1he oLenLlal 8ole of 1rauma 8eleaslng Lxerclses (18L) ln Lhe

1reaLmenL of 1rauma, 1Su and lLs Co morbld CondlLlons lncludlng

AnxleLy, uepresslon and SomaLoform ulsorders
Llnda A. Ldwards h.u., M.A..S.

!"#$%&'(#)%"
Approaches lnvolvlng some klnd of exposure and Lhe re-experlenclng of Lrauma have been repeaLedly shown Lo be
Lhe mosL effecLlve LreaLmenLs for 1Su (8radley eL al., 2003, Sharpless & 8arber, 2011, van der kolk eL al., 2007, van
LLLen & 1aylor, 1998). Powever, Lhey are noL hlghly effecLlve. Cnly abouL 30 of cllenLs lmprove (8radley eL al,
2003, ScoLL & SLradllng, 1997, SchuberL & Lee, 2009), veLerans lmprove less Lhan oLher groups (8radley eL al., 2003)
wlLh some veLerans experlenclng serlous adverse consequences (lLman eL al., 1991).
1here are many reasons. Some people have dlfflculLy vlvldly lmaglnlng Lhelr Lraumas (Sharpless & 8arber, 2011),
oLhers refuse Lo re-experlence Lhe lnLense emoLlons assoclaLed wlLh Lhelr Lraumas (ScoLL & SLradllng, 1997, van der
kolk eL al., 2007, vu[anovlc eL al. 2011), and sLlll oLhers are unwllllng Lo even Lalk abouL Lhelr Lraumas (ScoLL &
SLradllng, 1997) or are reslsLanL Lo openlng up abouL Lhemselves ln Lalk Lheraples ln general (Sharpless & 8arber,
2011) or drop ouL of Lherapy (vu[anovlc eL al., 2011). ln addlLlon Lo Lhe 30 who do noL lmprove, Lhere are many
LraumaLlzed lndlvlduals who do noL seek help (vu[anovlc eL al. 2011) because Lhey cannoL afford Lhe Llme or money
for Lherapy (Sharpless & 8arber, 2011) or are LoLally unwllllng Lo admlL Lhey need psychologlcal help (nlckel eL al.,
2006).
1he slLuaLlon ls even worse when lL ls recognlzed LhaL pure 1Su capLures a llmlLed aspecL of posLLraumaLlc
psychopaLhology (Creamer eL al., 2001, SchuberL & Lee, 2009, van der kolk eL al., 2003). ln a sLudy of 10, 600
AusLrallans, 88 of lndlvlduals wlLh 1Su were found Lo have aL leasL one oLher psychlaLrlc dlagnosls, 39 had 3 or
more dlsorders and 31 meL crlLerla for axls ll dlagnosls, and LraumaLlzed people presenLed wlLh varlous
comblnaLlons of depresslons, anxleLy, somaLlzaLlon ln addlLlon Lo 1Su (Creamer eL all., 2001, van der kolk eL al.,
2003). MosL 1Su research excludes 1Su wlLh comorbld condlLlons and hence excludes Lhe early onseL 1Su or
dlsorders of exLreme sLress noL overwlse speclfled (uLSnCS). eople wlLh Lhese complex 1Su dlagnoses usually
suffer from dlsLurbances ln percepLlon, lnformaLlon processlng, affecL regulaLlon, lmpulse conLrol, and personallLy
dlsorders whlch don'L respond Lo 1Su LreaLmenLs of cholce (SchuberL & Lee, 2009, van der kolk eL al., 2003). ln
addlLlon, Lhere ls sLlll no clear LheoreLlcal undersLandlng of Lhe processes lnvolved ln 1Su (SchuberL & Lee, 2009) or
even exacLly whaL crlLerla should deflne 1Su (8osen, SplLzer & McPugh, 2008, SchuberL & Lee, 2009, van der kolk
eL al., 2003).
