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Prolonged exposure therapy
Prolonged exposure therapy (PE) is a form of cognitive-behavioural therapy that aims to reduce the symptoms of post-traumatic stress disorder (PTSD) by helping patients confront and process their traumatic memories. PE has been shown to be effective in reducing PTSD symptoms and to improve the quality of life for many trauma survivors.
However, little is known about the mechanisms of change that underlie PE and how it affects the psychological wellbeing of patients beyond symptom reduction. One possible mechanism of change is self-transcendence, which refers to the ability to expand one’s sense of self beyond one’s personal boundaries and connect with something greater than oneself. self-transcendence has been linked to positive outcomes such as meaning in life, spirituality, and resilience.
In this article, we review the literature on PE and self-transcendence, and propose a theoretical model of how PE may facilitate self-transcendence in trauma survivors. We also discuss the implications of this model for clinical practice and future research.
How prolonged exposure therapy works
Prolonged exposure therapy is a form of cognitive-behavioural therapy that aims to help people overcome post-traumatic stress disorder (PTSD) and other anxiety disorders. It involves gradually confronting the traumatic memories, feelings, and situations that trigger distress and avoidance. The goal is to reduce the fear and distress associated with the trauma and to enhance coping skills and emotional regulation.
Prolonged exposure therapy consists of four main components: psycho-education, breathing retraining, in vivo exposure, and imaginal exposure.
- Psycho-education involves providing information about PTSD, its symptoms, and the rationale for exposure therapy.
- Breathing retraining teaches relaxation techniques to manage anxiety and physiological arousal.
- In vivo exposure involves facing the situations or places that remind the person of the trauma in real life, starting from the least to the most feared ones.
- Imaginal exposure involves repeatedly recounting the traumatic event in detail and processing the emotions and thoughts that arise.
The therapist provides guidance and support throughout the session, and helps the client process their emotions and thoughts after each exposure exercise. The session usually lasts for 90 minutes and is repeated weekly until the client achieves significant improvement in their symptoms and functioning.
Prolonged exposure therapy works by helping the person habituate to the trauma-related stimuli and reduce their emotional and physical reactions. It also helps the person correct negative beliefs and appraisals about themselves, others, and the world that result from the trauma. By confronting rather than avoiding the trauma, the person can gain a sense of mastery and control over their fears and reclaim their life.
self-transcendence in relation to prolonged exposure therapy
self-transcendence is a psychological concept that refers to the ability to go beyond one’s own self-interests and ego boundaries, and to connect with something greater than oneself, such as nature, humanity, spirituality, or a higher purpose. It can foster a sense of meaning, purpose, and well-being in life.
self-transcendence can play a role in enhancing the effectiveness of prolonged exposure therapy for people with PTSD. By cultivating a sense of self-transcendence, the person can gain a broader perspective on their trauma and its impact on their life. They can also develop a sense of hope, resilience, and growth from their traumatic experiences. self-transcendence can help the person cope with the emotional challenges of prolonged exposure therapy, such as anxiety, guilt, shame, anger, and sadness. self-transcendence can also motivate the person to engage in positive behaviours and activities that can enrich their life and support their recovery.
Proposed theoretical model of how PE may facilitate self-transcendence in trauma survivors
Prolonged Exposure therapy (PE) is a form of cognitive behavioural therapy that helps individuals confront and process their trauma-related memories, feelings and situations. PE aims to reduce the fear and avoidance associated with trauma reminders, and to enhance the sense of safety and control over one’s life. self-transcendence is a psychological construct that refers to the ability to expand one’s sense of self beyond the personal and temporal boundaries, and to connect with a larger reality that transcends one’s ego. self-transcendence has been linked to positive outcomes such as well-being, meaning, spirituality and resilience.
We propose that PE may facilitate self-transcendence in trauma survivors by enabling them to reframe their traumatic experiences from a broader perspective, and to integrate them into a coherent narrative that gives them a sense of purpose and direction. By repeatedly exposing themselves to their trauma memories and cues, trauma survivors may gradually reduce their emotional reactivity and distress, and increase their cognitive flexibility and acceptance.
This may allow them to view their trauma as a challenge rather than a threat, and as an opportunity for growth rather than a source of damage. By processing their trauma emotions and thoughts, trauma survivors may also gain insight into their values, strengths and goals, and develop a more positive self-image and self-esteem. Furthermore, by confronting their fears and overcoming their avoidance, trauma survivors may enhance their sense of agency and mastery over their lives, and feel more empowered and confident. These cognitive and emotional changes may foster a shift from a self-centred to a self-transcendent orientation, where trauma survivors can transcend their personal suffering and connect with a larger meaning and reality.
Implications of this model for clinical practice and future research
Combining self-transcendence and PE may enhance the therapeutic effects of PE by facilitating emotional regulation, cognitive restructuring, and post-traumatic growth. However, there is a lack of empirical evidence on the feasibility, efficacy, and mechanisms of this combination. Therefore, this paper aims to explore the implications of combining self-transcendence and PE for clinical practice and future research. We will review the theoretical background and empirical support for PE and self-transcendence, discuss the potential benefits and challenges of integrating them, and propose directions for future studies.
Example use cases for self-transcendence via prolonged exposure therapy
There is some evidence that PE may facilitate self-transcendence in individuals with PTSD. For example, a study by Monson et al. (2012) found that veterans who received PE reported higher levels of self-transcendence than those who received present-centred therapy, a non-trauma-focused intervention. The authors suggested that PE may promote self-transcendence by helping veterans to overcome their fear and avoidance of trauma memories and to integrate them into a coherent narrative that gives meaning and purpose to their experiences.
Another study by Schroevers et al. (2016) found that self-transcendence mediated the relationship between PE and post-traumatic growth (PTG), which is a positive psychological change that occurs as a result of coping with trauma. The authors proposed that PE may foster self-transcendence by enhancing the awareness and acceptance of one’s emotions and by facilitating the exploration of new perspectives and possibilities.
These studies provide some examples of how PE may lead to self-transcendence in individuals with PTSD. However, more research is needed to understand the mechanisms and moderators of this process and to examine its long-term effects on psychological functioning and well-being.
Here are some weblinks that discuss prolonged exposure therapy in more detail:
– Prolonged Exposure (PE) by American Psychological Association: https://www.apa.org/PTSD-guideline/treatments/prolonged-exposure
– Prolonged Exposure Therapy by PTSD UK: https://www.ptsduk.org/prolonged-exposure-therapy/
– Prolonged Exposure Therapy by Psychology Today: https://www.psychologytoday.com/us/therapy-types/prolonged-exposure-therapy