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As I continue to meet people and speak about what we do at The Restored Valor Project and our concentration on Dianetics as the best treatment for veterans struggling with PTSD, Hypervigilance, Military Sexual Trauma as well as other emotional conditions, I am frequently asked whether Dianetics counseling is similar at all to Exposure Therapy. So I figured I’d go ahead and break down the differences here for anyone who is interested.

First of all, it’s important to differentiate between “Exposure Therapy” and “Prolonged Exposure Therapy” – and I will make a point here to describe these simply and in layman’s terms.

EXPOSURE THERAPY began in the 1950s and is essentially the treatment of an anxiety, phobia, compulsion or trauma by way of exposing the person to stimuli in their present environment that are similar to the subject of the person’s emotional difficulties. For example, if you are afraid of dogs, the treatment is to expose you to dogs in various ways, starting in milder ways and building up to stronger and stronger stimuli, with the goal of conditioning you to being able to face the object of your fear. Virtual reality is also sometimes used as a proxy for the real thing in this therapy.

PROLONGED EXPOSURE THERAPY appears to have originated sometime after 1970 and is different in that it is aimed at treating PTSD, not generalized anxieties or phobias like regular Exposure Therapy is. Its technique is also different in that it has two major parts:

  1. Repeated retelling/re-experiencing of the specific traumatic memory – referred to as “Imaginal Exposure”. The therapist might also record your retelling of the incident in session and have you repeatedly listen to it outside of session, or you might be asked to write the content of the incident down and read it aloud to yourself outside of session.
  2. Repeated confrontation of situations and objects that trigger the trauma (but which are not currently dangerous) – referred to as “In Vivo Exposure” (in vivo basically means “in [real] life”. This part of the treatment is basically the same as classic Exposure Therapy.

Dianetics Counseling was actually developed over the 1940s and was released to the public on May 9th, 1950 with the book Dianetics: The Modern Science of Mental Health. Dianetics counseling bears no resemblance at all to classic Exposure Therapy. It does, however, share similarities to the “Imaginal Exposure” aspect of Prolonged Exposure Therapy, so it is between these two treatments that I will examine and explain the differences.

Dianetics Counseling versus Prolonged Exposure Therapy

BASIC THEORY/RATIONALE

Prolonged Exposure Therapy (PET)

Prolonged Exposure Therapy is based on what is called “emotional processing theory” which basically says that when a traumatic event happens the person learns to associate the trauma and danger with the other persons, objects, situation, etc. that were present. Therefore, Prolonged Exposure Therapy seeks to expose the person to the memories of the trauma as well as expose them to the same or similar persons, objects, situations, etc in a NON-dangerous, NON-traumatic environment with the idea that the person will thereby learn that:

  1. Memories and reminders of the trauma are not dangerous and can be experienced without significant distress.
  2. Distress does not last forever.
  3. Emotional responses gradually reduce with time even without doing anything.
  4. Responses (such as heart racing) are not dangerous.
  5. The client can handle negative emotions.

Dianetics

Dianetics is based on a few fundamental principles, the first of which is that the primary thrust of any organism – the one which motivates ALL of their actions and behaviors – is the urge to SURVIVE. This is not just the urge to survive in its barest and most basic sense, but the urge to survive AS LONG AS POSSIBLE and IN THE BEST POSSIBLE WAY. Further, this urge is not limited to the survival of SELF, but also includes the urge to survive through SEX AND PROCREATION, the survival of any GROUP YOU BELONG TO, the survival of YOUR SPECIES, etc.

The next key principle of Dianetics is that there are two parts of the mind:

