What Are the Pros and Cons of Exposure Therapy PTSD?

Flooding therapy is also called exposure therapy, shock therapy, or flood therapy, which is based on the emotional processing theory of Foa and Kozak ^[1] . Exposure therapy is divided into real exposure and imaginative exposure ^[2] , without any relaxation training for patients, allowing patients to imagine or directly enter the most horrible and anxious situations, in order to quickly correct the patient's misunderstanding of horror and anxiety stimulation, and eliminate Habitual horror and anxiety reactions triggered by this stimulus.

Slam therapy directly puts the patient into the situation that most scares him, quickly corrects the patient's misunderstanding, and achieves the goal of eliminating behavior. How the patient enters the fear environment:

Fear is a conditional response. The experience of fear caused by a certain thing or situation in a person will motivate him to evade behavior, regardless of whether the thing or situation really constitutes a threat to him. This evasion behavior leads to an enhanced fear experience, which plays a negative reinforcement role, which in turn enhances its evasion behavior. Therefore, experts believe that instead of escaping, let patients face the stimulation of fear, this is full irrigation therapy.

Slam therapy tells the patient in advance: here all kinds of first-aid equipment are available, medical staff are by his side, his life is absolutely safe and secure, so he can immediately imagine, listen or watch the scenes that scare him most, Under the stimulus of fear, even if the patient experienced autonomic nervous system reactions such as increased heartbeat, dyspnea, pale face, and cold limbs due to anxiety, the patient's most fearful disaster did not occur, and the anxiety reaction subsided accordingly.

Advantages of full irrigation therapy: short time, simple problem solving;

Disadvantages of slam therapy: It is difficult to implement and has a great impact on the patient's body and mind. It must be applied with caution.

Full irrigation is often used to treat

Full irrigation therapy is the opposite of systemic desensitization therapy.

The system desensitization method uses an anti-conditional effect, replacing the old response (anxiety and tension) with a new response (relaxation) to the same stimulus that can cause fear. The fear stimulus gradually upgrades until the patient is still given the strongest fear stimulus. Make a relaxing response to achieve the purpose of treatment. This slow gradual fading process requires certain step-by-step training to gradually adapt the patient to situations that cause fear. ^[3]

6.1 Full irrigation therapy 6.1 Slam therapy in the case of cleanliness:

6.1.1 Case Outline

The seeker is a 40-year-old logical staff member who is afraid to go out because he is afraid of shit pollution. He has not been to work for half a year. The emails sent are also afraid of shit pollution. He washed his hands more than 20 times a day. The children returned from school and must be replaced. Make contact with clothes only afterwards. Afraid of being rejected, the relationship with superiors and colleagues is not very good, after a detailed understanding of the illness has been three years.

6.1.2 Treatment process

Consultant: Please listen to me to explain this treatment method. Let me give an example first. If you have watched a thrilling movie, there are still some fears after the show and at night, if you want to eliminate this fear, you Go check out this video. If you watch it a few more times, you will not only feel scared, but you will feel boring and even doze off in the cinema. To treat your phobia with the same reason, you have to close your eyes like an actor, remember or imagine some scenes as much as possible, the more vivid the imagination, the more detailed the better, the scenes I want you to imagine It may be disgusting and unpleasant, but please do nt refuse to think about it and do not control your emotional response. Do you still have any questions?

Seeker: No.

Consultant: Then the treatment has begun. Please close your eyes and imagine that you are sitting in a comfortable chair at home and seeing something on the wall in your house. Please tell me in detail what do you really see?

Seeker: My bookshelf leaning against the wall to the west of my room is full of books. The walls are white. I saw a desk and a TV.

Consultant: Can you see clearly? Is there an image on the TV screen?

Seeker: Yes, it's very clear. The TV has images.

Counselor: Is your lover at home?

Seeker: Not here.

Consultant: You have to imagine that your lover came in and see her face clearly: see what clothes she is wearing, please tell me in detail what you see.

Seeker: She is tall and wears glasses. She wears a blue sweater on top and black pants on her bottom.

