Prolonged Exposure Therapy
One of the most well established and highly effective treatments for PTSD is prolonged exposure therapy. However, while this treatment has demonstrated much success over the years, focusing on habituation as the primary mechanisms of change has been called into question. The inhibitory learning model challenges outdated approaches and aligns with advances in neuroscience.
Inhibitory Learning Model: Advances in CBT
According to the inhibitory learning model, when exposure therapy results in extinction, information in the brain is not rewritten. Instead, new learning simply inhibits older excititory learning. The important take-home is that information is never unlearned. It just becomes inhibited. This means that depending on context and experience, spontaneous recovering of extinguished behavior can occur.
Supercharging Cognitive and Behavioral Therapies for PTSD
In order to strengthen inhibitory learning, exposure practitioners will want to focus on “violating expectancies” rather than habituation. Habituation has not proven to be a good predictor of outcomes. Just as Pavlov violated his dogs expectancy that food (unconditioned stimulus) would follow the bell (conditioned stimulus), exposure therapists will want to help violate expectancies of a catastrophe (unconditioned stimulus) occuring after exposure to a feared situation (conditioned stimulus). Additionally, because different contexts can lead to renewal of old memory, exposure should be conducted with multiple exposure cues and in a varied format. This will help strengthen new learning and the inhibitory process.
Podcast and Article
For more information on the inhibitory learning model, please click on the article below. A link has also been provided to a podcast by Dr. Craske discussing the science and application of inhibitory learning.
Craske Inhibitory Exposure Podcast
of Cognitive Behavioral Counseling LLC