DIRECT TALK THEREAPY AND RETRAUMATIZATION

Episode Transcript

Speaker 1 (00:00):
Welcome to the Psychological Theories Podcast. In this podcast, we
take a journey into the human mind with one psychological
theory at a time.

Speaker 2 (00:09):
So let's begin.

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Speaker 2 (00:54):
We'll be talking about retraumatization and direct talk therapy. Direct
talk therapy give you an idea. The versions are CBT,
trauma focus, CBT and prolonged exposure and EMDR is a
hybred and some argue that it can read traumatize into individuals.
So what is retraumatization? It occurs when therapeutic interventions such
as recalling or discussing a traumatic event trigger intense emotional

(01:17):
or physiological distress, potentially worsening trauma symptoms or causing the
client to feel they're reliving the trauma. In direct talk therapy,
clients consciously engage with traumatic memories through verbal narration and
CBT or mental imagery and EMDR, which can evoke strong
emotions or physical sensations, raising concerns about retraumatization. So is

(01:40):
it potential? Yes, it is a risk in direct therapies,
particularly those involving exposure like prolonged exposure or TFCBT, but
it can temporarily increase the stress as clients confront the
painful memories. This distress is often part of the therapeutic
process and allows for processing and desensitization. Yes, there are
some clients that may feel overwhelming or destabilizing, and this

(02:02):
topic is debated constantly. The risk, though, depends on factors
like the client's readiness, the therapist's school skip sorry, the
therapist's skill in understanding the client's readiness, the pacing of therapy,
and the client's support system, as well as giving them
good grounding techniques. Did the therapist prepare them before with
grounding techniques. Proper therapeutics protocols aim to minimize harm. For example,

(02:27):
on EMDR that stimulation is designed to ballot by Lateral
stimulation is designed to process memories with less verbal intensity,
so some argue this might be a safer way to
do direct therapy. Direct therapies are designed to reduce trauma
symptoms by processing memories in a safe, controlled environment, not
to retraumatize, and studies show that when conducted correctly, these symptoms,

(02:51):
these therapies lead to significant symptom reduction for most clients. Actually,
if you look at the studies, direct talk therapy like
prolonged exposure and CBT are highly effective with moderate to
strong effects sizes relative to nondirect therapy. Doesn't mean nondirect
therapy doesn't work. It doesn't show as much success in studies. Now,

(03:12):
clinical experience could show something different for you, which could
mean more about the therapist's skill set than actually using
indirect talk therapy, such as somatic type of therapies like
vander Kulks or polyvagal theory from porgious or others like
yoga neurofeedback support for efficacy. Again, of direct therapies. It

(03:38):
was a twenty seventeen minute analysis where they look up
twenty five studies, most of them randomized control trials, and
found that prolonged exposure reduced PTSD symptoms at sixty to
eighty percent in most participants with large effect sizes. Yes,
there was dropout rates and suggest some clients found the
exposure to stressing, but no consistent evidence of widespread retraumatization

(03:59):
was awarded. So again, it could be a clinical issue,
it could be a client didn't have the ability to
do it. Who knows. In twenty nineteen, a Journal of
Traumatic Stress found the prolonged exposure to stressed during sessions
increased anxiety typically decreased over time, indicating habituation rather than harm.

(04:20):
I'm sure this will not end the debate because they
can find studies that support indirectly. Like I said, it
does work, it's just the effect sizes are not as large,
so the debate will continue. But I wanted to make
I wanted to highlight this component for everybody, so at
least they understood a little bit more about where retraumatization occurs.