8ecenL neurosclence research appears Lo explaln why besL pracLlce verbal psychoLheraples for 1Su and Lrauma are
noL parLlcularly effecLlve, and Lhere are now calls for cllnlcal pracLlce Lo be lnformed by psychophyslology research
(ScoLL & SLradllng, 2001). neurosclence research has shown LhaL Lhere are slgnlflcanL llmlLaLlons Lo Lhe consclous
conLrol LhaL humans have over Lhelr acLlons and emoLlons (ScoLL & SLradllng, 2001, van der kolk, 1994, 2006). lL has
been flrmly esLabllshed LhaL lnsLlncLual unconsclous physlologlcal processes of Lhe cenLral nervous sysLem are
domlnanL ln LraumaLlzed lndlvlduals and Lhelr neocorLex processes are overrldden and dlmlnlshed ( orges, 1993,
2001, van der kolk, 2006). 1rauma occurs when Lhe lmmoblllzaLlon sysLem LhaL blocks Lhe neocorLex processes and
soclal engagemenL sysLem durlng poLenLlally LraumaLlc evenLs ls unable Lo reLurn Lo normal afLerwards
(orges,1993, 2001, Scaer, 2001, van der kolk, 2006). 1haL has led Lo an lnLeresL ln mlndfulness and boLLom-up body
orlenLed psychoLheraples (8Cs) belng lncluded ln 1Su LreaLmenL (Levlne, 2010, Cgden & MlnLon, 2000,
8oLhschlld, 2000, Sharpless & 8arber, 2011, van der kolk, 2006, vu[anovlc eL al., 2011)
1he lmporLance of 8C has long been recognlzed ln approaches such as locuslng (Cendlln, 1961), CesLalL Lherapy
(erls, 1969), 8loenergeLlc Analysls (Lowen & Lowen, 1977) and many oLhers. Powever, lL ls only recenLly LhaL
sufflclenL lnLeresL, and hence, effecLlveness sLudles effecLlveness sLudles lnvolvlng more Lhan anecdoLal evldence
have begun Lo emerge (8ohrlchL, 2009). ln hls recenL revlew of 8C research and evldence-based pracLlce, 8ohrlchL
found LhaL 8C ls helpful wlLh condlLlons such as somaLoform dlsorders, 1Su and chronlc schlzophrenla whlch do
noL respond well Lo neo-corLex-based psychoLheraples. Pe even found LhaL, followlng a robusL meLa-analysls, 8C
and oLher non-verbal Lheraples had been recommended as Lhe LreaLmenL of cholce for schlzophrenla by Lhe u.k.
nlCL guldellne. 1here has also been lnvesLlgaLlon of Lhe use of mlndfulness and/or 8C wlLh convenLlonal verbal
Lheraples (Sharpless & 8arber, 2011, vu[anovlc eL al., 2011) e.g. u81 has been found Lo be effecLlve wlLh 1Su (SLell
eL al., 2011) and C81 exposure comblned wlLh lnLerocepLlve exposure has ylelded poslLlve resulLs (Wald & 1aylor,
2007, 2010). Also, 1Su has been successfully LreaLed uslng AC1 (Crslllo & 8aLLen, 2003), whlch ls expecLed Lo be
effecLlve because of lLs success wlLh anxleLy and depresslon (lorman eL al., 2007) whlch are usually comorbld wlLh
1Su (Creamer eL al., 2001, van der kolk eL al., 1983).
Whlle Lhese new dlrecLlons are promlslng, recurrlng Lrauma has been lmpllcaLed ln mosL serlous menLal lllness
(Creamer eL al., 2001, van der kolk eL al, 1983), mass Lrauma due Lo wars and naLural dlsasLers are on Lhe lncrease
(8ercell, 2010a), many people can'L afford Lhe money or Llme or do noL have Lhe lncllnaLlon Lo engage ln whaL can
amounL Lo 30 Lo 60 hours of exposure homework per week (Sharpless & 8arber, 2011 or SLradllng & 1aylor, 1997?),
nor are Lhere sufflclenL LheraplsLs Lo meeL Lhe lncreaslng demand (8ercell, 2010a). sychoLherapy for Lrauma and
1Su ls aL a crlsls polnL and a paradlgm shlfL ls needed Lo provlde brlef effecLlve LreaLmenL Lo reverse mass Lrauma
qulckly ln Lhe ma[orlLy of people affecLed (8ercell, 2010a).
