with D. Barlow, PhD
Deepening understanding of the nature of emotional disorders including PTSD reveals that commonalities in etiology and latent structure among these disorders supersedes differences. This suggests new approaches to classification and the possibility of distilling a set of psychological procedures that would comprise a unified intervention for emotional disorders. Based on theory and data emerging from the fields of learning, emotional development and regulation, and cognitive science, we identify three fundamental therapeutic components relevant to the treatment of emotional disorders generally. These three components include (1) altering antecedent cognitive reappraisals; (2) preventing emotional avoidance; and (3) facilitating action tendencies not associated with the emotion that is dysregulated.
This treatment takes place in the context of provoking emotional expression (emotional exposure) through situational, internal and somatic (interoceptive cues), as well as through standard mood induction exercises, and differs from patient to patient only in the situational cues and exercises utilized. Theory and rationale and the latest data supporting this new unified transdiagnostic approach are described in the context of sequelae of the trauma of war and resulting combat related PTSD. It is suggested that this unified treatment may represent a more efficient and possibly a more effective strategy in treating emotional disorders, pending further evaluation.
Dr. David H. Barlow is professor of psychology and psychiatry and founder and director emeritus of the Center for Anxiety and Related Disorders at Boston University. He received his PhD from the University of Vermont in 1969 and has published over 500 articles and chapters and 60 books mostly in the area of the nature and treatment of emotional disorders. He is the recipient of numerous awards, including the Distinguished Scientific Award for Applications of Psychology from the American Psychological Association. He was formerly professor of psychiatry at the University of Mississippi Medical Center and professor of psychiatry and Psychology at Brown University and founded clinical psychology internships in both settings. Dr. Barlow was also distinguished professor in the Department of Psychology at the University at Albany, State University of New York. Currently, he is professor of psychology and psychiatry, and founder and director emeritus of the Center for Anxiety and Related Disorders at Boston University. He was chair of the American Psychological Association Task Force of Psychological Intervention Guidelines, was a member of the DSM-IV Task Force of the American Psychiatric Association, and was a co-chair of the Work Group for revising the anxiety disorder categories. Dr. Barlow is also a diplomat in clinical psychology of the American Board of Professional Psychology and maintains a private practice.