Implosion therapy is a form of behavioral psychotherapy used for phobias and anxiety disorder , including PTSD . The essence of the treatment is the deliberate immersion of the patient into traumatic memories [1] in order to reintegrate repressed emotions. He is confronted with the most unpleasant stimulus, and, accordingly, he must survive the most pronounced reaction of fear, anger, etc. [2] βImmersionβ is performed for a sufficiently long time (from 30 minutes to an hour), until as you get used to the situation, the unpleasant feeling will not disappear. In this case, the patient and the therapist should not use any techniques (such as distraction or complacency) that could reduce the discomfort. Imaginative immersion is commonly used to treat anxiety disorders , phobias , obsessive-compulsive disorders , and post-traumatic syndrome . Implosion techniques are mainly used in behavioral psychotherapy and cognitive-behavioral psychotherapy [3] . Implosion therapy has a certain similarity with the method of systematic desensitization ( en: Systematic desensitization ). Its difference from systematic desensitization lies in the fact that during implosion the patient is asked to get in touch with a frightening situation without prior training in relaxation techniques [4] .
There are three types of implosion therapy: in imagination ( in sensu ) [5] , in reality ( in vivo ) and virtual techniques. Usually in therapeutic practice, imaginary or virtual immersion is first used, and only then immersion in a real situation. .
Although in most cases implosion is used to get rid of fear, there are other possible uses of this method, for example, to reduce anger in annoying situations, or to get rid of bad habits (for example, a smoker forces himself to smoke a cigarette after a cigarette continuously, until the appearance of a cigarette or even the thought of her will not cause disgust) [6] .
Content
History
The implosion therapy method was created by the American psychologist Thomas Stampfl in 1961 [7] . The term "flooding" (born flooding - flood) was first used by Polin ( Polin AT ) in 1980 [5] [8]
The theoretical basis of implosion therapy is behaviorism . Implosion techniques are based on two phenomena:
- The phenomenon of extinction of conditioned reflexes (the idea of I. P. Pavlov ): if the stimulus (a frightening situation) is not accompanied by the expected consequences (the patient is not exposed to real danger), then the conditioned reflex (in this case, fear) gradually fades away.
- The addictive phenomenon: observations have shown that if an individual is in a frightening situation for a long time, then at first his fear becomes more intense, but then, if the stress lasts long enough, the individual gradually gets used to it, and the fear passes. Subsequently, the individual realizes that he is able to gain composure in a stressful situation, and such situations cause him less and less fear [3] .
A. Lazarus (2000) describes a case of therapy when a patient in a hospital who is afraid of becoming infected with fullness due to bodily contact with full people is placed (with his consent) in a room with very full patients who will inevitably touch him. After some time, the fear of bodily contact with fat people disappeared [5] .
Implose Therapy Scheme
First of all, the patient makes a hierarchical list of situations that cause him fear, starting with the easiest of these situations. Then the therapist applies the immersion technique (in the imagination or in reality), starting with the easiest situation for the patient. The session continues until the patient's fear is reduced by at least 50%. In this case, the patient should not try to reduce anxiety with the help of any techniques (such as, for example, distraction or relaxation), since he must learn to endure this anxiety. The transition to a more difficult situation is made only after the patient has learned to remain calm in an easier situation. If even the easiest situation causes an unbearable fear in a patient, the therapist can preliminarily apply the technique of systematic desensitization (that is, immersion with prior training in relaxation techniques).
Using implosion to treat panic attacks
One of the specific techniques of implosion therapy is the development of addiction to the symptoms of panic attack [9] . It is known that a panic attack develops according to the βvicious circleβ principle: a stressful situation causes unpleasant symptoms (palpitations, asphyxiation, dizziness, etc.), which in turn cause intense fear in the patient and thereby increase the stress response. For this reason, it is necessary to develop a patient attitude towards the symptoms of a panic attack, which will gradually lead to a decrease in the intensity of panic attacks, or even to their complete disappearance.
Advantages and limitations of implosion therapy
The advantage of the implosive method is the speed of achieving the result. Two or three sessions of implosion are often enough to eliminate fear. But since the procedure can be quite unpleasant for the patient, implosive therapy is quite stringent. First of all, the patient must make a decision about participation in implosive therapy completely voluntarily and consciously, based on complete and reliable information about the essence of the method and its effects. For this reason, implosive therapies are almost never applied to children. There are also certain requirements for the level of physical health of the patient, since implosion creates quite high physiological loads. Implosion is usually not applied to anxious individuals. The client is granted the right to terminate the procedure at any time and advance a sign on which the implosion will be terminated. The ideal client for implosion therapy is an adult healthy client, quite brave and responsible, whose single fear arose as a result of a single traumatic event [5] . The use of this technique requires a very high motivation from the client and a rather high resistance to stress [2] .
See also
- Stress vaccine therapy
Notes
- Del Sundel M., Stone-Sundel S. Behavior Change in the Human Services . - SAGE, 2005. - P. 241β2. - ISBN 978-0-7619-8870-0 .
- β 1 2 Kholmogorova A. B., Garanyan N. G. Cognitive-behavioral psychotherapy. - M .: Kogito Center, 2000. - p. 224-267. ISBN 5-89353-030-6
- β 1 2 Louis Chaloult. La thΓ©rapie cognitivo-comportementale: thΓ©orie et pratique. MontrΓ©al: GaΓ«tan Morin, 2008
- β Psychotherapeutic encyclopedia . Archived December 14, 2012.
- β 1 2 3 4 Romek VG Behavioral therapy of fears . Archived December 14, 2012.
- β Psychological Encyclopedia . Archived December 14, 2012.
- β Stampfl, TG Implisive Therapy: A Learned Learned Psychodynamic Technic. Uneversity of Cleveland, 1961)
- β Polin AT The effect of flooding and physical suppression of the extinction techniques on an anxiety-motivated avoidance locomotor response // Journal of Psychology. 47, 1959
- β Jacob RG, Pelhman WE Behavior Therapy. In Sadock et al., Kaplan and Sadock <s Comprehensive Textbook of Psychiatry . Philadelphie: Lippincott Williams & Wilkins, 2005
Literature
- Stampfl, TG (1970). Implosive therapy: An emphasis on covert stimulation. In DJ Lewis (Ed.), Learning approaches to therapeutic behavior change (pp. 182β204). Chicago: Aldine.
- Stampfl, TG & Levis, DJ (1967). Learning-theory-based psychodynamic behavioral therapy. Journal of Abnormal Psychology, 72, 496-503.
- Stampfl, TG & Levis, DJ (1976). Implosive therapy: A behavioral therapy? In JT Spence, RC Carson & JW Thibaut (Eds.), Behavioral approaches to therapy (pp. 189β210). Morristown, NJ: General Learning Press.
- Stampfl, TG (1987). Theoretical implications of the paradox as an experimental resolution. Behavior Analyst, 10, 161-173.