1he facL LhaL lL ls common for humans Lo be LraumaLlzed and develop 1Su, yeL wlld anlmals exposed Lo regular
predaLor aLLack rarely do, ls belleved Lo be Lhe key Lo provldlng early, fasL and effecLlve recovery from mass Lrauma
(8ercell, 2010a, Levlne, 2010).
*+'$%,+")( .$+/%$0
SLudles of anlmals under LhreaL have provlded lnformaLlon abouL behavlor and Lhe physlologlcal processes ln
slLuaLlons of boLh escapable shock and lnescapable shock (Marx eL al., 2008). MosL aLLenLlon has been glven Lo
lnescapable shock slnce lL has been seen as a good model for Lhe developmenL of 1Su ln humans. When anlmals
are prevenLed from escaplng (chronlc LhreaL), Lhey suffer sympLoms of lnescapable shock parallel Lo sympLoms of
humans wlLh complex 1Su (Marx, lorsyLh & LexlngLon, 2008, van der kolk, Creenberg, 8oyd & krysLal, 1983). 1hls
has led Lo an lnLeresL ln learnlng how Lo reverse lnescapable shock ln anlmals so LhaL flndlngs can be applled Lo
LreaLmenL of 1Su (van der kolk eL al.,1983).
Powever, Lhere ls a more dlrecL approach. Slnce anlmals ln Lhe wlld are rarely LraumaLlzed (Levlne, 2010), and
experlmenLal anlmals sub[ecLed Lo lnLermlLLenL LhreaL develop reslllence (Lyons eL al., 2010), lL would be useful Lo
know whaL usually happens behavlourally and physlologlcally ln anlmals LhaL rarely happens ln humans LhaL mlghL
prevenL Lrauma sympLoms from developlng ln humans (Scaer, 2001)
1he behavlor of experlmenLal anlmals durlng Lhe lmmoblllLy response Lo escapable LhreaL has been well researched
(8raud & Clnsburg, 1973a) and repeaLedly found Lo lnclude Lhe followlng sequence: brlef sLruggllng (flghL/fllghL),
lmmoblllLy (freeze), Lrembllng llmbs, and flnally loud nolses, followed by normal behavlor (8raud & Clnsburg, 1973b).
CbservaLlons of wlld anlmals have shown a slmllar sequence (Levlne, 1997, 2010) wlLh Lhe expecLed dlfference LhaL
Lhe flghL/fllghL behavlor was usually runnlng Lo Lry Lo escape Lhe predaLor raLher Lhan brlef sLruggllng Lo geL ouL of
Lhe hand of Lhe experlmenLer. lL has also been observed by Afrlcan gamekeepers LhaL lf capLured anlmals do noL
shake and freeze when released back lnLo Lhe wlld, Lhey do noL survlve (Levlne,1997, 2010). 1hls led Levlne Lo
expecL LhaL Lhe lmporLanL anlmal behavlour LhaL ls ofLen mlsslng ln humans ls Lhe Lrembllng of llmbs. 8elng aware
LhaL Lhe freeze response ls assoclaLed wlLh hlgh levels of boLh parasympaLheLlc and sympaLheLlc arousal (orges,
1993, 2001), he proposed LhaL shaklng and oLher lnsLlncLual movemenLs use up Lhe excess blo-chemlcals bullL up ln
Lhe organlsm afLer a fllghL-fllghL-freeze response allowlng Lhe physlologlcal processes of Lhe body Lo reLurn Lo a
normal non-alerL sLaLe (8ercell & napoll, 2006, Levlne, 2010). 1hls ls conslsLenL wlLh Lhe facL LhaL body shaklng ln
experlmenLal anlmals afLer cessaLlon of LhreaL ls assoclaLed wlLh a reducLlon ln oplaLes (van der kolk eL al., 1983).
