Feeling overwhelmed by cravings and avoiding things that remind you of past trauma? It’s a tough spot to be in, but there are ways to work through it. This article talks about a plan, kind of like a weekly schedule, for facing those difficult situations safely. It’s all about taking small steps, learning to handle the discomfort, and eventually feeling more in control. We’ll explore how to build up your tolerance and manage those intense urges, turning avoidance into a path toward healing.
Key Takeaways
- A craving exposure schedule helps you face avoided situations step-by-step, making them less scary over time.
- Building a list of challenging situations, from easy to hard, is the first step in creating your personal exposure plan.
- Practicing these situations multiple times and letting the discomfort naturally decrease is key to learning new responses.
- Tracking your feelings and understanding cravings as temporary waves can help you manage them without giving in.
- Techniques like ‘urge surfing’ teach you to experience cravings without trying to push them away, which can reduce their power.
Understanding the Rationale for Craving Exposure Schedule
So, why exactly do we talk about a "craving exposure schedule"? It might sound a bit counterintuitive at first. We often think of cravings as something to fight or suppress, right? But the idea behind this approach is actually quite powerful. It’s about learning to face the things we’ve been avoiding, not because they’re inherently dangerous, but because avoiding them keeps us stuck. By gently and safely confronting these situations, we start to chip away at the unhelpful beliefs that might be fueling our anxiety and cravings.
Confronting Avoided Situations Safely
Think about it: when something makes us anxious or reminds us of a difficult past experience, our natural instinct is to steer clear. This avoidance, while offering temporary relief, actually reinforces the idea that the situation is something to be feared. The craving exposure schedule flips this script. It’s designed to help you gradually re-enter situations or engage in activities that you’ve been avoiding, but in a controlled and safe manner. The goal isn’t to overwhelm you, but to show you, through direct experience, that these situations are manageable and not as threatening as your mind might be telling you. This process helps to dismantle the fear response over time.
Challenging Unhelpful Beliefs Through Exposure
Often, our avoidance is tied to specific beliefs we hold about ourselves, the world, or the situations we fear. For instance, you might believe you can’t handle feeling anxious, or that a certain place will inevitably lead to a craving. Exposure work directly challenges these beliefs. By staying in a situation that triggers anxiety or a craving, and noticing that the distress eventually lessens on its own, you gather evidence against these unhelpful thoughts. It’s like conducting a personal experiment where the results consistently show that your fears are exaggerated and your ability to cope is stronger than you thought.
Learning to Respond with Reduced Anxiety
The core of exposure therapy, and by extension this schedule, is habituation. This means that when you’re repeatedly exposed to something that initially causes distress, your anxiety response naturally starts to decrease. It’s similar to how a loud noise might startle you initially, but after a while, you barely notice it. By practicing these exposures, you train your nervous system to recognize that the trigger is no longer a threat, leading to a calmer, more measured response. This learned ability to tolerate and move through anxiety, rather than immediately trying to escape it, is a significant step toward managing cravings and improving overall well-being.
Constructing Your Personalized Exposure Hierarchy
Okay, so you’ve got a handle on why we’re doing this exposure stuff. Now, let’s talk about building your own personal list of things to face. Think of it like creating a map for your journey, starting with the smaller hills before you tackle the big mountains.
Identifying Trauma-Related and Anxiety-Provoking Situations
First things first, we need to figure out what exactly makes you anxious or brings up memories of the tough stuff. This isn’t just about the big, obvious triggers. It can be anything – a certain smell, a place, a time of day, even a song. We’re looking for anything you’ve been avoiding because it feels unsafe, reminds you of a bad experience, or just makes you feel generally down or less interested in things you used to enjoy. Jot down everything that comes to mind. Don’t filter yourself at this stage; just get it all out there.
Prioritizing Activities Impairing Current Functioning
Now, let’s look at that list and figure out what’s really messing with your day-to-day life. Are there things you’re skipping out on – like going to work, seeing friends, or even just leaving the house – because of these anxieties or memories? We want to focus on the situations that are causing the most trouble right now. These are often the ones you’re most motivated to change, and tackling them can make a big difference pretty quickly. It’s about getting back to living your life, not just managing the fear.
Collaboratively Building a Graded Hierarchy
This is where we work together. We’ll take all those situations you’ve identified and arrange them from least scary to most scary. It’s like building a ladder, one rung at a time. We’ll aim for a list with about 15 to 20 items. This gives us plenty of options to work with. We’ll start with things that cause a moderate amount of distress – challenging enough to be meaningful, but not so overwhelming that you feel defeated right away. The goal is to build your confidence with each step.
