Exposure is considered to be an essential ingredient of cognitive-behavioral therapy treatment of social phobia and of most anxiety disorders. To assess the impact of the amount of exposure on outcome, 30 social phobic patients were randomly allocated to 1 of 2 group treatments of 8 weekly sessions: Self-Focused Exposure Therapy which is based essentially on prolonged exposure to public speaking combined with positive feedback or a more standard cognitive and behavioral method encompassing psychoeducation, cognitive work, working through exposure hierarchies of feared situations for exposure within and outside the group. The results show that the 2 methods led to significant and equivalent symptomatic improvements which were maintained at 1-year follow-up. There was a more rapid and initially more pronounced decrease in negative cognitions with the Self-Focused Exposure Therapy, which included no formal cognitive work, than with the more standard approach in which approximately a third of the content was cognitive. In contrast, decrease in social avoidance was more persistent with standard cognitive-behavior therapy which involved less exposure. The results indicate that positive cognitive change can be achieved more rapidly with non cognitive methods while avoidance decreases more reliably with a standard approach rather than an approach with an exclusive focus on exposure.

J Nerv Ment Dis. 2009 Jul;197(7):507-13. Borgeat F, Stankovic M, Khazaal Y, Rouget BW, Baumann MC, Riquier F, O'Connor K, Jermann F, Zullino D, Bondolfi G. Department of Psychiatry, University of Lausanne, Lausanne, Switzerland. francois.borgeat@umontreal.ca

Margaret Lee Lyles, known as "Marge" to most, was a busy massage therapist when, in 1992, she discovered she had a malignant tumor. She opted for natural healing without chemotherapy or radiation. Six months after the diagnosis however, Marge contracted hepatitis-A virus, causing the tumor to regain size and forcing her to choose a lumpectomy to spare her life.

In her third year of recovery, her doctor encouraged her to practice the "Reiki" healing method to strengthen her immune system. Today, in her mid-seventies, the author maintains her remission from cancer with a strong enthusiasm for living. She does not claim Reiki cured her cancer but definitely feels it is largely responsible for her current state of wellness.

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