Retelling the Story

2)It is an interesting fact that, whatever exposure treatment and EMDR have in common, their course is typically different. Namely, in exposure, the story is retold several times to decrease the SUDS level.

In EMDR, typically (for an adult onset PTSD condition with a single trauma) a single long session will neutralize the memory. We told retell or reprocess the same material twice. When we do revisit the same trauma, different material comes up.

To be clear, for a motor vehicle accident (MVA) a year ago as an example: after informed consent, we'd target the accident itself, initially. The next visit we'd check the SUDs, and if its a 3 or 4 now (instead of the initial 8, say), we'd ask what the most disturbing thing is now, and they'd say maybe, "the ambulance ride to the hospital" or the "lies in the police report" or "the stupid lawyer in the depo" or "how the pain in my back affected my marriage." So we'd process that. Next time we'd go back and it might be "the ongoing pain and medical treatment and physical therapy that is so time consuming and maddening." So its changing all the time.

Now with a more complex case, with say an MVA on top of a history of child abuse, any of these present-day issues, when processed, is likely to take the client back to other material held in the same "file folder" -- terror of dying, or shame or sadness or anger--- related to childhood experience.

What about your experience with exposure therapy?

Replies:

Re:Retelling the Story, by Cahill, 02/10/03 Re:Retelling the Story, by Sandra Paulsen Inobe PhD, 02/10/03

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