Ideal suds (distress) level for retraining your brain

[kilted]

The idea of pushing one's SUDS level up to get "faster" results is unlikely to work and is as simplistic as taking expecting to get better faster if one doubles the dosage of a medicine..... or thinking that people learn to swim faster if the instructor throws novices in the deep end of the pool...... some may indeed learn to swim, but some will drown, and others will have a lifelong fear of water, swimming instructors and the smell of chlorine and never try to learn again. Good PE is like learning to swim......a good instructor will reduce the stress levels by using floats and a phased approach to technique, depth of water and distance to safety.

This is borne out by our current understanding of the underlying neurochemical processes.

 

[joeylittle]

The idea of pushing one's SUDS level up to get "faster" results is unlikely to work and is as simplistic as taking expecting to get better faster if one doubles the dosage of a medicine

No, that's not how it works.

I'm not advocating for it, by the way. I'm speaking from a combination of experience, and research. I'm also happy to be proven wrong. But PE works through repetition, and there needs to be stress present in order for the repetition to create de-stress. You can't expose yourself to something that is not a stressor, simply put. There's nothing to expose. And there's not so much a zone called 'too much stress', as there is a point at which you cannot hold together and tolerate it.

So, when you double the dose of a medicine, you can reach anything from non-eventful to toxic levels. But when you increase pressure on exposure work, the threshold is simply, can you tolerate the pressure. A crude analogy would be more like, eating a bowl of crickets if you've never had crickets before. Doing it very minutely and very slowly, it will likely stay moderately unpleasant start to finish. Try and just shove the whole bowlful down your throat, well, if you can - great. But if you vomit it all up again, it didn't work. Purposefully chewing through them while maintaining your presence of mind is the way to go. If you can do that five at a time, it'll go quicker than 2 at a time.

So long as you, the individual, are capable of remaining present and tolerating the stress - you can push yourself has hard as you'd like. And, in my own experience, it does progress more quickly. Sometimes, faster is better - if you have a limited amount of time to cut the intensity of the problem in half, say. Sometimes, you need to be functional in other ways that would encourage you to not be so immersive.

The re-traumatization notion then follows; if the actual pressure of the exposure is too intense, causing you to lose your grounding, you potentially create a new layer of trauma right on top of the original one. Experientially, it can lead a person to want to just stop and never open the pandora's box again. I'm sure many people here can speak to having pushed too hard, too fast into doing trauma work. But it is going to be unpleasant and stressful at the outset; that's the very nature of it, and it's why it's crude and other methods were developed to try and circumnavigate the scale of the upset that occurs.

This is borne out by our current understanding of the underlying neurochemical processes.

I think you are talking about habituation, not exposure. But I'd love some recommended reading that backs this up, if not. It has been awhile, for me.

 

[Dana1010]

it's crude and other methods were developed to try and circumnavigate the scale of the upset that occurs.

Can you say a little more about these, please?

 

[Sideways]

Experientially, it can lead a person to want to just stop and never open the pandora's box again.

My (vague) understanding was that too much pressure leads to a flooding situation, which can reinforce the amygdala's fear response, which has the opposite of the desired outcome...?

 

[joeylittle]

too much pressure leads to a flooding situation

Yes. At which point, you are no longer doing exposure therapy, you are losing your shit, PTSD-wise, and nothing productive is coming of it.

which can reinforce the amygdala's fear response

Not quite - this is the misunderstanding about re-traumatization. It's not that the old trauma is being reinforced, so much as a profoundly negative reaction to recalling the trauma is now being stored as an experience tied to the trauma. if that makes sense.

I'm trying to think of a good analogy...lets use a phobia for a second. Say you are afraid of spiders. You go to work on this using exposure technique, and here's the day when it's time to hold a tarantula. They place it in your hand, and you try really hard, but you are not coming down from the stress. But you persevere. Suddenly, it moves one leg and you scream, throw it across the room, and in so doing, smack your therapist in the face and break their nose.

You still have your spider phobia. But you also have, now, guilt, anxiety, etc, around a tarantula and sending your therapist to the hospital. Did your spider phobia get worse? Maybe a little - or it just got more specific. But you have new emotional baggage. Not profound enough to generate it's own PTSD symptoms, but strong enough that you are averse to working on your original problem - the phobia - anymore.

 

[Changing4Best]

Someone put their hands on me this week and I was immediately at a 100 or what I call a 10 (I agree that the BIG numbers only make this scale harder to deal with, they don't help!). I raised my voice in protest. Yet, I have hugged that person before. This time, however, he came from behind, so I had no warning that he was about to touch me. That freaked me out. He had already upset me several times in the previous few days and on that day too, by things that he had said, so when he put his hands on me, I lost it and protested loudly so that everyone in the room could hear me. He backed off in a hurry.