The psychophysiological process of therapy in a case of injury-scene-elicited fainting.

In a single case study, the psychophysiological process of change was studied during treatment of fainting with exposure to blood/injury stimuli. Therapy involved two procedures: a muscle-tensing maneuver and a cognitive coping strategy, each applied in A-B-A format. During therapy, bradycardia was associated with reports of greater fear. Muscle tensing brought higher heart rate and lower fear ratings. In contrast, the cognitive strategy produced lower fear ratings without affecting heart rate. At termination and at 6- and 30-month follow-up, the patient reported problem-free exposure to injury stimuli. Results supported the efficacy of the treatment approach, differentiated the effects of separate components of the intervention, and clarified its physiological basis.