A new study suggests that sleep might be a useful tool to add to the therapeutic approaches used to treat phobias. The study, conducted using 15 participants, revealed evidence that the slow wave portion of the sleep cycle might be utilized to aid in reducing fear reactions to fear producing stimuli.
In the study the participants were shown two faces, while simultaneously being exposed to a mild shock and an odor. After the fear response was conditioned in the participants, they took a nap and during the short wave stage of sleep were exposed again to the odor in intervals of 30 seconds. Fear responses, such as sweating, were present but declined over the course of the nap. The reduction in response remain consistent once the participants were awake where those who did not experience the scent exposure showed no such reduction in fear.
Traditional approaches to the treatment of phobias involve a process of exposure known as systematic desensitization. In a controlled, therapeutic setting a person is exposed to the source of their fear in gradually increasing degrees until the fear has been made extinct. Popular depictions of this type of therapy involve a therapist supporting a person as they gradually make their way into a room containing a feared object, such as a snake or spider. This process is often referred to as flooding as the person willingly immerses themselves in a fearful situation until their fear dissipates.
Prolonged exposure therapy is used to treat phobias that result from PTSD. Components of this treatment involve learning about stress reactions common to PTSD as well as ways to help calm them. Exposure is then introduced to provide practice in returning the body to a relaxed state while a therapist is present who can listen as the person discusses what they are experiencing and what troubling memories are surfacing.
Both are an extension of cognitive behavioral therapy, which requires a person to be awake and fully aware of their emotional discomfort. The results from this latest study present the possibility that a person might be still able to address their fear with less awareness when the fear is treated with sleep.
There are limitations to the findings of this study. The phobias were created in a short period of time, in a controlled setting and were quickly addressed. Clinical applications of this approach to therapy would be addressing phobias that would likely be much more firmly established in a person’s psyche. The method also centers solely around the use of the olfactory system to illicit the memory recall and many phobia containing memories would not be tied to this particular sense.
Another problem stems from memory dysfunction in those suffering from PTSD. In the study, the memory tied to the fear was well known and therefore easily recalled. Those suffering from PTSD have to contend with neurobiological abnormalities that tamper with memory formation and recall, making this process much less straightforward.
Difficulty sleeping and nightmares also could interfere with this method of treatment.
Lead author of the study, Katherina Hauner, stressed that more testing needs to be done, stating, “This is a very novel area. I think the process has to be refined.”
There is a potential for therapeutic benefit in these findings, however. Exposure therapies, while effective in treating phobias, are often very distressing for the individuals, making compliance with the treatment more difficult to achieve. It is thought that by exposing the participants to stimuli specifically tied to their phobias, the types of memory recalled may have been more controlled, thereby directing exposure therapy while the participant was asleep. This method seemed to be markedly less distressing than traditional forms, if only because the fear was being treated with sleep which might reduce the conscious awareness of the exposure.
Written by: Vanessa Blanchard
Prolonged Exposure Therapy