  • The Analytical Mind – This is the conscious, rational, aware mind – the mind you use to make decisions and solve problems in your life. It is constantly recording information from your senses and storing all of that information in a consecutive series of 3-dimentional pictures of every moment of your life. These pictures can be thought of as forming a kind of chronological film strip referred to as your “time track”. This mind is an ideal computing machine that is working constantly to plan futures and solve problems related to survival based on its data banks of past experiences and the current data and perceptions available to it. However, when the individual encounters a significant source of PAIN in the present, this computer, in order to protect itself, sort of “blows a fuse” and shuts down in whole or in part (i.e. an example of full shutdown might be getting knocked out by a blow to the head, whereas partial shutdown might be breaking one’s arm and being a bit “out of it” as a result of the pain). In either case, when the Analytical Mind shuts down to some degree, another part of the mind takes over to that same degree the control of the person and also the job of recording what’s going on.
  • The Reactive Mind –  There are two elements of a memory that the analytical mind cannot store – painful emotion and physical pain. When a person is made partially or fully “unconscious” as a result of pain, the reactive mind takes over and exactly records all the perceptions of that incident, including what happens or is said around the person. It also records all pain and stores these mental image pictures in its own data banks where it is unavailable to the individual’s conscious recall and not under his direct control. Though it may appear that a person who is knocked out in an accident is unconscious and unaware of happenings around him, his reactive mind is actually industriously recording everything for future use.

Both parts of the mind attempt to forward the SURVIVAL of the person, but they think in completely different ways. The Analytical Mind thinks in DIFFERENCES and SIMILARITIES and uses REASON to solve problems and lead the person towards survival and pleasure and away from pain and death. The Reactive Mind however thinks in IDENTITIES. To the Reactive Mind, every element in a painful incident is EQUAL TO or has the SAME IDENTITY AS every other element in the incident. If you were out in the heavy rain on a baseball field and were assaulted and badly beaten the reactive mind would ‘think’ that the sound and feel of heavy rain EQUALS the feeling of pain in your head and stomach where you were hit, and that feeling of pain EQUALS the smell of freshly mowed grass that was present on that field, and that EQUALS the idea that you are a “loser” as the boys who assaulted you shouted during your beating, and that EQUALS the sound of the motorcycle that drove by loudly while all of this was happening, etc. Later, if you encounter one or more of these stimuli in your environment, it may trigger all the physical and emotional sensations contained in the incident – imposed on you by the Reactive Mind in an irrational attempt to get you to avoid the same situation from happening again. You consciously may have no idea what is happening or why exactly you feel bad – this stimulus-response “data” is simply enforced on you in the background without you knowing.

As an analogy, think of the analytical mind as a calculator. Let’s assume that on this calculator we were attempting to do the equation “1 x 2”, but inexplicably it was returning the answer “14”. If you were trying to solve the problem of why this calculator was malfunctioning by using PE Therapy you would consider that this calculator somehow, through past mishandling of the machine, had “learned” to calculate wrong, and that the solution would be to use various ways to get it to RE-learn how to do multiplication. But with Dianetics we do not consider that the calculator is actually miscalculating at all. Instead, we consider that somehow there is hidden information being entered into the equation without the awareness of the person operating the calculator. And lo and behold we find that a tiny piece of soldering was left on the number 7, causing the calculator to automatically multiply every equation by 7 in the background. The calculator WAS calculating correctly “1 x 2 x 7” IS 14! It just looked irrational because we could not see all the data.

So the basic theory in Dianetics is to bring all the DATA from the painful experience to light – all the details of the experience that are difficult to confront or which have been obscured behind the pain and unconsciousness – bring it back to full access and clarity of exactly what happened in that experience. Once that occurs, the memory loses ALL PAIN OR CONTROL OVER THE PERSON and the incident disappears from the Reactive Mind and is re-filed as a normal memory in the data banks of the Analytical Mind.

THERAPY TECHNIQUE/PROCEDURE

Prolonged Exposure Therapy (PET)

I’m going to go ahead and quote here the description provided on the American Psychological Association’s website:

“Therapists begin with an overview of treatment and understanding the patient’s past experiences. Therapists continue with psychoeducation and then will generally teach a breathing technique to manage anxiety.

“Generally, after the assessment and initial session, exposure begins. As this is very anxiety-provoking for most patients, the therapist works hard to ensure that the therapy relationship is perceived to be a safe space for encountering very scary stimuli. Both imaginal and in vivo exposure are utilized with the pace dictated by the patient.

