Processing Imaginal Exposure for PTSD: Tips for Therapists
Associate Vice-Chair of Clinical Research, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
Director, Emory Healthcare Veterans Program
Director, Emory Trauma and Anxiety Recovery Program
Paul A. Janssen Chair in Neuropsychopharmacology
Key Points
- As soon as the patient opens their eyes, say, “You did great. How was that for you?” This begins the emotional processing.
- Let the patient describe their observations first.
- Don’t tell the patient how they should feel or think.
- Make comments that match the patient’s experience.
- Phase your comments and questions appropriately.
Materials Downloads
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Transcript
Video 6: Processing the Imaginal Exposure.
As soon as the patient opens her eyes, I say, “You did great. How is that for you?”
Foa, E., Hembree, E. A., Rothbaum, B. O., & Rauch, S. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences - Therapist guide (2nd ed.). Oxford University Press. Rothbaum, B. O., Foa, E., Hembree, E. A., & Rauch, S. (2019). Reclaiming your life from a traumatic experience: Client workbook (2nd ed.). Oxford University Press.
Ask the patient to express her thoughts and feelings about the imaginal revisiting of the traumatic experience. “What was that like for you?” Provide positive feedback and acknowledgment of the client’s courage and ability to confront these painful memories. Provide support and calming when needed. Normalize and help her understand her reactions and behaviors in the trauma and its aftermath. Comment on habituation that you observed within or across sessions or a lack of it, if indicated. If you see that it looks like it’s getting easier and the patient hasn’t mentioned that, you can say that. You can say, “It looks like it’s getting easier.” You might say, “I noticed you didn’t cry as much today. How is it feeling for you?”
Foa, E., Hembree, E. A., Rothbaum, B. O., & Rauch, S. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences - Therapist guide (2nd ed.). Oxford University Press. Rothbaum, B. O., Foa, E., Hembree, E. A., & Rauch, S. (2019). Reclaiming your life from a traumatic experience: Client workbook (2nd ed.). Oxford University Press.