Exposure

principle Exposure in vivo represents the final common pathway of many techniques described by several schools of psychotherapy. The first, person to write a report, on successful exposure in agoraphobia was a French author, Perroud4 who was working at the Hôpital de la Charité, in Lyon. Janet5 used the exposure principle in several cases of obsessions or phobias. Inhibitors,research,lifescience,medical Later, Freud6 made a. forgotten contribution to CBT with the straightforward judgement that for resistant agoraphobia “one succeeds only when one can induce them by the influence of the analysis to go into the street and to struggle with their anxiety.” In this respect, cognitive behavior therapists arc more Freudian than modern psychoanalysts, who continue to treat agoraphobia Inhibitors,research,lifescience,medical with classic psychoanalysis, while its effectiveness remains to be demonstrated. Wolpe7 and Marks,8 a fervent reader of Janet, systematically developed the exposure paradigm in anxiety disorders and put. this principle under systematic scientific

inquiry, in several controlled trials, which were sellectchem replicated all over the world. Exposure consists in habituating degree by degree the patient to the feared situations in imagination Inhibitors,research,lifescience,medical and then in vivo. The aim is to obtain a habituation of emotional responses and the extinction of avoidance behaviors, which are reinforced by anxiety. Generally, the therapy starts with exposure in imagination confronting the patient, step by step to the feared Inhibitors,research,lifescience,medical situations until habituation occurs. Graded in vivo exposure is then carried out. Each session of exposure in vivo or in imagination

may last up to 45 minutes, which is, in general, the maximum length Inhibitors,research,lifescience,medical of time required to habituate the anxiety responses. Cognitive restructuring CT implements two main strategies: (i) cognitive restructuring on misinterpretations of bodily sensations; and (ii) breathing retraining in order to control the physiological effects of hyperventilation and tachycardia. Treatment, typically includes 15 to 20 sessions, which can be summarized as follows: Modifying panic attacks, (i) Breathing retraining to control GSK-3 the sensations resulting from hyperventilation frequently involved in panic attacks; (ii) Valsalva technique through abdominal breathing to control tachycardia; and (iii) cognitive restructuring to modify misinterpretations of bodily sensations and challenge the danger cognitive schemata. Modifying agoraphobia. Behavioral experiments consist, in modifying avoidance behaviors through graded exposure followed by cognitive restructuring through self-talk and written disputing on appropriate forms. Interoceptive exposure for panic attacks Some researchers designed specific techniques for the bodily symptoms.