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Prolonged Exposure

Another symptom that block people from the natural recovery process following a traumatic event is avoidance. Internal avoidance is when people attempt to suppress the memories of the traumatic event and associated negative thoughts and feelings. However, the very act of avoiding the memories makes them more powerful and prevalent (try NOT to think about a pink elephant for 1 minute and see how you do). Suppressing negative emotions can numb individuals from all emotions, including positive ones, and can become exhausting, like holding down a floating ball in the ocean that keeps trying to pop-up to the surface. External avoidance is when people attempt to evade people, places, objects, and situations that have the potential to trigger the traumatic memory. This approach may relieve some anxiety in the short-term, but actually can have negative long-term effects on your functioning in multiple areas of your life.

Prolonged Exposure (PE) is a form of cognitive-behavioral therapy that targets avoidance. It teaches you to approach the memory of the traumatic event through verbal re-tellings called “imaginals,” so you can process and release the associated negative emotions and re-encode the memory without such strong emotions attached to it. PE also teaches you to approach the external situations you may be avoiding in a gradual and systematic way, called “in vivos,” so you learn that these situations are not dangerous and gain confidence in your ability to handle them. 

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