a safe, controlled way, people learn that they can tolerate the discomfort and that the memories are not dangerous.

How Trauma Avoidance Keeps PTSD Alive

After a traumatic experience, it’s common for people to go to great lengths to avoid reminders of the trauma. This avoidance can include staying away from certain places, people, activities, or even memories and thoughts. While avoidance may provide short-term relief, it often reinforces fear in the long term. Prolonged exposure therapy helps break this cycle by showing the brain that these triggers are no longer threatening.

How Prolonged Exposure Therapy Works

Prolonged exposure therapy involves two main techniques: imaginal exposure and in vivo exposure. Imaginal exposure involves recounting the traumatic memory in detail during therapy sessions, helping the brain reprocess it and reduce its emotional power. In vivo exposure means gradually approaching the real-life situations or cues that have been avoided. These steps are planned collaboratively with the therapist and are done at a pace that supports safety and success.

What to Expect in Prolonged Exposure Therapy

This therapy typically follows a structured protocol and is delivered over 8 to 15 weekly sessions. The process begins with education about PTSD and the rationale for exposure. The therapist helps the client identify their specific avoidance patterns and develop a personalized exposure hierarchy. Sessions include real-time exposure practice and between-session assignments to reinforce progress. Over time, the distress associated with the memory and related triggers decreases.

Who Can Benefit from Prolonged Exposure

Prolonged exposure therapy is a first-line treatment for PTSD and is recommended by leading organizations including the American Psychological Association and the Department of Veterans Affairs. It is especially effective for people who are ready to directly address their trauma and want a time-limited, structured treatment with a high likelihood of symptom relief. It can be used alone or alongside other approaches like medication or skills-based therapies such as DBT.

Is Prolonged Exposure Therapy Too Intense?

Some people worry that prolonged exposure therapy will be too painful or overwhelming. However, the process is designed to move at a tolerable pace, and therapists are trained to support clients in staying grounded throughout the experience. While the work can be challenging, many clients report that the relief and freedom they gain is well worth the effort.

Finding a Therapist for Prolonged Exposure

Not every therapist is trained in prolonged exposure, so it’s important to find someone with specific expertise in this modality. A qualified prolonged exposure therapist will guide you through the process with care, structure, and respect. With the right support, it is possible to move beyond trauma and reclaim your life.

Healing by Facing, Not Avoiding

Prolonged exposure therapy is about leaning into what scares us in order to defuse its power. For people living with PTSD, this approach offers a path forward—one where fear no longer rules, and trauma no longer defines.