Prolonged Exposure Therapy (PET)
Prolonged Exposure Therapy (Foa and Kozak, 1985, 1986) is a bottom up trauma process recommended for single include traumas (known as type 1 trauma) and other trauma-related reactions such as depression or anxiety following any kind of trauma where the sufferer has sufficient recall of the trauma and can describe it with a beginning, middle and end. The purpose is an emotional processing of traumatic experiences through repeated exposure. Fear is regarded as the primary emotion in type 1 trauma which often leads the sufferer to avoid reminders of the trauma, thereby exacerbating the problem.
Prolonged exposure therapy utilises psychoeducation, breathing retraining as well as both in vivo and imaginal exposure in a systematic way in order for habituation to occur. The fear structure is activated during exposure in order for new information to be incorporated. Prolonged Exposure has a large research and evidence base and its efficacy is well documented (Foa, Hembree & Rothbaum, 2007). To keep it simple, in this type of therapy the trauma memory is revisited in a detailed and prolonged way – this helps the brain to understand that the trauma is only a memory and is not happening now (a process called habituation), and any danger has passed. Alongside this, therapy also looks to help a person stop avoiding aspects of the trauma in a step-by-step way.
Written Exposure Therapy
Written Exposure Therapy (WET) is designed to help individuals process and cope with traumatic memories and is based on the principles of exposure therapy. It promotes habituation through repeated exposure to traumatic memories in a controlled way which helps lessen the emotional charge over time. It involves writing about traumatic or distressing events in detail, often in a structured and focused way, with the goal of reducing the emotional intensity and negative impact of those memories over time.
In WET, you are encouraged to write about your traumatic experiences, focusing on the details of the event, your thoughts, emotions, and reactions. You typically write for a set period as advised by your therapist it’s completed in the therapy session so no homework. By confronting and expressing these difficult experiences through writing, you can begin to process your emotions and integrate the memories, reducing symptoms of PTSD (post-traumatic stress disorder) or anxiety.