What is exposure therapy?
Exposure therapy is an evidence-based treatment modality used to treat phobias, fears, and anxieties. When someone is terrified of something, they tend to avoid their fear, whether it’s a situation, behavior, person, or object. Avoiding their fear can help reduce anxiety symptoms in the short term, but in the long run, the phobia magnifies. (1)
Exposure therapy breaks the cycle of fear and avoidance by gradually and safely exposing the patient to their phobia in a controlled, monitored setting. The idea is that slowly, over time, exposure can decrease feelings of anxiety and fear, thus reducing avoidance.1
Exposure therapy can help eating disorder patients in a few ways, including:1
- Self-efficacy: Exposure to fear foods or skipping eating disorder rituals can prove to the patient that they are capable of confronting their phobias and dealing with the anxiety.
- Emotional processing: Eating disorder patients can learn to tolerate fear and anxiety better and replace unhelpful thought patterns with more realistic, healthy beliefs related to the fear.
- Habituation: Gradually, exposure can reduce anxiety and fear reactions to feared stimuli.
- Extinction: Exposure can break the learned associations between phobias and negative outcomes over time.
What does exposure therapy entail?
Many people with eating disorders have extreme fears related to their disordered eating behaviors, whether it be eating a certain amount, eating a particular food, looking in the mirror, or avoiding a behavior like compulsive exercise. Exposure therapy for eating disorders involves confronting their fears and incorporating them into the patient’s everyday life under the guidance of a therapist or psychologist.
Exposure therapy for eating disorders like anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder (ARFID), and binge eating disorder involves exposing patients to their fear, which may initially cause a spike in anxiety as they begin to face their fears. Still, over time, the patient will typically adapt to the feared situation and experience a reduction in anxiety.
Moreover, exposure therapy can help eating disorder patients develop new associations between their fears and outcomes. After exposure to their fear, they may learn that the outcome is not what they had expected. Developing tools to safely manage if the feared outcome does occur can also be part of this process.2
Within Health eating disorder treatment
At Within Health, we tailor our treatment plans to meet the unique needs and challenges of each patient, and that includes creating thoughtful and individual exposures to support our patients. This includes support around exposures to new or feared foods during programming.
Movement group therapy
Our movement groups are also exposure therapy groups. Some eating disorder patients are afraid of moving their bodies or exercising because this brings about awareness of their bodies. Exposure work may involve doing small increments of movements if nutritional intake is appropriate. We also individualize this movement exposure by finding movement that brings our patients joy or involves something they’d like to learn, such as dance.
Alternatively, some movement exposure groups may involve the cessation of movement. This is typically for patients with a history of compulsive exercise or exercise addiction. For example, if a patient typically engages in a rigid exercise regime, they may be asked to take more rest days or change the duration and intensity of their workouts, which can ultimately help them to overcome their fear of not exercising.
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Eating disorders treated with exposure therapy
Exposure therapy may be used to treat many different eating disorders, including:2
Additionally, exposure therapy may be used to treat eating disorder patients with co-occurring mental health conditions, such as:1