Here’s a rough idea of what that might look like:
| Situation Description | Estimated Distress Level (0-10) |
|---|---|
| Walking past a specific store | 3 |
| Being in a quiet park alone | 5 |
| Attending a small social gathering | 7 |
| Driving on a highway | 8 |
Remember, this hierarchy is your map. It’s built on your experiences and your feelings. We’ll adjust it as we go, making sure it feels right for you. It’s a tool to help you gradually face what you’ve been avoiding, building your ability to handle distress along the way.
Implementing Your Weekly Craving Exposure Schedule
Now that you have a clear picture of what situations trigger your cravings and anxiety, it’s time to put that knowledge into action. This section is all about building a practical, week-by-week plan to face those challenges head-on. It’s not about jumping into the deep end right away, but rather taking steady, manageable steps.
Selecting Initial Moderate Distress Items
When you first start creating your exposure schedule, it’s wise to pick items from your hierarchy that cause a moderate amount of distress. Think of it like dipping your toes in the water before a full swim. These aren’t the situations that send you into a panic, nor are they the ones you barely notice. They’re the ones that make you feel a bit uneasy, maybe a knot in your stomach, but you know you can handle them with some effort. Choosing these moderate items helps build confidence and shows you that facing your fears is possible. This initial success is a big motivator for tackling more difficult situations later on.
Practicing Situations Multiple Times
Consistency is key here. For each item you select from your hierarchy, the goal is to practice it multiple times before your next session. This isn’t a one-and-done deal. Repetition helps your brain learn that these situations aren’t as dangerous as they seem. It allows the initial surge of anxiety or craving to become more familiar, and eventually, less intense. Think of it like learning a new skill; the more you do it, the more natural it becomes.
Allowing Distress to Naturally Decline
This is perhaps the most important part of the exposure process. When you’re in a situation that triggers distress or cravings, your first instinct might be to escape. Resist that urge. Instead, stay in the situation. Allow the feelings to be there, observe them, and notice how they change over time. You’ll find that, much like a wave cresting and then receding, your distress and cravings will naturally start to decrease on their own. This process, sometimes called ‘urge surfing,’ teaches you that these uncomfortable feelings are temporary and manageable. You don’t need to avoid them; you just need to ride them out.
Here’s a way to think about tracking your progress:
- Rate your distress before the exposure. Use a scale of 0-10, where 0 is no distress and 10 is the worst imaginable.
- During the exposure, note how your distress changes. Are there peaks? Do you feel an urge to leave?
- Rate your distress after you’ve stayed for a while. The goal is to see a significant drop, ideally by half, or to stay until the distress naturally subsides.
The aim isn’t to eliminate anxiety or cravings entirely during exposure, but to learn that you can tolerate them and that they will pass. Each time you successfully stay with the discomfort, you weaken the association between the situation and the intense fear or urge, and strengthen your belief in your own ability to cope.
Monitoring Progress and Managing Cravings
Keeping tabs on how you’re doing and handling those urges is a big part of this whole process. It’s not just about showing up; it’s about noticing what’s happening inside you and learning to work with it. This is where you really start to see the changes happening.
Subjective Units of Discomfort and Craving Tracking
Think of this as your personal progress report. When you’re working through your exposure list, you’ll want to keep track of how uncomfortable you feel and how strong your cravings are. We often use a scale, maybe from 0 to 10, where 0 is no discomfort or craving at all, and 10 is the absolute worst you can imagine. Jotting these numbers down after each exposure exercise gives you concrete data. It helps you see patterns and understand what situations push your buttons the most.
Here’s a simple way to track it:
| Activity | Start Discomfort (0-10) | Peak Discomfort (0-10) | End Discomfort (0-10) | Start Craving (0-10) | Peak Craving (0-10) | End Craving (0-10) | Coping Used |
|---|---|---|---|---|---|---|---|
| [Activity Name] | |||||||
| [Activity Name] |
Differentiating Adaptive and Maladaptive Coping
As you track your progress, you’ll also notice how you’re dealing with the discomfort and cravings. There’s a difference between coping in a way that helps you move forward and coping in a way that just helps you avoid feeling bad in the moment. Adaptive coping means you’re sticking with the exposure, even when it’s tough, and letting the feelings pass. Maladaptive coping might look like leaving the situation early, getting really distracted, or, of course, turning to substances. Recognizing this difference is key to making sure your exposure work is actually effective.
