Applying Exposure Therapy to Addiction Treatment

Exposure therapy isn’t generally thought of as a form of treatment that could work with healing from addiction. In general, exposure therapy is used with healing from phobias and anxiety. It involves the exposing a client to whatever he or she is afraid of. The point is to lower their level of fear by being in the presence of the object long enough to learn that it doesn’t have to induce fear after all. If the client can see that there is no danger, he or she might be able to overcome the anxiety or fear.

This same technique could be applied to healing addiction as well, according to Dr. A. Tom Horvath, the founder and president of Practical Recovery in San Diego, CA, as well as the president of SMART Recovery, an international nonprofit offering free, self-empowering, science-based, mutual-help groups for addiction recovery. In an article he wrote on The Fix, he explains exactly how this form of therapy could be used in addiction treatment. On the whole, addiction treatment is learning how to handle high risk situations. Frequently, the development of an addiction happens begins of poor coping skills in situations that are difficult to face. This can continue in recovery when individuals become fearful of bars or seeing people that they know are still getting high. They are afraid that being faced with those people or places might make them vulnerable to using. Of course, recovering addicts are already vulnerable to relapse and the dangers old and familiar people and places might lead to drug use or drinking.

Some recovering addicts become so fearful of these situations that it creates anxiety which only makes the situation worse. Dr. Horvath suggests finding a way to actually face that situation head on. In exposure therapy, a therapist would accompany a client to the top of a building who might be afraid of heights. Once that client recognizes that he or she is in fact safe in that situation, then perhaps the level of fear might go down. However, Dr. Horvath points out that exposure therapy only works if the client is able to stay with their fear long enough to see through it. For instance, if someone who is afraid of heights can’t stay in a building long enough to get up to a high floor then the therapy isn’t going to take place.

The same is true when applying exposure therapy to addiction treatment. For instance, if an individual is afraid of driving down a particular street because there are many bars and clubs in that location, then the therapy might be to actually visit that street. Of course, that person is accompanied by a therapist or trusted friend so that relapse doesn’t actually occur. Instead, if he or she can stay long enough without drinking then a new connection might be formed in the brain. In this case, a client might be able to see that he or she is safe at a bar and that he or she has the power to not drink. This can be incredibly empowering. When a client recognizes that being at a bar doesn’t have the same power over them, then he or she has more freedom than before. And if it can happen at a bar, then maybe a client can attend a party and not feel powerless to drinking there. Dr. Horvath also points out that exposure therapy isn’t as simple as it might at first sound.

During the first few weeks, a therapist would need to establish some points of safety to protect against any overwhelming feelings or the giving in to a strong craving. Certainly, exposure therapy gone wrong is a client’s relapse. However, with the right precautions and a strong therapeutic relationship, exposure therapy could be just the right antidote for recovering addicts to feeling fearful of certain places and people. As Dr. Horvath states in his article, with a few experiences of making it through strong cravings, one’s level of confidence in their ability to stay sober can soar. In fact, Dr. Horvath states the following:

I am confident that if rehabs adopted the practice of exposure therapy for appropriate clients, these people would be much better prepared to return to the real world.

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