Counselor: Look at her face. She is distressed about your illness. She also said two words to complain about you. Tell me what do you see and what do you hear?

Seeker: She complained that I didn't go out or go to work. I feel a little angry.

Counselor: Experiencing this emotion-she doesn't understand your illness and uses unreasonable words to stimulate you, and you are upset. Seeing her open the door, a dog came in! How do you feel watching it shit in your room and squatting your ass?

Helper: Very annoying, very annoying.

Consultant: Keep imagining with your eyes closed, another dog is coming in, and shit is in your house. Dogs are walking around the room! The dog has stepped on the shit, making the shit all over the floor! It bounced the shit with its hind feet, and there was shit on the table, on the chair, and on the bed! You pick up the stick to get the dog out and hit the dog with the stick. A dog is fierce. It bites your trousers. You take a step back and the stick falls to the ground. Hurry up and pick it up. There is shit on the stick, there is shit on your feet, and there is shit on your hands. There is also a little shit on your face. You smell the smell of shit. You wipe your face with your hands, and the whole face is shit. You ca nt move on the ground, you ca nt move at all, you just smell the shit, and you see shit everywhere. Both hands are shit, there is shit on the face, and a big bitch comes in. It doesn't bite people and moves slowly. It walks towards you and puts your butt on you, and shit on your head. Now, you can see clearly, the anus is open, the shit comes out slowly, and the yellow thing falls off with heat and falls on your face. There was some thin shit on the face, and shit was flowing into the ears, eyes, and mouth. The shit was flowing into the throat, and the taste was sour and bitter. You're completely in the shit.

Okay, please open your eyes slowly, this time the treatment is over.

6.2 Full Stomach Therapy 6.2 Case of Slam Therapy for Phobia

6.2.1 Case of Phobia

A female patient suffering from unholy phobia and cancer phobia spends a lot of time every day washing hands, brushing furniture, and cleaning the floor. She dared not sleep in her own bed for a few years with her mother.

To cure her illness, the psychologist personally took the lead, touching the floor and soles with her hands, touching the mouth of the cup with dirty hands, drinking the water from the cup, and letting the patient do the same, and no hand washing was allowed for two hours. . In this way, the anxiety and horror caused by the patient's exposure to dirt are partially resolved by a two-hour delay. Initially, patients need to wash for 1 hour to "disinfect", and then gradually limit their hand washing time to 45 minutes, 30 minutes, and 15 minutes. Have the patient repeat the above process at home every day. After a few days, let her go back to her dirty bed, which has been sealed for many years, to sleep, and finally let the patient sit on the chair where the cancer patient sat and shake hands with the cancer patient. These measures put patients in a state of panic, insomnia, and loss of appetite, without any sedative drugs, waiting for the symptoms of anxiety to resolve on their own. After a period of treatment, the patient's horror of uncleanness and cancer gradually disappeared.

6.2.2 Case of Phobia

A phobia patient who was paralyzed because of the fear that the cold would freeze his lower limbs. Even in summer, the upper body was only wearing single clothes, but the lower body was still wearing thick fleece pants and cotton pants. The patient told him that he only needed to take off cotton pants or imagine that In cotton pants, the lower limbs trembled and became stiff enough to stand and walk.

The room temperature during treatment was 28 degrees Celsius. The upper body of the patient was only wearing single clothes, but the lower body was wearing a pair of underpants, a cotton wool pants, a wool pants, a thick cotton pants, and a pair of thick long socks. The healer told the patient that after examination, his lower limbs had the same function as the upper limbs, and that he would not be paralyzed at room temperature. He also prepared injections and electrical stimulation equipment to prevent the situation he was worried about. Under the guarantee of the therapist, after obtaining the patient's consent, the patient is required to lie down on the treatment bed and take off their cotton-pants, sweaters, and cotton pants, including stockings, very quickly, leaving only short Underwear, as a result, the patient's lower limbs did not appear to be trembling and stiff. The patient was asked to move his lower limbs on the bed and walk down on the ground after a few minutes.