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EMDR for PTSD

Written by Onaolapo Adeyemi. Posted in EMDR, ptsd

Practice guidelines have identified the treatments that have the most evidence for treating PTSD. The best treatments include different talk therapies (or psychotherapy) and medications. Eye Movement Desensitization and Reprocessing (EMDR) is one of these treatments.

What Type of Treatment Is This?

EMDR is a psychotherapy for PTSD. EMDR can help you process upsetting memories, thoughts, and feelings related to the trauma. By processing these experiences, you can get relief from PTSD symptoms.

How Does EMDR Work for PTSD?

 

 

 

After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps you process the trauma, which can allow you to start to heal. In EMDR, you will pay attention to a back-and-forth movement or sound while you think about the upsetting memory long enough for it to become less distressing. Although EMDR is an effective treatment for PTSD, there is disagreement about it works. Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite.

What Will I Do?

During the first stage, you will learn about physical and emotional reactions to trauma. You and your provider will discuss how ready you are to focus on your trauma memories in therapy. To prepare, you will learn some new coping skills. Next, you will identify the “target”, or the upsetting memory you want to focus on–including any negative thoughts, feelings and bodily sensations related to the memory.

You will hold the memory in your mind while also paying attention to a back-and-forth movement or sound (like your provider’s moving finger, a flashing light, or a tone that beeps in one ear at a time) until your distress goes down. This will last for about 30 seconds at a time, and then you will talk about what the exercise was like for you. Eventually, you will focus on a positive belief and sensation while you hold the memory in your mind. Towards the end of treatment, your provider will re-assess your symptoms to see if you need to process other targets.







What Are the Risks?

You may feel uncomfortable when focusing on trauma-related memories or beliefs. These feelings are usually brief and people tend to feel better as they keep doing EMDR. Most people who complete EMDR find that the benefits outweigh any initial discomfort.

Group or Individual?

EMDR is an individual therapy. You will meet one-to-one with your provider for each session.

Will I Talk in Detail about My Trauma?

No, in most cases you will not be asked to talk about the details of your trauma out loud. But you will be asked to think about your trauma in session.

Will I Have Homework?

No, EMDR does not require you to complete homework or practice assignments between sessions.

How Long Does Treatment Last?

About 1-3 months of weekly 50-90 minute sessions. But, many people start to notice improvement after a few sessions. And the benefits of EMDR can last long after your final session with your provider.

This is an article from the public library for public knowledge.  More information can be found at EMDR for PTSD

How to Rewire Your Brain to Fight PTSD and Trauma

Written by Onaolapo Adeyemi. Posted in Alternative Trauma, Military, ptsd

PTSD Symptoms – Rewire Your Brain to Fight PTSD Symptoms and Trauma

PTSD symptoms and trauma according to the VA Web site is a mental health problem that can occur after someone goes through a traumatic event like war, assault, an accident or disaster.  After a trauma or life-threatening event, it is common to have reactions such as upsetting memories of the event, increased jumpiness, or trouble sleeping. Note that you don’t have to go to war before you can experience such reactions.  People with bad bosses at work or kids that are being picked upon by bullies tend to have these symptoms.  If these reactions do not go away or if they get worse, you may have Post Traumatic Stress Disorder, also known as (PTSD).  I enjoy writing and sharing all these information to the public because of my own experience with PTSD symptoms.  I understand what these men and women who have served are going through because I am a wounded warrior.  Please share as you read, and watch these videos.  The information could be of help top someone you know.  I found this video on National  Geographic Television.

 

Video credit – Credit to National Geographic Television.  More information on this new technique can be found at Http://Channel.NationalGeographic.Com/channel/brain-games/videos/defusing-ptsd/

What are the symptoms of PTSD?

PTSD Symptoms and Side effects of PTSD might disturb your life and make it difficult to proceed with your everyday exercises. You might think that it’s hard just to traverse the day.

