Progressive Counting is a psychotherapy technique developed by Ricky Greenwald designed for trauma resolution based on the counting method. It is used to reduce or eliminate symptoms such as anxiety, depression, guilt, anger, and post-traumatic reactions. It can also be used to enhance psychological resources such as confidence and self-esteem.
How Does Progressive Counting Work?
The procedure involves having the client visualize a series of progressively longer "movies" of the trauma memory while the therapist counts out loud (first to a count of 10, then 20, then 30, etc.). By repeatedly imagining the movie of the memory, the memory gets "digested" or healed, via desensitization, emotional processing, gaining perspective, or other means.
Prior to the session, the therapist actively guides the client in identifying the beginning moment of the chosen movie (before the trauma event happened) and the ending moment (a point after the trauma event which provided relief). The client is asked to watch, in imagination, a movie of the trauma memory from beginning to end, while the therapist counts aloud from one to 10; then the next time to 20; then to 30, and so on, to a maximum of 100.
Later when the memory is nearly resolved and there is less work to do, the length of the counting for the movies is progressively decreased. The client can choose to discuss the memory but is not required to; thus the client can maintain privacy regarding memory details. The therapist then asks the client to rate their level of distress on a scale of 0-10 (according to the subjective units of distress scale or SUDS).
The therapist's goal is to bring the SUDS rating of the painful life experience or traumatic memory to a score of 0 (no distress), and can adjust the exposure level as needed by increasing or decreasing the numbers counted during their movie. Reducing the level of distress related to the painful life experience or trauma means that it will likely no longer get triggered in the present in a way that is unhealthy or what EMDR describes as “maladaptive.”