Whlle humans can and ofLen do shake or Lremor lnvolunLarlly afLer llfe-LhreaLenlng evenLs, lL ls consldered Lo be a
sympLom of fear (uS uepL uefence, 2006) and a slgn of weakness (8ercell, 2009). ln addlLlon, lf shaklng and
Lrembllng happen ln a non-LhreaLenlng conLexL, lL ls seen as paLhologlcal e.g. epllepLlc selzures, arklnson's Lremors,
and anxleLy dlsorders lncludlng 1Su and non-epllepLlc selzures (PowleLL & 8uber (2009). lL would appear LhaL
soclallzaLlon has suppressed lL (Schore, 2002). 1hls ls conslsLenL wlLh 8ercell's (2008) observaLlon ln bomb shelLers ln
Afrlca of parenLs sLopplng Lhemselves from Lrembllng because Lhey dldn'L wanL Lhelr chlldren Lo Lhlnk Lhey were
afrald. lor all Lhese reasons, Lhe poLenLlal LherapeuLlc value of Lhe Lremorlng LhaL occurs afLer Lhe flghL-fllghL-freeze
response ln anlmals and humans has rarely been lnvesLlgaLed (Scaer, 2001).
neverLheless Lhere ls qulLe a blL of evldence from dlverse sources whlch supporLs Levlne's novel Lheory. ln a recenL
sLudy of wlld geese flLLed wlLh elecLronlc monlLorlng of physlologlcal processes, kral[-flser eL al.(2010) reporL an
lncrease ln body shaklng and wlng flapplng assoclaLed wlLh fasLer recovery from flghL-fllghL sLress under condlLlons
where LhreaL was held consLanL. 1hls, LogeLher wlLh Lhe facL LhaL oplaLes reduce afLer body shaklng (van der kolk eL
al., 1983), suggesLs LhaL shaklng has more Lo do wlLh recovery Lhan fear. Llkewlse, chlcks LhaL were reLhreaLened
before Lhey have flnlshed shaklng and flapplng abouL afLer a prlor LhreaL has been shown Lo reduce Lhelr survlval
capaclLy (Seyle, 1936, Scaer, 2001), whlle chlcks LhaL had experlenced lnLermlLLenL LhreaL (been caughL, brlefly held
and leL go Lo compleLe Lhelr lmmoblllLy response) developed beLLer reslllence Lhan Lhose chlcks who had noL been
LhreaLened (Clnsburg, 8raud & 1aylor, 1974).
ln humans, Chl Cong Leachers ln Chlna have clalmed for Lhousands of years LhaL sponLaneous body movemenL
pracLlses lncludlng shaklng releases psychologlcal sympLoms (!ahnke, 1997). ln Lhe WesL, dellberaLe acLlvaLlon of
naLurally occurrlng body Lremorlng has been exLenslvely used Lo faclllLaLe sponLaneous breaLhlng and release of
chronlc muscle Lenslon ln Lhe developmenL of Lhe performer's volce (Meler, 2010). ln addlLlon, many 8ody CrlenLed
sychoLheraples (8C) recognlze shaklng or Lrembllng as LherapeuLlc e.g. 8loenergeLlc Analysls (Lowen & Lowen,
1977) , PoloLroplc 8reaLhwork (Crof, 1988), sensorlmoLor psychoLherapy (Cgden & MlnLon, 2000), SomaLlc
Lxperlenclng (Levlne, 1997) , body-orlenLed hypnoLherapy (Ldwards, 2002).
