Emotional Processing Theory (EPT)

The theoretical perspective behind Prolonged Exposure is the Emotional Processing Theory (EPT) that originated from the psychological fundamentals of classical conditioning (Ougrin, 2011). EPT was developed in 1986 by Michael J. Kozak and Edna B. Foa to cure anxiety disorder. Foa later used EPT to introduce Prolonged Exposure Therapy for PTSD. According to this theory, PTSD symptoms develop and get worse over time because patients cognitively and behaviorally avoid any situations, thoughts, or reminders that are relative to their trauma- making this a long-term disorder. Active avoidance can lead to the continuous input and reassurance of negative beliefs that the person has constructed for the world around them as well as for their self-image.

Consistent evasion of the stimuli due to trauma reinforces the existing notion of fear correlating to the said stimuli, causing patients’ brain processes to assume or expect that it is harmful, hindering the input of new information concerning the stimuli. By consistently avoiding it, the fear of the object or setting grows and can possibly stop a person from engaging in social situations or in the worst cases, lead them to stress and suicide if they are unable to cope with the symptoms of PTSD. EPT proposes that the exposure to feared stimuli can change its relationship to the associated networks. However, in order to do so, the fear structure must first be activated so that it can be accessed and then modified (Foa, 2011). Required for input and modification is new information that contradicts the feared beliefs to allow for habituation, and should in no way further reaffirm their fears. The new information would prevent the activation of the fear structures and over time, disconfirmation of their expectations about the fear reduces

Foa developed this type of treatment after discovering and dissecting the origins of PTSD and its effects on patients by using the EPT as an explanation (Foa, 2011). Briefly, EPT suggests that emotional processing is not possible because victims of trauma tend to avoid related situations that cause them distress, prohibiting them from taking in new information that can rule the situation as harmless. Instead, their fear increases because of this avoidance due to automatic fear structures when similar settings to their previous experience are encountered. The theory states that because PTSD is caused by active evasion, the best way to reduce symptoms and cure the patient is to expose them to those fear inducing stimuli which would in turn erase the reinforcement they have built up from their fears and avoidance. Doing so allows the patient to habituate, and the effects of their trauma would diminish over time, eventually curing him or her. Through Prolonged Exposure Therapy, Foa introduced new methods and techniques that help the patient gradually expose themselves to the sources of stress and realize that they have been fearing potentially harmless ideas or scenarios. The techniques of the treatment were discussed earlier but involve exposure on two different levels. One being imaginative where the patient is guided by the