Imaginal prolonged exposure is a powerful process for both therapist and client. It results both in reduced distress and in greater understanding of what happened and why. “Putting the pieces of the jigsaw puzzle together” is crucial to recovery and has long been recognised as an effective treatment.
Early variations on prolonged exposure (such as “abreaction”) used drugs to access the memories, while more recent approaches (such as desensitisation) placed a heavy emphasis on relaxation and arousal reduction during exposure. We now know that neither is recommended; people can access the memories, and can tolerate the distress, without these additions.
While there is a common perception that the best way to recover from trauma is to forget about it and focus on the future, the research and clinical evidence is clear: for trauma survivors with PTSD, that is not the case. Indeed, the evidence is now sufficiently strong that it would be negligent not to offer a trauma-focused psychological treatment to a patient with PTSD.