TL;DR
SUDS stands for Subjective Units of Distress (or Discomfort) Scale. It's a 0 to 10 rating of how much something is bothering you right now, where 0 is none at all and 10 is the worst you can imagine. It comes from behavior therapy and is still widely used in therapies like EMDR. I use it at the start and end of every session for one reason: you give the number, not me. It isn't proof that energy healing works, and the research on the scale itself is limited, but it keeps the claims small and puts the judgment in your hands.
When people ask me how they'll know whether a session did anything, my answer is simple. You'll tell me. Not with a vague "I feel better," but with a number.
Before we begin, I ask you to rate whatever you came in with, pain, anxiety, exhaustion, grief, on a scale from 0 to 10. At the end, I ask again. That's the SUDS scale, and it's the backbone of how I track progress.
Where the Scale Comes From
SUDS was introduced by the psychiatrist Joseph Wolpe, one of the founders of behavior therapy, in his 1969 book The Practice of Behavior Therapy. He used it during exposure work: a patient would rate their distress as they faced something frightening, so the therapist could see in real time whether it was rising or settling. Wolpe's original version ran from 0 to 100. Most people today use the simpler 0 to 10 version, and it shows up in many settings, including EMDR therapy and tapping-based approaches.
What the Research Says
Here's the honest part. For a tool used so widely, the scale itself hasn't been studied as much as you'd expect. In a 2012 paper, "Validity of global physical and emotional SUDS," psychologist Bruce Tanner said as much, then looked at data from 182 patients at a psychology clinic. Their emotional SUDS ratings lined up meaningfully with clinicians' own ratings of how they were functioning, and with standard measures of emotional distress. His conclusion was that SUDS works as a general measure of both emotional and physical discomfort.
That's useful, but it's not a blank check. A SUDS rating is subjective by design. It tells you how you feel, which matters, but it can be nudged by mood, expectation, or wanting to please the person asking. I keep that in mind, and you should too.
What a SUDS check looks like
An example only, not a real client's numbers. Move the sliders to try it.
Why I Use It
- 1You do the reporting. I don't tell you what you felt. You tell me, in a way we can both compare.
- 2It takes belief out of it. You don't have to buy into anything to give a number. Skeptics often give the most careful ratings, which I appreciate.
- 3It shows when nothing changed. If your number doesn't move, that's real information too, and we talk about it honestly.
- 4It tracks over time. One session's numbers are a snapshot. Several sessions start to show a pattern, or the lack of one.
How to Give a Good Number
A few things help. Rate one thing at a time, the thing you most want help with. Rate how it feels right now, not on your worst day last month. Don't overthink it: the first number that comes to mind is usually the honest one. And if a session leaves you feeling different in a way the number doesn't capture, say so. The scale is a tool, not a cage.
What a lower number does and doesn't mean
A drop from 7 to 4 means you feel less distress than when we started. It doesn't diagnose anything, cure anything, or replace your doctor's care. I use SUDS the same way I describe in Distance Energy Healing and Fair Questions About Energy Healing: to keep my claims small and let you be the judge.
"Tell me your number at the start, tell me your number at the end. That's the whole experiment."