- Adaptive: Staying present, breathing through it, using learned skills.
- Maladaptive: Escaping, excessive distraction, substance use, avoidance.
It’s easy to want to escape when things get tough. But remember, the goal here is to learn that you can handle these feelings without resorting to old habits. Each time you choose a helpful response over an avoidant one, you’re building a stronger foundation for recovery.
Understanding Cravings as Transient Waves
Cravings can feel overwhelming, like a tidal wave about to crash over you. But here’s the thing: they don’t last forever. They rise, they peak, and then, if you let them, they subside. Think of it like surfing. You don’t fight the wave; you learn to ride it. By observing the craving without immediately acting on it, you start to see its temporary nature. This perspective shift is incredibly powerful. It helps you realize that you don’t have to give in; you just have to wait it out, and it will pass.
The Power of Urge Surfing for Unavoidable Cravings
Experiencing Cravings Without Suppression
Sometimes, no matter how hard we try, we can’t just avoid the things that make us want to use. Maybe it’s a certain place, a person, or even just a feeling that pops up unexpectedly. When avoidance isn’t an option, "urge surfing" comes into play. It’s a way to handle those intense cravings when you can’t get away from the trigger. Instead of fighting the urge or trying to push it away, the idea is to just let it be there. Think of it like watching a wave in the ocean – it builds up, reaches its peak, and then eventually goes back down. It takes practice, but learning to sit with the craving, rather than immediately acting on it, can make a big difference.
Focusing on Physical Sensations of Craving
When a craving hits, it doesn’t just exist in your head; it shows up in your body too. Urge surfing encourages you to pay close attention to where you feel it. Is it a tightness in your chest? A knot in your stomach? Maybe a buzzing in your hands? By tuning into these physical signals, you start to see the craving as a temporary physical event, not an overwhelming command. It’s about observing these sensations without judgment, just noticing what they feel like.
Here’s a way to break down the process:
- Acknowledge the craving: Simply notice that it’s there.
- Locate the physical sensations: Where in your body do you feel it most strongly?
- Describe the sensations: What do they feel like? Tight, hot, shaky, empty?
- Observe without judgment: Just watch the sensations come and go.
Visualizing Cravings as Submerging Waves
The wave metaphor is really helpful here. Imagine yourself standing on the shore. A craving starts as a small ripple, then grows into a bigger wave. You don’t try to stop the wave from coming; you just stand there and let it wash over you. It might feel intense at the top, but just like a real wave, it has to recede. This visualization helps you remember that cravings are not permanent. They rise, they peak, and they fall. The key is to ride the wave out, rather than getting pulled under by it.
This technique is similar to how we approach difficult memories in therapy. Instead of trying to forget or ignore them, we learn to face them, understand them, and allow the intense feelings associated with them to naturally lessen over time. Urge surfing applies this same principle to cravings, teaching us that even the most powerful urges will eventually pass if we allow them to.
Integrating Imaginal and In Vivo Exposure
Sometimes, you need to work with memories in your head, and other times, you need to face things in the real world. Both imaginal and in vivo exposure are powerful tools, and using them together can really help you move forward. Think of it like this: imaginal exposure is about revisiting the past in your mind, safely, to process what happened. In vivo exposure is about facing those avoided situations or triggers out in the world.
Repeatedly Revisiting Traumatic Memories
Imaginal exposure involves bringing memories of traumatic or anxiety-provoking events into your mind. The goal isn’t to relive the trauma exactly as it happened, but to process the emotions and thoughts connected to it. You’ll be guided to recall the event as vividly as possible, focusing on what you saw, heard, felt, and thought at the time. This repeated revisiting helps your brain learn that the memory itself isn’t dangerous and that you can handle remembering it without being overwhelmed. It’s about differentiating the memory from the actual event and reducing the distress associated with it. Often, we pick the memories that feel the worst, the ones that pop up in nightmares or intrusive thoughts.
Processing Unhelpful Beliefs and Distress Levels
As you go through imaginal exposure, we’ll pay close attention to any unhelpful beliefs that come up. For example, you might believe you’re weak or that bad things will always happen. By confronting these thoughts during exposure, you can start to challenge them. We’ll also track your distress levels. The idea is to allow the distress to naturally decrease as you stay with the memory. It’s not about making the distress disappear instantly, but about learning that it’s temporary and manageable. This process helps you build confidence in your ability to cope.
