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The Benefits of Using the "Subjective Units of Discomfort" Scale to Treat PTSD

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[Dr. Michael Roy] Finding ways in the session that work that help to decrease their anxiety, and we measure that on what's called the SUDS scale— Subjective Units of Discomfort. "So from 0-100, how uncomfortable are you feeling right now?" And we're actually measuring how much they're sweating, what's happening with their blood pressure and their heart rate, and so forth? So we can use those to guide the pace and the direction of therapy. So we want to get them somewhat uncomfortable but not overboard— not too uncomfortable. We don't want their heart rate spiking incredibly. We want to be able to measure and modulate. So put them a little on the edge but not over the edge, and work session after session to push a little further—a little further— until things that they were very uncomfortable at first now they can handle; they're comfortable with them. And then they have what we call "in vivo" exposures, they have homework assignments to— "Alright, you haven't been going out to the movie theater. You haven't been going out to restaurants. You haven't been taking the subway. We want you to do these things; get out there. Keep track of how it goes, how you're feeling, and so forth so we can work through that." So get them to progressively do things in real life, in addition to the session.

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Michael Roy, MD, Col. (Ret.) talks about helping service members and veterans learn ways to decrease their anxiety in therapy, which can later translate into strategies to use in life.

See more video clips with Dr. Michael Roy.


Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.

Michael Roy, MD, Col. (Ret.)Michael Roy, MD, Col. (Ret.) is professor of Medicine and director of the Division of Military Internal Medicine at Uniformed Services University and director of Recruitment for USU's Center for Neuroscience and Regenerative Medicine.

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