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Prolonged Exposure for PTSD

Trauma treatment that gives you back the places avoidance took.

Prolonged Exposure is a structured PTSD protocol with strong research support. It works by approaching — carefully, in a planned order — what fear has been telling you to stay away from.

Why avoidance keeps PTSD going

After trauma, avoidance is a reasonable strategy — it works, briefly. But every avoided situation teaches the nervous system that the danger is still present and that you could not have handled it. Over time your world narrows, and the memory never gets the chance to be filed as something that happened rather than something happening.

How Prolonged Exposure changes that

PE reverses the pattern deliberately. Through imaginal exposure, you revisit the traumatic memory in a controlled, repeated way until it becomes tolerable to think about. Through in-vivo exposure, you re-enter safe situations you have been avoiding, in an order you help set. Breathing retraining and education about trauma responses support the work throughout.

Sessions are usually weekly and often 90 minutes, running roughly 8 to 15 sessions. You will always know what a session involves before it starts. Nothing is sprung on you.

Safety and pacing

Before exposure begins, we look honestly at current risk, substance use, and support. If stabilization or skills work should come first, we do that first. Trauma treatment done at the wrong moment is not brave, it's ineffective — and pacing is a clinical decision we make together.

What recovery tends to look like

Intrusive symptoms lose their charge. Sleep often improves. Places and people come back into reach. Many people describe the memory as still sad but no longer commanding.

What the work looks like

A clear structure, at a pace that is workable

  1. 01

    Assessment & rationale

    We confirm PTSD symptoms, review your history and safety, and I explain exactly how and why PE works before we begin.

  2. 02

    Breathing & in-vivo planning

    You learn breathing retraining and we build a list of avoided-but-safe situations, ordered from manageable to hardest.

  3. 03

    Imaginal exposure

    In longer sessions you recount the memory aloud with support, then we process it together and you listen back between sessions.

  4. 04

    Consolidation

    As symptoms drop, we review your gains, plan for triggers, and decide what maintains progress after treatment ends.

Common questions

Questions people ask first

What is Prolonged Exposure therapy?
Prolonged Exposure (PE) is a structured, evidence-based treatment for PTSD. It combines repeated imaginal exposure — recounting the traumatic memory in a controlled way — with in-vivo exposure to safe situations that have been avoided, plus breathing retraining and psychoeducation.
Will I have to describe every detail of what happened?
You revisit the memory in a deliberate, paced way with support, and you always know what the session will involve. The work is structured rather than open-ended, and you set the pace of in-vivo exposures with me.
How many sessions does Prolonged Exposure take?
PE protocols typically run in the range of 8 to 15 weekly sessions, often 90 minutes each. Your actual course is planned individually and reviewed as we go.
Can I do trauma work if I also use substances?
Often yes, with sequencing. We assess safety and stability first and may build emotion regulation skills or address use patterns before or alongside exposure work. Substance use does not automatically disqualify you from trauma treatment.