Daily Homework for Continued Engagement
After a session of imaginal exposure, you’ll likely be given homework. This often involves listening to a recording of your session. It’s important to engage with this homework fully. This means finding a quiet time and place where you can focus on the recording without distractions. Avoid listening while doing other tasks or when you’re about to sleep, as this can interfere with the process. The goal is to continue the work of processing the memory and reducing its emotional impact between sessions. Consistency is key here.
Here’s a look at how the two types of exposure can work together:
| Type of Exposure | Focus |
|---|---|
| Imaginal | Processing memories, thoughts, and emotions |
| In Vivo | Facing avoided situations in real life |
Navigating Engagement During Exposure
Sometimes, when you’re working through difficult memories or situations, you might find yourself either zoning out or feeling completely overwhelmed. It’s like your brain is trying to protect you, but it gets in the way of healing. We need to find that sweet spot where you’re really present with the experience, but not so much that it’s unbearable.
Addressing Underengagement with Trauma Narratives
This happens when you’re going through a memory or a situation, but you’re not really there. Maybe you’re thinking about what to have for dinner, or you’re just reciting words without feeling anything. It’s a way of keeping the distress at bay, but it stops you from actually processing what happened. To get more engaged, we can try a few things. Your therapist might ask you specific questions to help you focus on what you were seeing, hearing, or feeling at the time. It’s about bringing those details back to life, even the uncomfortable ones.
Managing Overengagement and Intolerable Distress
On the flip side, there’s a point where the distress becomes too much. You might feel flooded with emotions, or the physical sensations become overwhelming. When this happens, it’s hard to learn anything new; you’re just trying to survive the moment. If this occurs, the goal isn’t to push through the unbearable pain. Instead, we might shift the focus slightly. This could involve talking about the memory in the past tense or reminding yourself that it’s a memory, not something happening right now. It’s about finding a way to be present without being completely consumed.
Enhancing Focus on Thoughts, Feelings, and Sensations
To help you stay engaged in a productive way, paying close attention to your internal experience is key. This means noticing:
- Thoughts: What specific ideas or beliefs are running through your mind during the exposure?
- Feelings: What emotions are you experiencing? Try to name them specifically (e.g., fear, sadness, anger, shame).
- Sensations: Where do you feel these emotions in your body? Are there physical sensations like tightness, heat, or trembling?
Being aware of these internal cues helps you stay grounded in the present moment of the exposure. It’s like being a detective of your own experience, gathering clues about how the past affects you now. This detailed observation is what allows for real learning and change to happen.
Shifting Focus to Hot Spots in Traumatic Memories
Sometimes, when we’re working through difficult memories, we tend to skim over the parts that feel the most intense. It’s like trying to avoid the biggest waves when you’re swimming. But in exposure therapy, these "hot spots" are actually where a lot of the healing can happen. These are the moments in your memory that bring up the strongest feelings, the parts you might skip over, or where you feel a strange lack of emotion even though you know it was a big deal.
Identifying High Distress Areas in Narratives
Think about telling your story. Are there specific sentences or moments where your voice changes, you get quiet, or you just want to speed through it? Those are likely your hot spots. It’s not about finding the most dramatic part, but the part that you find most difficult to talk about or revisit. It might be a specific image, a sound, a feeling, or even a thought you had at the time.
Addressing Skipped Details and Affective Gaps
We often unconsciously edit our memories. If a detail is too painful or confusing, our brain might just gloss over it. Or, you might remember something happening but feel strangely numb about it. This numbness can be a sign that there’s a lot of unprocessed emotion underneath. The goal here is to gently bring those skipped details or emotional blanks back into focus. It’s not about forcing yourself to feel something you don’t, but about creating space for whatever might be there.
Prolonged Exposure to Most Distressing Aspects
Once we’ve identified these hot spots, the next step is to spend more time with them. This doesn’t mean dwelling on them endlessly, but rather engaging with them in a structured way. We’ll revisit these specific moments repeatedly, allowing yourself to experience the associated thoughts, feelings, and physical sensations without trying to push them away. The idea is that by staying with the distress for a sustained period, it will naturally start to lessen. It’s a bit like holding onto a burning ember – at first, it hurts, but if you can tolerate it, the heat eventually fades.
Here’s a way to think about identifying potential hot spots:
- Moments of intense fear or panic: Where did you feel most overwhelmed?
- Parts you tend to skip or rush through: What details do you avoid mentioning?