  • “Imaginal exposure occurs in session with the patient describing the event in detail in the present tense with guidance from the therapist. Together, patient and therapist discuss and process the emotion raised by the imaginal exposure in session. The patient is recorded while describing the event so that she or he can listen to the recording between sessions, further process the emotions and practice the breathing techniques.
  • “In vivo exposure, that is confronting feared stimuli outside of therapy, is assigned as homework. The therapist and patient together identify a range of possible stimuli and situations connected to the traumatic fear, such as specific places or people. They agree on which stimuli to confront as part of in vivo exposure and devise a plan to do so between sessions. The patient is encouraged to challenge him or herself but to do so in a graduated fashion so as to experience some success in confronting feared stimuli and coping with the associated emotion.”

Dianetics

Dianetics is always done as a 1-on-1 therapy where the counselor directs the person to identify a specific incident of physical or emotional pain. The person is asked close their eyes and return to that incident mentally starting at the beginning. They then recount the incident aloud while describing it in present tense (i.e. as if they are there now). No hypnosis is used. The counselor’s goal is to assist the person and guide them in their action of confronting the content of the incident. The person is asked about what they see, what they hear, smell, taste, etc. They also are gotten to closely contact any negative emotions that were felt at the time and as well closely contact any physical pain experienced at the time in the incident (if the incident involved illness or injury). Once the end of the incident is reached, the person is sent back to the beginning to recount it again, and pick up any additional details that they might not have noticed the first time (it will be found that more details will typically surface each time and this is a sign that progress is being made).

The counselor does not try to engage in conversation ABOUT the incident now (in retrospect) and does not try to give any advice or evaluation about the incident. The focus is on helping the person to confront every aspect of the incident. The person will ON THEIR OWN come to a greater clarity of the incident simply by confronting it and allowing its pain and any unconsciousness to be released from the incident. Typically the incident will intensify on the first few recountings, and then start to diminish in intensity with further recountings, with the person’s emotional outlook concerning the incident improving more and more. There are a variety of techniques that the counselor can employ while addressing an incident to help the person to deintensify particularly difficult parts more rapidly, or to help the person unearth data that is obscured by unconsciousness in the incident.

One very important aspect to Dianetics is the recognition that painful incidents of a similar nature form CHAINS in the person’s mental time track. Earlier, similar painful incidents often HOLD THE PAIN OF LATER INCIDENTS IN PLACE. Therefore is it is a principle of Dianetics that if a person has gone over an incident a number of times and the incident is not showing marked change and reduction of it’s painful charge, then the counselor must ask for an earlier, similar incident to this one and must address that incident. Sometimes this can lead down to several incidents until the BASIC (earliest) incident is found on that chain. Once that basic incident is run through repeatedly and fully reduced (released of its pain) the counselor will find that all the later incidents on that chain are much easier to now address and discharge of their pain. This concept of “chains” and how to address them is largely unknown in other forms of therapy and is a primary reason for any failures to fully resolve such traumas. This is a major reason why Dianetics gets such amazing results in such a short amount of time.

In all cases, a Dianetics session is always concluded on a WIN and with the person feeling good. This means typically that either the original incident is fully released of all its pain and trauma or the basic incident on the chain is released of its pain. In addition, as a beneficial side effect, a physical pain incident addressed in this way typically results in some notable improvement in the area of the body affected – i.e. lingering psychosomatic pains going away, or an improvement in the body’s ability to heal and respond to medical treatment in the area that had been affected. This is due to the fact that the memory of the injury is no longer repeatedly sending signals to that part of the body that it is still injured.

TYPICAL LENGTH OF PTSD TREATMENT

Prolonged Exposure Therapy (PET)

Prolonged Exposure Therapy sessions typically last 90 minutes and occur once a week for approximately three months to address one significant traumatic event, though treatment can be shorter at two months or longer at 15 weeks.

Dianetics

Dianetics Counseling typically FULLY resolves any one significant traumatic event in only ONE SESSION. Sessions do not have a set time limit because session length is dictated by when the incident is fully resolved and that can vary from person to person and incident to incident. That being said, a common range of session length is from 1.5 to 2.5 hours. There are factors that can cause an incident to need to be addressed further in subsequent sessions, but normally this is not the case.

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I hope this helps in breaking down the differences and similarities between Dianetics Counseling and Exposure Therapies.