There are four sorts of PTSD symptoms and side effects:

  1. Reliving the event (also called re-experiencing symptoms)

Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:

    • You may have nightmares.
    • You may feel like you are going through the event again. This is called a flashback.
    • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
  1. Avoiding situations that remind you of the event

You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:

    • You may avoid crowds because they feel dangerous.
    • You may avoid driving if you were in a car accident or if your military convoy was bombed.
    • If you were in an earthquake, you may avoid watching movies about earthquakes.
    • You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
  1. Negative changes in beliefs and feelings

The way you think about yourself and others changes because of the trauma. This symptom has many aspects, including the following:

    • You may not have positive or loving feelings toward other people and may stay away from relationships.
    • You may forget about parts of the traumatic event or not be able to talk about them.
    • You may think the world is completely dangerous, and no one can be trusted.
  1. Feeling keyed up (also called hyperarousal)

You may be jittery or always alert and on the lookout for danger. You might suddenly become angry or irritable. This is known as hyperarousal. For example:

    • You may have a hard time sleeping.
    • You may have trouble concentrating.
    • You may be startled by a loud noise or surprise.
    • You might want to have your back to a wall in a restaurant or waiting room.

Additional and Supplemental Treatments for PTSD

Written by Onaolapo Adeyemi. Posted in Alternative Trauma, ptsd

With the goal of helping readers to navigate the growing literature on CAM, below we briefly review the current evidence for the most well-established mind-body therapies for PTSD: acupuncture, relaxation training, and meditation.

Based on that evidence, we make recommendations as to the next appropriate steps in pursuing the development of these interventions.

Acupuncture

ptsd_acupunctureAcupuncture, a modality of Chinese medicine, encompasses a group of therapies in which needles are inserted into subcutaneous tissue in order to restore balance within body systems. For those interested, Hollifield (2011) provides an accessible summary of the conceptual rationale and proposed biological mechanisms in support of the potential efficacy of acupuncture for PTSD.

One good-quality study identified in the Strauss et al. (2011) review found that improvement in PTSD following 12 weeks of biweekly, 60-minute acupuncture sessions was comparable to a group CBT and greater than waitlist control in a predominantly male, non-Veteran sample (Hollifield, Sinclair-Lian, Warner, & Hammerschlag, 2007). Treatment gains following acupuncture were retained at the 24-month follow-up.

Although the study was methodologically rigorous, strong conclusions cannot be drawn from a single RCT. This study also highlights the challenge of selecting an adequate comparison condition for these novel interventions. The control that was used, a group intervention that included psychoeducation, CBT skills (e.g., behavioral activation, activity planning, cognitive restructuring), and exposure exercises, may have been selected to provide a comparison to treatment as usual or minimal good treatment.

Nonetheless, it does not control for critical features of the technique, such as the application of needles. To understand whether or not study results could be driven by different expectations about the treatments, a control such as placing needles in sham sites would be necessary. Thus, we believe that proof-of-concept has been established for acupuncture, but recommend withholding judgment about its effectiveness for PTSD until additional controlled trials have been conducted.

Read more information here

Relaxation

Strauss et al. (2011) identified three relatively small RCTs of relaxation techniques; they did not demonstrate significant clinical improvement relative to active comparators (Echeburúa, de Corral, Sarasua, & Zubizarreta, 1996; Vaughan et al., 1994; Watson, Tuorila, Vickers, Gearhart, & Mendez, 1997). In each case, interpretation of study findings was hampered by significant methodological flaws, including ambiguous reporting of randomization and treatment of missing data, nonblinded group assignment and/or assessments, and inadequate statistical power. In some cases, lack of clarity about differences between components of the intervention and active comparator further complicate the picture. Additionally, the Echeburúa et al. (1996) study compared a CBT intervention that included instruction in progressive muscle relaxation (PMR) to PMR alone, but the differences in “dosing” and the introduction of PMR within these protocols was not specified. Of note, the Strauss et al. (2011) review of relaxation studies was limited to those in which the intervention was conceptualized as an active treatment and described in sufficient detail to understand the key components.

