Thinking Through Exposure

Chapter 2 introduces a model of fears in terms of a network of learned associations among interconnected nodes. When these memories are cued, they can elicit expectancies for potential threat outcomes. Exposure therapy is used to alter these danger expectancies through new learning through confronting feared cues. This is an active learning process in which patients learn unconditional safety in response to their fear cues across diverse contexts. Over time, patients learn the difference between danger and fear (true vs. false alarms). To achieve this, it is important to (a) identify negative outcome expectancies to safe but feared cues (false alarms), (b) actively test these expectancies with exposure, (c) conduct postexposure processing of what was (was not) learned, and (d) rehearse this learning between sessions.