- Feelings of numbness or detachment: Where do you feel disconnected from the experience?
- Confusing or illogical events: What parts of the memory don’t make sense to you?
It’s important to remember that revisiting these difficult parts is a process. It takes courage, and it’s okay to feel uncomfortable. The aim isn’t to relive the trauma, but to process the memories in a way that reduces their power over you. We’ll work together to make sure you have the support you need throughout this.
Sometimes, we might even explore what you imagine happened if there are gaps in your memory. This isn’t about making things up, but about exploring the fears and beliefs that arise from not knowing. It’s a nuanced approach, and we’ll discuss what feels right and most helpful for you.
Structuring Sessions for Optimal Exposure
Think of your therapy sessions like a well-organized workshop. Each one has a purpose, and by following a clear structure, you get the most out of the time spent working through difficult memories and situations. It’s not just about showing up; it’s about engaging with the process in a way that leads to real change.
Reviewing Symptoms and Homework Assignments
We’ll start each session by checking in. How have things been since we last met? We’ll look at any changes in your symptoms and, importantly, review the homework you’ve been assigned. This might involve discussing how you approached a specific situation or practiced a coping skill. This review helps us see what’s working and where we might need to adjust our approach. It also gives us a chance to talk about any substance use that might have happened, as this can sometimes get in the way of processing emotions during exposure work.
Focusing on Substance Use and Coping Skills
We’ll dedicate time to specifically address how substance use relates to your trauma and anxiety. This isn’t about judgment; it’s about understanding the patterns. We’ll explore why you might turn to substances and work on developing and practicing alternative coping skills. This might include things like managing intense emotions, dealing with urges, or improving sleep. Having a solid set of these skills is like building a safety net for when things get tough.
Assigning New Homework for Continued Practice
At the end of each session, we’ll set you up with new homework. This is where the real work happens between sessions. It will be tailored to your specific needs and goals, often involving practicing the exposure exercises we discussed or trying out new coping strategies in real-world situations. The idea is to keep the momentum going, gradually building your confidence and ability to handle challenging experiences without relying on avoidance or substances.
Differentiating Avoidance in PTSD and Substance Use
It’s really interesting how avoidance shows up differently when you’re dealing with PTSD and substance use issues. They often go hand-in-hand, and understanding this difference is key to figuring out what to face and what to steer clear of.
Avoiding Relapse Triggers Strategically
When it comes to substance use, avoiding certain things is actually a smart move. Think about places or people that strongly remind you of using drugs or alcohol. Staying away from these triggers is a way to protect yourself from falling back into old patterns. It’s like putting up a temporary barrier to give yourself space to build up your coping skills without immediate temptation. This isn’t about running away forever, but about making strategic choices to keep yourself safe in the short term.
Confronting Trauma-Related Situations
On the flip side, with PTSD, the goal is often to gradually confront situations or memories that bring up distress related to the trauma. This might sound scary, but it’s done in a controlled way. The idea is that by facing these memories and feelings safely, they lose their power over you. Avoiding them, even if it feels like it’s helping in the moment, can actually make the PTSD symptoms stick around longer. It’s about learning that you can handle the distress without needing to numb it or escape it.
Understanding the Rationale for Differential Avoidance
So, why the different approaches? It boils down to what’s actually helpful for healing. For substance use, avoiding direct exposure to high-risk situations is about preventing a relapse that could be harmful. For PTSD, confronting trauma-related memories and situations is about processing them so they no longer control your life. It’s not about being reckless; it’s about being smart with your healing. Therapists help you map this out, distinguishing between situations that are genuinely risky for substance use and those that are safe to explore for trauma processing.
Here’s a simple way to think about it:
- Substance Use Avoidance: Focuses on preventing immediate relapse by staying away from known drug/alcohol cues.
- PTSD Confrontation: Focuses on processing past trauma by gradually facing related memories and situations.
The key is recognizing that what might seem like avoidance in one context is actually a protective strategy, while in another, it might be maintaining the problem. Learning to tell the difference is a big step in recovery.
It’s important to remember that these aren’t always black and white. Sometimes, a situation might trigger both a craving and a trauma memory. In these cases, a therapist will help you figure out the best way forward, often prioritizing safety from relapse while still finding ways to address the trauma.
