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J Contemp Psychother (2006) 36:6165
DOI 10.1007/s10879-006-9008-yORIGINAL PAPEREmotional Processing Theory (EPT) and Exposure
Therapy for PTSDSheila Rauch Edna FoaSpringer Science+Business Media, Inc. 2006Abstract Emotional processing theory developed by E. B.
Foa and M. J. Kozak (1986) has informed the conceptualization of anxiety disorders and the development of effective
treatments for these disorders, including posttraumatic
stress disorder (PTSD). This article presents a summary
and update of emotional processing theory as it applies to
the treatment of PTSD, data in support of this theory, and
clinical examples of how the theory can be used to assist
in the treatment of clients with PTSD. Common difficulties
confronted during exposure therapy for PTSD, including
underengagement and overengagement, are discussed in the
context of emotional processing theory and suggestions for
how to manage these difficulties are presented.Keywords Exposure therapy . PTSD . Trauma . Emotional
processing1. IntroductionEmotional processing theory developed by Foa and Kozak
(1986) has informed the conceptualization of anxiety disorders and the development of effective treatments for these
disorders, including posttraumatic stress disorder (PTSD).
This article presents a summary and update of emotional
processing theory as it applies to the treatment of PTSD,
data in support of this theory, and clinical examples of how
the theory can be used to assist in the treatment of clients
with PTSD.S. Rauch ([envelopeback]) E. FoaDepartment of Psychiatry, Center for the Treatment and Study of
Anxiety, University of Pennsylvania,3535 Market Street, 6th Floor, Philadelphia, 19104 Pennsylvania
e-mail: [email protected] starting point of the theory is Langs bioinformational
theory of fear (1977, 1979). In this theory, fear is represented
in memory as structures that are made up of associated stimulus, response, and meaning elements designed as a program
to avoid or escape danger. For instance, a fear structure may
include a gun as a stimulus element. This would be connected
to various behavioral and physiological response elements(i.e., running away, hiding, heart racing, sweating, etc.). In
addition, it would be connected to various meaning elements(i.e., I am going to die). When something in the environment matches one or more of the fear structure elements, it is
activated and the activation spreads throughout the network.Foa and Kozak (1986) proposed that specific pathological
fear structures underlie the anxiety disorders. Pathological
fear structures are different from normal fear...