Some of Lhese have been reporLed Lo be LherapeuLlcally effecLlve e.g. somaLlc experlenclng wlLh hurrlcane survlvors
(LelLch, 2007) and Lsunaml survlvors (arker & uocLor, 2008), PoloLroplc 8reaLhwork wlLh mosLly mlddle-aged whlLe
females (Polmes eL al., 1996), and 8loenergeLlc Lxerclses wlLh 1urklsh lmmlgranLs (nlckel eL al., 2006), schlzophrenla
(8ohrlchL & rlebe, 2006), female sexuallLy (Ladas & Ladas, 2003), and cllenLs ln general (koemeda-LuLz eL al., 2006,
venLllng, 2002).
ln addlLlon, LMu8, whlch ls consldered Lo be a LreaLmenL of cholce for 1Su (SchuberL & Lee, 2009), can be regarded
as provldlng supporL for Lhe LherapeuLlc value of Lremors. 1he eye movemenLs whlch lL acLlvaLes and whlch are
known Lo have a dearousal effecL (Sack eL al., 2008, SchuberL & Lee, 2009) may be havlng a dearousal effecL on Lhe
whole body ln Lhe way Levlne suggesLs, or ln a more resLrlcLed way connecLed wlLh Lhe facL LhaL eye movemenLs are
lnvolved ln Lhe lnlLlal orlenLlng response Lo LhreaL .
llnally, Lhere ls subsLanLlal evldence of Lhe medlcal beneflLs of mechanlcally lnduced Lremorlng called whole body
vlbraLlon (W8v) for a varleLy of condlLlons (!ordan eL al., 2003). Cf parLlcular relevance Lo psychologlsLs, W8v has
been shown Lo reduce paln (8lLLweger eL al., 2002) and sLress-produclng hormones (8osco eL al., 2000), whlch means
lL mlghL have a beneflclal effecL on depresslon and 1Su as well as anxleLy.
ln summary, Lhere ls subsLanLlal evldence from dlverse sources LhaL naLurally occurrlng and mechanlcally lnduced
Lremorlng ls llkely Lo be LherapeuLlc.
ln order Lo address Lhe problems wlLh exlsLlng LreaLmenLs for 1Su, and ln accord wlLh van der kolk 's (2006) call for
mlndful somaLlc approaches comblned wlLh physlcal acLlon, and orges (2001) call for lnLervenLlons LhaL exerclse
physlologlcal processes ln a conLexL of safeLy, 8ercell developed a seL of Lrauma releaslng exerclses (18L) Lo
reacLlvaLe neurogenlc Lremors ln LraumaLlzed lndlvlduals and applled lL Lo large groups of Lhese people over a perlod
of 13 years ln 19 war-Lorn counLrles ln Afrlca and Lhe Mlddle LasL (8ercell & napoll, 2006). 1he anecdoLal evldence
he accumulaLed over Lhose years showed LhaL Lhe exerclses were safe and many people losL hyperarousal sympLoms
commonly experlenced ln 1Su such as dlfflculLy sleeplng, exaggeraLed sLarLle response, lrrlLablllLy, dlsLurblng
memorles and deLachmenL. 1hese people were from dlverse culLural and rellglous backgrounds and feedback was
equally poslLlve from boLh clvlllans and Lhe mlllLary.
AfLer reLurnlng Lo Lhe WesL, 8ercell underLook some prellmlnary plloL sLudles. Pe found self-reporL evldence LhaL
18L lmproves sleep and reduces sLress ln Amerlcan Leen school sLudenLs (8ercell, 2010b), slgnlflcanL reducLlon ln
Lhree measures of sLress ln soclal work sLudenLs dolng agency lnLernshlps (8ercell & napoll, 2006), and ln a
randomlzed conLrolled sLudy, he found 18L Lo reduce anxleLy ln college sLudenLs compared wlLh a "sLress release
exerclse" conLrol group (8ercell, 2009). 1here ls a u.S. Army sLudy underway and a reporL on wheLher 18L reduces
sLress ln combaL Lroops ls pendlng. Also, anecdoLal evldence conLlnues Lo bulld ln Lhe WesL. sychlaLrlsL and
neurologlsL 8oberL Scaer (2008) says he has LaughL 18L Lo paLlenLs wlLh conslsLenLly remarkable resulLs.
lL ls clalmed LhaL 18L acLlvaLes neurogenlc Lremors by sLreLchlng and genLly faLlgulng parLlcular groups of muscles
LhaL are lnvolved ln a LraumaLlc evenL, especlally Lhe psoas muscles deep ln Lhe pelvls (8ercell & napoll, 2006).
