Prolonged Exposure (PE) therapy is an evidence-based treatment for trauma and PTSD that consists of 12 to 16 (80-minute) therapy sessions. The treatment was originally developed for use with survivors of rape, but over two decades of research has shown PE to be highly effective in the treatment of trauma and PTSD for individuals with varying traumas. PE is endorsed by the Institute of Medicine report and SAMSHA as one of the leading treatments for trauma and PTSD, and is also one of the leading treatments recommended by the VHA-DOD Clinical Practice Guidelines. The symptom-reduction experienced over a relatively short period of time makes this an appealing treatment, as well. During the first part of the treatment, the client is educated about reactions to trauma and PTSD. The middle and end stages of treatment consist of two components: exposure to real-world, trauma-related situations that are objectively safe but avoided due to trauma related distress (this is called in-vivo exposure) and exposure to the traumatic memory through repeated recounting of the traumatic event (called imaginal exposure – which is literally exposure through one’s imagination/recall of the event and its sensory details).
As noted in Foa, Hembree, and Rothbaum (2007) and Hembree and Foa (2007): “Many individuals who experience a traumatic event go through a process of natural recovery, especially during the first 3 months following trauma exposure.” Therefore, PE may be appropriate when an individual has experienced at least three months of post-trauma symptoms that meet criteria for PTSD or that cause distress and interfere with one’s daily functioning. Since PE requires revisiting the memory through recall, it is important that clients are able to recall and narrate the event; fragmented memories are still workable as long as the client is able to visualize and describe the traumatic experience. Often fragmented memories become whole through the process of PE, which sounds distressing, but actually contributes to the effectiveness of PE and reduction of trauma or PTSD symptoms.
If you have a vague sense that you experienced “something” in your life but do not have a clear episodic memory, you still may benefit from the in-vivo exposure component of treatment. Your therapist will work with you to determine which trauma-focused treatment is best for you based on your symptoms, therapy treatment and psycho-social history, and treatment goals.