The idea with PE is to stop avoiding.

So with Prolonged Exposure, the idea is that people who get

PTSD after trauma are the ones who really avoided

thinking about the experience of the trauma after it happened.

They don't want to think about it,

they start to avoid the memories,

and then that expands to avoiding people, places,

any situation that reminds them of it.

And so the idea with PE is to stop avoiding,

to start doing the things that they haven't been doing, and

start thinking about the memory, to process it and process any

feelings that came up at the time that kind of got cut off,

with the idea that then there'll be recovery,

and you'll start to feel better.

And it's very effective and works in most cases.

So part of what happens with that avoidance process

is avoidance kind of snowballs on itself.

So someone might say,

"If I go to the grocery store when it's crowded,

I won't be able to watch everyone.

Something dangerous might happen, and I won't be able

to see it in advance."

And so they have to go to the store, and they

start getting nervous, and they start getting more nervous,

and then they get in the store, and it feels heart racing,

eyes blinded, and sweating, and,

"This is ridiculous, I can't do this."

And they leave.

And so what happens when they leave?

They immediately feel relief, and they feel better.

And so it's easy to say to yourself,

"The way to feel better is to avoid.

Next time, I won't even go near the store."

So the avoidance kind of grows and grows,

and I see people who start saying,

"Well, I won't even go when it's not so crowded.

I won't go at all.

I'll get the groceries delivered."

And literally we end up, sometimes, we see people

who haven't left their house, barely, in years

because the avoidance just snowballs on itself.

So what we start to do in Prolonged Exposure, we don't

throw someone right into a big store at the busiest hour,

but we start gradually moving toward

doing those avoided things again in a safe way.