I’m An Exposure Therapist. Here’s How I Confront Patients With Their Worst Fears.

I'm An Exposure Therapist. Here's How I Confront Patients With Their Worst Fears.

In 2013, I graduated with a Master of Arts degree in Professional Counseling. I was as unprepared as any intern would be, thrown into a world I’d only learned about in grad school. I quickly realized that being a traditional “talk therapist” was not appealing to me. I couldn’t find my specialty or ideal client. I felt inadequate.

I was working with individuals in a traditional setting, dealing with traditional things people seek therapy for: depression, work problems, parenting and relationship issues, and life dissatisfaction. It’s not to say that these issues aren’t serious or worth seeking counseling for, but treating those issues wasn’t the right fit for me.

I tried working in other settings, like a residential treatment center for traumatized children, where I loved the job, but the physical demands, secondary trauma and burnout were not sustainable for me.

So when I saw a listing for a position that would give on-the-job training at an anxiety center, I was intrigued, even though it was not in my area. I interviewed for the position and was offered the job. So I moved halfway across the country to try something new: working exclusively with clients with anxiety disorders and Obsessive Compulsive Disorder (OCD) using an approach under the Cognitive Behavioral Therapy (CBT) umbrella called Exposure and Response Prevention (ERP).

ERP is used to break the negative reinforcement cycle by encouraging the individual to confront stimuli that trigger distress. I use ERP to treat specific phobias like agoraphobia (fear of leaving one’s own home), emetophobia (fear of vomit or vomiting), aerophobia (fear of flying), nosophobia (fear of contracting chronic illnesses), fear of driving, fear of natural disasters, and even fear of monsters under the bed.

When working with clients who have OCD, I use it to treat variable subtypes like contamination (obsessions about contracting illnesses or spreading germs), sexual obsessions, harming obsessions (intrusive thoughts or images about harming self or others), perfectionism, relationship obsessions, checking behaviors, cleaning/washing rituals, mental compulsions, “just right” obsessions (thoughts or feelings that something is not quite right), feelings of disgust, and more.

ERP can also be indicated for school avoidance, social anxiety disorder, panic disorder and disordered eating.

Once I started successfully helping people face their fears, I knew I had finally found my specialty. ERP got me out of…

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