Though we may not think of them this way, our brains act as little pattern detectors, designed to find order in chaos. The fantastical processing power of the human brain has been instrumental to our success as a species. However, it is the same propensity for pattern-finding that often underlies anxiety disorders. One’s own hypervigilance can feed into the brain’s desire to avoid harm, leading to the development of strong and stable associations between benign situations and fear. This is especially evident in a condition like OCD and PTSD, where fear and anxiety become deeply ingrained into one’s psyche. Let’s say for example you have OCD and one of the ways it manifests is through germophobia. Well, every time you give into a compulsion and clean or avoid germs and end up not getting sick, the loop in your brain is further reinforced (Fear Conditioning, 2016; Kimble et al., 2014; Van Den Hout & Kindt, 2004). The question is: how do we extinguish the association between innocuous items/thoughts and resultant anxiety?
One of the best therapeutic treatments for OCD and other anxiety disorders is exposure therapy. The idea here is to incrementally expose the individual to experiences that make them anxious, while they are in a safe and loving environment. Over time this shows your brain that the item or experience that provokes anxiety does not lead to a negative outcome. This can work to extinguish deeply ingrained associations (Cooper et al., 2017; Craske et al., 2014).
There are several different ways in which the exposure portion of exposure therapy can take place. Practitioners often start with imaginal exposure, where the client is tasked to remember/imagine the scenario that causes them stress, or interoceptive exposure, where the physiological symptoms that accompany their anxiety are mimicked in a safe setting. For more advanced desentization, clinicians will implement in vivo (also called “in-person”) exposure where the client directly engages in the activity that elicits stress (What is Exposure Therapy, 2017).
Although exposure therapy may seem like a scary prospect, a good practitioner allows the client to set the pace, ensuring that no session is too difficult to surmount. Most importantly, exposure therapy is incredibly effective at reducing symptom severity and even prompting full remission in people with anxiety disorders (Eftekhari et al., 2013; McGuire et al., 2014).
