Disturbing Reading Off-shoots Of Exposure Therapy

[anthony]

Its rare I am disturbed by treatment methods when it comes to PTSD, because I have always been able to see the validity in the method, whether cognitive, behavioural or placebo. Saying that, I remember reading in Steven Taylors "A clinicians guide to cognitive behavioral therapy" where he has broken exposure therapy into 3 areas vs. the conventional two. The creators of exposure therapy determined two types, being:

1. Imaginal (all done in the brain via remembering), and
2. In Vivo (situational, actual exposure to physical elements to surpass fear)

Now, I remember reading in this book, he mentioned 3 types, being:

1. Imaginal (same as above)
2. Interoceptive (in therapist office using tools to cause distress)
3. Situational (as original In Vivo)

This has been sitting on my brain a while now, though just getting around to actually writing it out.

Steven Taylors interpretative version of either what he has created or what he picked up elsewhere, is a little daunting and scary if you ask me, and this is what gets me about people trying to make a name for themselves. His interpretative In Vivo I can only see as a re-traumatizing form of exposure.

His interpretive version of In Vivo has changed from situational to getting patients to feel as though they are drowning, or gasping for air, or putting them into intentional fits through oxygen depravation exercises and other methods.

Now I could be wrong here, but this to even me, is re-traumatizing, not exposure to the fear based stimuli, which is what exposure therapy is all about. Its not about exposing a person to an actual traumatic situation or even trying to replicate the physical sensations experienced from a traumatic occurrence, because that is re-traumatization, but instead to use fear based stimuli to change cognitive function in relation to aspects that are detracting from their life, hindering their ability to function, work, etc, correctly.

I remember reading this and my jaw dropped to the floor, which doesn't happen often. If anyone with PTSD actually did this, I could only see the patient literally becoming more traumatized vs. able to see a clear and distinctive benefit to improving their ability to function in life. Who really wants to be feeling like they are drowning, or starving for oxygen? Safe environment or not... that is re-traumatizing a person directly with little to no real benefit.

Some people are very smart, and Steven Taylor has an excellent book... but that one part quite honestly detracted the subject matter IMHO. It was only a small part, but his method of changing well tested methods of exposure therapy and putting his own spin on things, and I think that method would quite honestly backfire on the majority vs. be helpful.

 

[deer_in_headlights]

How horrifying!
I have chills reading this!

No wonder your jaw dropped, Anthony. This is really bad, dangerous, and how terrible that Steven Taylor wrote this specifically for clinicians... the people we need to be able to trust not to harm us further. Therapy is difficult and challenging. It should not be re-traumatizing.

I'm glad you're putting the warning out, Anthony!

 

[becvan]

Holy crap! Can't say I've been drowned but I sure as hell have been without oxygen due to smothering/choking. I can't imagine someone doing that to me in the name of therapy. It's more along the lines of how to torture a person. Exposure therapy is more of working to be able to put on a turtle-neck, being able to have covers over my face, ability to not panic with a safety mask on my face, not being choked all over again! It scares me that this could potentially be used! Thanks for the heads up!

bec

 

[Tinyflame]

That's not Therapy that's 're-retraumatization'

 

[Teddy]

Nope, there is no way I would ever go back. If any one did that sort of stuff to me I would really think they were out to kill me and that would cause more problems. Me personally, I think I have decided that I feel too much like a 'lab rat' and I don't partake in anything that frightens me beyond my abilities before I even start. That just sounds like trouble to me. I will stretch myself but I am not going to risk being snapped and that I think would snap most people even ones without PTSD.

 

[anthony]

I looking at some examples, ie. with a tongue depressor, place in mouth for 30 seconds at back of throat to facilitate gagging response. I know in what context this is, sexual assault, however; I cannot see how making someone gag intentionally is going to bring good to them in facing their traumatic aspects. The idea is not to retraumatise, but to change the fear response... how does getting a person gagging again intentionally change their fear response?

This book is 99% gold, but this one detracting aspect is a little daunting. I pulled it out to relook some of the aspects discussed about his version of this type of exposure, when I cannot find it anywhere from the original experts, ie. Foe being one of them.

 

[Teddy]

Nope, sorry I don't think I would believe anything this dude says if that is his idea of how to fix the PTSD stuff. Certainly wouldn't help me. If some one pulls my hair I just end up a mess so having some one do it on purpose would just make me feel like I was being attacked again. (I was nearly scalped in a machine when I got caught on the driveshaft by my ponytail) I was brushing my own hair this morning and got the brush caught in a knot. I nearly freaked and it was me doing it to myself. I had my accident 16 years ago. Sorry I would not go near this treatment or anything else he reckons is a good idea.

 

[Teddy]

Sorry got a bit strong there. Paniced a little

 

[Nicolas Connault]

The whole point of exposure therapy (of any kind) is to help the person learn that anxiety is not dangerous, and that although it peaks to very high levels (creating terror and panic), it will eventually subside on its own without the need for avoidance of the feared stimulus. However, this needs to be done gradually. Inexperienced therapists can create NEW feared responses in their clients if they shoot straight for the most anxiety-provoking situations. At all times the clients must be the decision-maker: s/he must decide which stimulus to try, and whether or not to stay with the anxiety.

So, some of the methods described in this book may sound horrific, but if the client decides to go for them they may actually work very well. It's always a very difficult balance to achieve: the client must push him/herself to his/her very limits, and the therapist helps him/her to go just a little bit beyond that limit, by being encouraging, calm, and instructive.

 

[soulofLC]

Geese, I get anxiety from just reading about someone else's trauma sometimes, much less having someone trying to deliberately inflict it on me! Not that we should not write about our trauma, because it is liberating and the support for emotions is life affirming. I just can't imagine someone purposefully inflicting it on one who has already suffered. Sounds a just a tad Sadistic!