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Ideal suds (distress) level for retraining your brain

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Dana1010

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Is anyone familiar with the SUDS (Subjective Units of Distress) scoring system in trauma treatment? I heard that in order for re-learning to occur, your SUDS level has to be somewhat raised. But if it's raised too high and you're just plain triggered, you will not learn that the situation at present is safe, you are not in danger or about to be attacked, etc.

So what is the ideal score (I understand the scale is 1 to 100) for retraining yourself to overcome triggers? If you go into a situation and wind up triggered, are there any good ways to bring your SUDS level back down to the ideal level for retraining?

(P.S. I wanted to post this in the discussion forum, but it seems to have disappeared, so if this belongs somewhere else, feel free to move it.)
 
They use Suds in EMDR. My suds have not gone down over the past five or so sessions but the feelings are changing so things are happening
I know at least with EMDR the trick is that you have to have one foot in the present and one foot in the past so in order for you to feel safe you need to have that one foot in the present
If you're all the way in the past you're not going to feel safe Federal have difficulty processing trauma. Does that make sense?
I know in the beginning I let myself go too far in the past then I would dissociate. My therapist has worked on different grounding techniques, and different angles I can look at the trauma from so that I can maintain one foot in the present. This has helped a lot with my dissociation and ability to process. Don't beat yourself up about the suds just try to look at your memories from the present don't let yourself go all the way back there. It takes a lot of practice and a scale therapist is also helpful.

Sorry, "skilled therapist".
 
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Because SUDS is subjective, there isn't an "ideal score". Therapists know that each client has a different SUDS scale, so you can't compare scores across clients. It's like a new vocabulary that's co-created in the therapy room.

The background to this comes from Cozolino.... The Neuroscience of Psychotherapy. In addition to the "just enough stress", he adds three other factors into the "enriched environment" that produces change in the therapy room.....

1) A trusting relationship with the therapist
2) A cognitive framework in which to place emotional responses
3) The co-creation of a new narrative
 
Because SUDS is subjective, there isn't an "ideal score".
Well, I think we can agree that even subjectively, 100 is more stressful than 50 is more stressful than 0. I was just looking for a ballpark level of stress.
 
Well, I think we can agree that even subjectively, 100 is more stressful than 50 is more stressful tha...
I can only speak for myself - but I find that it's generally between a 6-8, with 10 being high and 1 being low. I can keep myself cognitively aware at an 8, so long as it is coming down periodically. But if things are stuck at an 8, it's going to stop being productive shortly.
 
I can only speak for myself - but I find that it's generally between a 6-8, with 10 being high and 1 being low.
Whoa, that sounds high. My idea of 60 is too distressed to think clearly; 80 is basically catatonic.

My best in vivo assignment so far has been somewhere in the upper 30s, I'd say. A bit uncomfortable, but not quite triggered. "Triggered" would begin at about 50 and then worsen to the point of can't-think, can't-speak shock and horror.
 
Whoa, that sounds high. My idea of 60 is too distressed to think clearly; 80 is basically catatonic.
Yeah, that's the thing about everyone's scale - it's pretty different. What matters is that you know your own scale. Like, in my scale, I'm just barely hanging on by my fingernails at a 10. If there were an 11, and I were in it, I wouldn't know what was going on at all - that would be a fully out of it zone.

I operate in daily life between a 3 or 4 and a 6. My baseline is 5, because I can think of that as, "not good on the inside, coping face on the outside." That's my sense of normal. My big goal is to move that baseline down, but that's a project. When I have biggish chunks of time at a 4, I consider that real progress.

Took me awhile to figure out what worked best for me, SUDS-wise. It's like the mental/emotional equivalent of target heart rates, exercise-wise.
 
I use a 1-10 scale because the big numbers do my head in! My 10, most distressed I could possibly be - that would be me getting sectioned. In 5 years, my approximate 10 may change as I get better at distress tolerance and no longer ever reach that degree of stress...maybe!

8 is still way too high to sustain for me, because at that level I'm scanning and likely to dissociate. Bringing it back to around 6 is probably my peak functioning level that I could sustain safely for several hours.

One of the reasons they recommend checking your SUDS regularly is so that you can get to know what's normal and healthy for you. My 8 and your 8 are potentially two very different experiences, and what each of us can sustain is also going to be different. Personally I'd be wary of anyone trying to give you a fixed number for your "optimal" stress level;)
 
Personally I'd be wary of anyone trying to give you a fixed number for your "optimal" stress leve
Well, supposedly there is neuroscience behind this. I'm just trying to figure out what the researchers found to be the stress level at which brain retraining and relearning can occur. If not expressed as a number then perhaps with some words that we can all understand. Eight, six, ten, four -- we may understand these levels differently; we may tolerate them differently. But the stress level at which brain re-wiring can occur should be pretty well understood. lf not, then prolonged exposure therapy is bunk.
 
The stress level is associated with hormones such as cortisol. Blood tests can measure this, but not in real time in a therapy situation.

If you read Van Der Kolk, Cozolino, Schwartz, Levine etc you'll get an idea that PE isn't as successful a therapy as it's made out to be.
 
If you read Van Der Kolk, Cozolino, Schwartz, Levine etc you'll get an idea that PE isn't as successful a therapy as it's made out to be.
I read some Levine. Are you referring to the somatic theory of trauma release?
 
But the stress level at which brain re-wiring can occur should be pretty well understood. lf not, then prolonged exposure therapy is bunk.
The more stressed you are, the faster the effect. I don't believe there's an optimal level, so much as there is a tolerance point and then optimal time spent - that's where the protocols in PE get more specific. How much time to spend on it, and how frequently.

Otherwise, you should push as hard as you think you can.

PE is very uncomfortable, stressful even. It's crude but reliable. But if you could do it at a 90% stress level, for the amount of time required, then that would simply make it go more quickly.

I don't even think there's proof that it won't work with low stress - but that's not how it was conceptualized, so that's not really been studied. Instead, EMDR was developed as a more controlled and ideally less stressful alternative. I think you as the person actually working through the stuff actually have more control over your own stress levels in PE, because you can just bail out. EMDR doesnt really allow for that.
 
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