Exposure Therapy: Scott Stossel and Scott Pelley
Scott Stossel published a powerful and detailed article on his personal journey to find a solution to anxiety (The Atlantic on Dec 22, 2013). This article gives a personal voice to the 40 million adults in United States (according to the National Institute of Mental Health) who suffer with anxiety.
Scott Stossel gave an account of his highly motivated and determined efforts to conquer his anxiety. He spent 30 years bravely trying a long list of treatments for a variety of phobias and (I’m guessing) Generalized Anxiety Disorder. Of all of the treatments listed, I was struck by his shocking and disturbing account of drinking ipecac in the presence of a psychologist using cognitive behavioral based therapy called Exposure Therapy to treat emetophobia (fear of vomiting). This experience of Exposure Therapy was traumatizing for Scott and worsened his emetophobia instead of curing it.
On November 24, 2013, 60 Minutes aired an episode called The War Within: Treating PTSD reported by Scott Pelley. The “new therapy” reported in this episode describes Exposure Therapy. Veterans reviewed a traumatic event 5 times in great detail during a therapy session. The Veterans continued to review the same traumatic event multiple times over many weeks.
Exposure Therapy (also called In Vivo Therapy) is based on a very old cognitive behavioral theory of desensitization to the event causing a person anxiety. In theory it makes sense but in practice it can be experienced as re-traumatizing and can greatly worsen anxiety.
A much faster, less painful and more effective treatment than Exposure Therapy is Eye Movement Desensitization and Reprocessing Therapy (EMDR). EMDR is one of the most researched and effective treatments available for anxiety, phobias and PTSD. The major advantage of EMDR is that a traumatic event needs to be reviewed only one time (not 5 times per session for weeks as the VA Center treatment program did in ‘The War Within’ 60 minutes episode). EMDR reprocesses a memory with one treatment session so that this memory or piece of the memory will be forever changed. EMDR enables the disturbing image to be faded out and the accompanying emotion (usually fear) to be decreased or eliminated.
Scott Stossel, I know you have tried 30 years of treatments-none of which has worked very well so far. My suggestion is to try a highly researched and effective treatment called EMDR. I would recommend a therapist who has used it for 10 or more years and can understand the application of this treatment for someone as complicated as yourself. Ask therapists who belong to a larger organization who is skilled enough to handle your situation.
Scott Pelley, I would recommend giving more air time to EMDR. Veterans don’t have to keep re-living their trauma with Exposure Therapy-they can rapidly reprocess their traumatic memories with EMDR.