Two mechanisms are most widely considered to be crucial in overcoming traumatic events: (a) habituation to the frightening stimuli that occurs after exposure through self-confrontation to the traumatic memories and avoided stimuli (Foa & Riggs, 1995; chapter 6, this volume;Vaughan & Tarrier, 1992) and (b) cognitive reappraisal of the traumatic experiences (chapters 6 and 10, this volume; Resick & Schnicke, 1992). These mechanisms lead to two main ingredients in the cognitive-behavioral treatment of posttraumatic stress disorder (PTSD) and pathological grief: Imaginary exposure is used to help patients to confront the sensory perceptions, emotions, and thoughts they usually avoid. Cognitive reappraisal implies challenging dysfunctional automatic thoughts and stimulating reinterpretation of misattributions about the traumatic event, in order to accommodate a new symbolic meaning about the experience. The effectiveness of treatment by self-confrontation is well-established (Jaycox & Foa, 1996). There is also evidence for the effectiveness of cognitive therapy for patients with
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