two points I disagree with

point 1.

there is no specific time limit or duration to an invivo session-it is
best to keep it strictly goal oriented. 90 minutes is no more a magic
number then 120 minutes


point 2.

there is no problem where the patient derives some degree of comfort
by using "safety" behaviors to accomodate their proximal anxiety,
removing them to create a so called "pure" encounter environment is
really a misnomer since then presence of the therapist itself is a
safety behavior-there is s trusted someone there to help in need. The
trick to any successful desensitization is using methods of retreat
and those very safety behaviors already mentioned. Many patients still
carry xanax or other benzos around with them as a safety net. There is
nothing wrong with this. This intern got lucky as did then patient in
that then behaviors were not well entrenched. Using just a "practice"
type of therapy alone is like combing half your hair. It is a very
worthy tool and one very often not used because of time restraints. It
is a shame this internist didn't have a more recitivistic client-he
will be greatly frustrated when he does andn not know what to do

LM

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