Memo 3: What Is SDR Therapy – An Introduction
As I write this we’re about to go into our 5th clinical trial testing SDR Therapy on a variety of psychological issues. This next trial, a well-powered examination of SDR Therapy for non-malignant chronic pain, will be held in March 2020. The trial paper will include a comprehensive cost-benefit analysis comparing SDR to every other treatment currently used for chronic pain (pharmacological, physical/surgical, and psychological).
SDR is an acronym for Sensory Disruption of Reconsolidation (of conditioned responses). SDR has a robust theoretical foundation, and for the last 10 years has been the subject of important research by many scientists from varied fields which shows that disruption of conditioned responses is a far more effective extinction technique than inhibition.
This superiority to inhibition strategies is why SDR is far faster and more reliable than cognitive therapies including CBT and mindfulness/ACT. It is also very much more reliable than EFT or EMDR because its theoretical foundation has been robustly validated with excellent empirical evidence and this has given rise to techniques which are science based rather than concept based.
It is also much easier for both the client and the therapist.
Although SDR has a history stretching back well over 50 years, it is only in the last 10-20 years that modern research has been able to verify the theoretical basis and practice by:
- Accurately describing and measuring the “reconsolidation” phase of a conditioned response
- Demonstrating that disruption of an active reconsolidation phase causes rapid and permanent extinction of a conditioned response
- Demonstrating via fMRI that most emotional issues and disorders (and including most chronic pain presentations) are a result of amygdala-based brain activity, ie; conditioned responses.
A representative sample of this research is listed on our “Research” page, including our own technical papers following a few of our own studies.
The challenge to mastering SDR is not the sensory aspect, because anyone can see how simple that is. The sensory stimulation used must merely be intense enough to cause disruption, and also different enough to the unwanted conditioned response.
If the sensory stimulation is weak in comparison it cannot disrupt the reconsolidation. If the sensory stimulation is similar to the unwanted conditioned response it may enhance reconsolidation instead of disrupting it.
So the challenge is not really in relation to the sensory stimulation. The real challenge is to:
- Identify specific and precise conditioned stimuli, one at a time
- Maintain the associated S-R in the reconsolidationphase
- While appropriate sensory stimulation is applied
Below are some FAQs which may answer your questions about SDR, and you are encouraged to use the comment section to ask other questions that you may have.
What Is SDR?
SDR is a therapy application, based on sound theory and principles which are not in any way disputed. SDR is used in the context of a comprehensive therapy plan, and very rapidly and permanently eliminates a very wide range of conditioned responses which are associated with emotional distress, or associated with inappropriate and unwanted thoughts, feelings and behaviours, allowing the client to very quickly move into a solution-oriented state, and to experience new and more adaptive cognitions automatically and independently. It is also very effective in reducing or entirely eliminating non-malignant chronic pain, very quickly and permanently.
It is not something “done to” the client, but done with the client, teaching the client to self treat so that he/she can maintain momentum and progress between sessions with the psychologist.
Why Do Psychologists Need to Learn to Use SDR in Their Practices?
Psychologists and other health professionals do their very best to assist their clients, using strategies and techniques which they have judged to the best of their ability to be evidence based. And yet the efficacy rates have been disappointingly low. Even though we are used to seeing clients seem to improve, when we actually review the literature, we learn that for most people the real effects are short lived (if any) and that real outcomes are close to placebo effect.
Despite doing their very best, therapists have had to be satisfied with effect rates close to only 30%, and effect sizes of only around 10%, and it is more likely that any positive changes are due to the passing of time, supported by a professional who has at least provided a healthy, nurturing environment and asked some thought-provoking questions, rather than any technique or strategy used. Various studies into the efficacy of the therapeutic liaison support this assertion.
In addition, we’ve often had to persist in the face of resistance, and had to work hard to help the client recognise illogic, and be prepared to in turn work hard at making changes. Outcomes have not come easily.
SDR Therapy represents an entirely new paradigm in therapy treatment (although it should not, because its roots go back to the work of Pavlov over 100 years ago). It is certainly faster, easier, deeper and more efficacious than any other therapy method currently in common use. This doesn’t mean dumping your existing skills, but using SDR to get more enjoyment from your practice, and more and better outcomes for clients.
In short, SDR Therapy is empowering for both therapist and client.
These claims may seem outrageous, but are backed by robust research by ourselves and by independent researchers.
How Is SDR Different to CBT or Mindfulness?
With training, a therapist qualified to deliver CBT or Mindfulness may find it relatively easy to identify a range of specific and precise conditioned stimuli, because he/she is trained to recognise “loaded” language, or to notice changes in physiology, and perhaps even to ask questions which expose unconscious processing. This is indeed the only overlap, because from this point SDR bears no relationship whatsoever to CBT or mindfulness/ACT.
Instead of asking the client to recognise illogic and practice alternative self talk, or asking the client to consider and accept or sit with their feelings, we subject problematic thoughts and feelings to the SDR Therapy process, which quickly resolves the problem without effort, and permanently. There is simply no need to put the client through a laborious and painful intervention, nor to blame the client’s suffering on his or her self talk.
Some therapists talk about “honouring” painful feelings as if the feelings were actually part of the person. In the case of relatively fresh grief such treatment may be experienced as also honouring the departed, and given a supportive and nurturing environment, most people will move through that painful phase and experience considerable relief or even peace, without feeling they have abandoned their loved one. Likewise feelings such as guilt or shame can (not always) benefit from being unpacked and properly digested.
However what typically drives someone to the psychologist is more likely to be a chronic issue that has finally become so painful that they feel completely overwhelmed, or which they accept is now threatening their personal or professional lives beyond recovery (perhaps they’re now in danger of losing a job, or losing a relationship). These may or may not involve existential issues, but in any case frequently include:
- Sexual dysfunction
- Sleep dysfunction
- Chronic pain (because due to a lack of sufficiently explanatory pathology, their doctor suspects a psychological problem rather than a neurological issue)
Every one of these, with the obvious exception of some aspects of sexual or sleep dysfunction, is intrinsically and directly caused by amygdala-mediated activity in response to internal or external cues (conditioned stimuli).
When we extinguish the variety of S-R bonds which produce the symptomatology, the client is immediately freed from distress, becomes non-resistant (if resistance was present), less reactive, and much more open and solution focussed, and suddenly demonstrates very different and more adaptive thoughts, feelings and behaviours.
Because the client is no longer constantly trying to overcome conditioned impulses, the changes are deeper and more transformative, as well as being achieved quite quickly and easily. This makes therapy a far more satisfying experience for both client and therapist, and in turn creates more intrinsic, positive change in the family/community in which the client engages.
A free introductory study program is available for licensed psychiatrists, psychologists, and counsellors who would like to explore the theory and practice of SDR Therapy.