Five additional studies, in which relaxation showed modest effects and performed less well than active comparators, were excluded
from that review based on these criteria. Relaxation likely has a role to play in helping to manage the arousal associated with PTSD, but relaxation alone is unlikely to be sufficient to reduce other types of symptomatology for many people with PTSD.

Meditation

The first studies of meditation techniques for PTSD involved mantra meditation (including transcendental meditation and mantra my repetition), a type of meditation that involves intensely focusing attention on an object or word. Studies of these techniques have shown some positive effects but are limited by small sample sizes, enrollment of exclusively male Veterans, and lack of follow-up (Bormann, Thorp, Wetherell, & Golshan, 2008; Brooks & Scarano, 1985). Thus, these studies primarily demonstrate the feasibility of enrolling and retaining Veterans in mediation group interventions.

More recently, Bormann et al. (2012) compared the addition of mantra my repetition to usual care (i.e., medication and case management) to usual care alone, and found modest improvements in symptoms of depression and PTSD. Without a control for nonspecific aspects of the group meetings, however, it is difficult to definitively attribute these gains to use the man tram approach. Work is ongoing to more definitely answer this question. Kearney and colleagues (2012) conducted an uncontrolled study of mindfulness-based stress reduction (MBSR) as an adjunct to usual care for Veterans with PTSD.

MBSR is a group intervention that incorporates mindfulness practices, including meditation and yoga. The authors reported a medium effect size in the change in PTSD, depression, and functioning in those who took part in the group. Although mechanisms of change could not be determined by this uncontrolled study design, it is notable that changes were mediated by changes in mindfulness. Because MBSR is a well-established intervention with some demonstrated effectiveness for treatment of anxiety more generally, additional empirical evaluation of MBSR is indicated.

A struggle for those who undertake such studies will be the selection of appropriate controls. For example, it may be appropriate to compare mindfulness to relaxation, to establish that observed changes are attributable to something more than a quiet pause in one’s day. Alternately, it may be important to compare a mindfulness-based approach to other commonly used coping skills, such as cognitive-behavioral anxiety management techniques.

Lang et al. (2012) recently reviewed the theoretical basis for three types of meditation as an intervention for PTSD. Based on the extant literature in this area, it appears that there could potentially be different mechanisms underlying different types of meditative practice. The literature on cognitive changes related to mindfulness suggests that through the practice of shifting attention and assuming a nonjudgmental stance, patients may learn to be less reactive to intrusive or ruminative thoughts. Mantra meditation has more commonly been linked to decreasing physiological arousal.

For patients with PTSD, this may be a good coping strategy for times when memories are intentionally (as in exposure-based therapy) or unintentionally triggered. Compassion meditation, which involves directing feelings of warmth and compassion towards others, has been linked to increases in positive emotion and social connectedness. Given the deficits in positive emotion and feelings of connection with others that are characteristic of PTSD, compassion meditation is a promising strategy but is without empirical application to PTSD. It is also possible that there are nonspecific factors common to all of these types of meditation. Future research should evaluate these approaches and attempt to understand the mechanisms by which they create change.

Conclusions

In summary, CAM is widely requested and used by consumers for a variety of complaints and conditions, and the relevant research base is rapidly evolving. The umbrella of CAM modalities includes a broad range of approaches, not all of which may hold the same level of promise for the treatment of PTSD.

Preliminary findings, albeit mixed, suggest that CAM treatments merit consideration. At this point, there is very limited empirical evidence of their effectiveness, so they may be best applied as an adjunct to other PTSD treatments or as a gateway to additional services for patients who initially refuse other approaches.

Overall, the current evidence base does not support the use of CAM interventions as an alternative to current empirically-established approaches for PTSD, or as first-line interventions recommended within evidence-based clinical guidelines.

 

This article was originally published by National Center for PTSD
VA Medical Center (116D)
215 North Main Street
White River Junction
Vermont 05009-0001 USA
http://www.ptsd.va.gov/professional/newsletters/ptsd-rq.asp




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