1hese exerclses lnvolve slmple, safe and easy acLlons such as ralslng and lowerlng Lhe heel whlle sLandlng on one
fooL, sLandlng on one leg wlLh fooL flaL on Lhe floor whlle bendlng and sLralghLenlng Lhe welghL-bearlng knee, slLLlng
agalnsL Lhe wall, and lylng on Lhe floor wlLh knees benL, whlch ls Lhe usual flnal Lremorlng poslLlon. 1hese exerclses
are modlfled Lo a lesser or greaLer degree dependlng on Lhe physlcal healLh, flLness, age and flexlblllLy of Lhe
lndlvldual. lf even Lhe sllghLesL blL of paln ls experlenced, Lhe person ls lnsLrucLed Lo cease Lhe exerclse
lmmedlaLely. aln ls seen as counLerproducLlve Lo a procedure LhaL relles on relaxaLlon for lLs success. Also, Lhe
full seL of exerclses ls LaughL lnlLlally (dependlng on Lhe person) Lo ensure LhaL Lhe Lremourlng response ls acLlvaLed.
Powever, as Lhe body becomes recondlLloned Lo Lhe naLural Lremorlng response, lL ls ofLen sufflclenL Lo slL or lle ln a
flxed poslLlon wlLh sllghL Lhlgh Lenslon Lo acLlvaLe Lremorlng, especlally afLer physlcal or emoLlonal sLress. MosL
people are lnsLrucLed Lo pracLlse Lremorlng for 13 mlnuLes Lwo or Lhree Llmes per week for aL leasL Lhree monLhs
and Lo do mosL of Lhe acLlvaLlng exerclses aL leasL once per week.
.1+ 2%3+ %4 #1+ 506(1%3%,)0#
1hose wlLh deep Lrauma such as 1Su wlLh uLSnCS and oLher psychlaLrlc dlsorders mlghL need Lo resLrlcL
Lhemselves Lo Lwo mlnuLes of Lremorlng per sesslon so as noL Lo release lnLense emoLlonal or physlcal experlences.
lL ls because each person ls dlfferenL and each lndlvldual needs Lo learn Lo self-regulaLe Lhe Lremorlng LhaL wlll
release Lhelr lncompleLe pasL Lrauma reacLlons, LhaL Lhose deeply LraumaLlzed lndlvlduals wlLh 1Su and comorbld
psychlaLrlc dlagnoses need Lo learn and pracLlse Lremorlng under Lhe supervlslon of a psychologlsL or oLher menLal
healLh professlonal who ls also experlenced ln Lhe use of 18L (8ercell & napoll, 2006). 1he coachlng psychology
model should be helpful for lmprovlng compllance, for wlLhouL regular pracLlce over a Lhree monLh perlod, llLLle may
be galned by chronlcally LraumaLlzed lndlvlduals.
18L may well solve a number of problems presenLed by currenL 1Su LreaLmenLs. llrsL, because 18L ls a seL of
exerclses whlch can be learned ln a group seLLlng as sLress reducLlon exerclses, people who would never consulL a
counsellor or psychoLheraplsL may be able Lo recelve help (8ercell & napoll, 2006 , PoweLL & 8euber, 2009, nlckel eL
al., 2006, vu[anovlc eL al. 2011) by belng persuaded Lo slgn up for a weekly class.
Second, lf as clalmed, 18L acLlvaLes Lhe naLural self-heallng neurophyslologlcal processes of Lhe body and bypass Lhe
cllenL's ego defences (8ercell, 2003), lL has an enormous advanLage ln lncreaslng wllllngness Lo recover from Lrauma.