Identifying and Managing Trauma-Related Cravings
Assessing Trauma Symptoms as Craving Triggers
Sometimes, the urge to use substances isn’t just a random thought. It can be directly linked to unresolved trauma. Think about it: if you’ve experienced something deeply upsetting, your mind and body might try to find a way to cope, and for many, that path has unfortunately led to substance use. We need to look closely at what’s happening with your PTSD symptoms. Are nightmares keeping you up? Is anxiety through the roof? These can all act as signals, telling your brain it’s time to seek relief, and that relief might feel like it’s found in a drink or a drug. Recognizing these connections is the first step toward breaking the cycle.
Recognizing the Link Between Trauma and Substance Use
It’s pretty common for people who’ve been through trauma to turn to substances. It’s not a moral failing; it’s often a survival mechanism, a way to numb the pain or escape overwhelming memories. This can create a tricky situation where the very things that cause distress also trigger the desire to use. We’re talking about flashbacks, intense emotional reactions, or even just feeling unsafe. These experiences can become powerful cues for substance use, making it hard to tell where the trauma ends and the craving begins.
Developing Strategies for Numbing and Sleep Impairment
When trauma makes it hard to sleep or causes intense emotional pain, the temptation to use substances to ‘numb out’ or force sleep can be really strong. This is where we need to get creative and build new tools. Instead of reaching for a substance, we can explore other ways to manage these difficult moments. This might involve learning relaxation techniques, practicing mindfulness, or engaging in activities that provide a healthy distraction. For sleep issues, we can look at sleep hygiene and other non-substance-related aids. The goal is to find ways to cope that don’t involve using, so you can start to heal without the added burden of substance dependence.
Dealing with cravings that come from past difficult experiences can be tough. These urges might feel overwhelming, but understanding them is the first step to managing them. You don’t have to face this alone. Visit our website to learn more about how we can help you overcome these challenges and build a healthier relationship with yourself. Take the first step towards healing today!
Moving Forward with Confidence
So, we’ve talked about building a plan for facing things that make you anxious, step by step. It’s not about jumping into the deep end, but about carefully choosing situations, practicing them, and learning that you can handle them. Remember, the goal isn’t to never feel uncomfortable, but to learn that discomfort fades and that you have the strength to get through it. By creating your own schedule and tracking your progress, you’re actively taking charge. It’s a process, and some days will be tougher than others, but each exposure, each small win, builds your ability to face life more fully. Keep at it, be patient with yourself, and celebrate every bit of progress you make. You’ve got this.
Frequently Asked Questions
Why is facing scary things helpful?
Facing things you’ve been avoiding, especially those linked to bad memories, helps you see they aren’t as dangerous as you thought. It’s like learning that a shadow isn’t a monster. This helps lower your fear and makes it easier to handle tough situations without feeling overwhelmed.
How do I make a list of things to face?
You and your therapist will create a list of situations or memories that cause you worry or remind you of difficult times. We’ll put them in order from least scary to most scary, focusing on the ones that make your daily life hardest. This list helps us know where to start and how to move forward step by step.
How do I start facing my fears?
We begin with things that cause a little bit of worry, not the most terrifying ones. The goal is to practice these situations several times. You’ll stay in the situation until your distress starts to fade away on its own. This shows you that the bad feelings don’t last forever.
How do I know if I’m getting better?
We’ll keep track of how much distress or craving you feel using a simple scale. We’ll also talk about how you’re handling these feelings. It’s important to notice that cravings are like waves – they get strong, but they eventually go down. Learning to ride these waves without giving in is key.
What is ‘urge surfing’?
Urge surfing is a way to handle strong cravings when you can’t avoid them. Instead of fighting the craving, you learn to just notice it. You focus on how it feels in your body, like feeling a wave build up and then pass. It’s about letting the craving be there without acting on it.
What’s the difference between imagining and doing?
Imaginal exposure means thinking about or vividly recalling difficult memories. In vivo exposure means actually facing the situations or places you’ve been avoiding in real life. Both are important. We might start with imagining and then move to doing, or do both at different times.
What if I feel too much or too little during an exercise?
Sometimes you might feel like you’re not getting into the memory enough, or you might feel completely overwhelmed. Your therapist will help you find the right balance. They can guide you to focus more deeply or help you calm down if it’s too intense, making sure the exercise is helpful, not harmful.
How does this help with cravings for drugs or alcohol?
Often, cravings for substances are linked to trauma or difficult memories. By facing those memories and learning to handle the anxiety they bring, you can reduce the need to ‘numb out’ with substances. We’ll learn skills to manage cravings directly, recognizing they are often triggered by trauma symptoms.