Objective: In traumatic simple phobia (TSP) fear of retraumatisation tends to be enduring and may show little reduction with time despite frequent and prolonged exposure. This paper describes how hypervigilant behaviour may account for this enduring response by interfering with exposure.
Method: Three case histories illustrating the clinical features of TSP and its treatment using in vivo exposure coupled with direct inhibition of hypervigilance are presented.
Result: In all three cases, reduction of anxiety occurred with spontaneous generalisation of improvement.
Conclusions: The efficacy of in vivo therapeutic exposure for fear of retraumatisation may be enhanced by the use of strategies to inhibit hypervigilant behaviour.