1hlrd, whlle lL ls known LhaL early lnLervenLlon reduces sufferlng, LradlLlonal crlsls lnLervenLlon focuses on cognlLlve
skllls durlng and lmmedlaLely afLer sLress, a Llme when Lhe funcLlonlng of Lhe neocorLex ls slgnlflcanLly reduced
(orges, 1993, 2001, van der kolk, 2006). Powever, because 18L ls a physlcal process of acLlvaLlng an lnsLlncLual
neurologlcal process LhaL does noL lnvolve Lhe neocorLex, lL ls posslble LhaL wlLh mlnlmal guldance mosL healLhy
funcLlonlng adulLs LraumaLlzed by naLural dlsasLers, crlme or war wlll be able Lo use 18L as a self-help recovery Lool
(8ercell, 2010a), Lhus slgnlflcanLly reduclng Lhe cosL and Llme (Sharpless & 8arber, 2011) of deallng wlLh mass
Lrauma (8ercell, 2010a).
lourLh, for slmllar reasons, 18L may be useful as a prevenLaLlve measure for soclal workers and psychologlsLs who
are llable Lo suffer vlcarlous LraumaLlzaLlon when consLanLly worklng wlLh LraumaLlzed people (8ercell & napoll,
2006, McCann & erlman, 1990).
llfLh, Lhe beneflLs of 18L appear noL Lo be resLrlcLed Lo 1Su. LxlsLlng evldence wlLh whole body vlbraLlon and
neurogenlc Lremors suggesLs LhaL Lhose sufferlng from anxleLy and paln may beneflL, and because Lrauma ls a
precursor Lo depresslon (van der kolk, 1987) and Lhe dysregulaLlon of neurophyslologlcal processes ln 1Su and
depresslon are slmllar (Sharpley, 2010), lL ls llkely LhaL depressed lndlvlduals wlll also beneflL.
SlxLh, [usL as Lhe drop ouL ln LMu8 ls less Lhan C81 exposure (SchuberL & Lee, 2009), lL ls expecLed LhaL dropouL ln
18L would be less because lL alms Lo avold exposure by dlrecLly releaslng Lhe blo-chemlcals and deep muscle Lenslon
dlrecLly raLher Lhan forclng Lhe lndlvldual Lo re-experlence Lhe lnLense LhoughLs and emoLlons LhaL occur ln Lop-
down processes.
SevenLh, mosL exposure based Lheraples lnclude beLween 30 and 60 hours of exposure homework per week
(SchuberL & Lee, 2009) whlle 18L only lnvolves 1 hour (usually Lhree 20 mlnuLe sesslons) Lo achleve lLs resulLs
(8ercell & napoll, 2006). 1hls lmproves Lhe chances of compllance wlLh homework.
LlghLh, whlle convenLlonal psychoLheraples are unsulLable for complex cases of 1Su lnvolvlng mulLlple physlcal
sympLoms (PowleLL & 8euber, 2009, van der kolk eL al., 2003), lL ls consldered Lo be almosL as slmple and easy Lo
Leach 18L Lo Lhese people as Lo anyone else. 1he healLh professlonal slmply needs Lo Lake Lhe process more slowly
so Lhe cllenL wlll noL have Lo experlence lnLense physlcal or emoLlonal sympLoms (8ercell, 2008).
llnally, because 18L lnvolves less sufferlng Lhan exposure-based LreaLmenLs of cholce, Lhere ls an eLhlcal lmperaLlve
for psychology researchers Lo lnvesLlgaLe Lhe poLenLlal of 18L Lo reduce Lhe sufferlng lnvolved ln LreaLmenL. Also,
Lhe recenL spaLe of bushflres, floods, cyclones, earLh-quakes and revolLs ls a sLark remlnder LhaL mass Lrauma ls
lndeed on Lhe lncrease, and 18L's poLenLlal Lo LreaL large groups of LraumaLlzed people qulckly, provldes an
addlLlonal economlc as well as eLhlcal lmperaLlve. ln Lhe meanLlme, pracLlLloners Lralned ln 18L need Lo monlLor
Lhe effecLlveness of 18L wlLh each lndlvldual cllenL and ad[usL Lhe use of Lhls new lnLervenLlon accordlngly.
77777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777777
2+4+$+"(+0
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