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Saturday, April 6, 2013

What works for PTSD?

My friend Sean Huze, actor, playwright, and a former Marine Corps veteran who experienced combat during operations in Iraq, just last week posted this on the Facebook news feed: "22 Iraq or Afghanistan (or both) veterans killed themselves every day last year according to all major news networks.  Veterans who reach out for help from the VA for depression, PTSD, and suicidal thoughts have been scheduled for an appointment...six months later.  Some didn't make it.  The average VA backlog for veterans is 273 days.  Many have waited far longer."  Sean was imploring Americans to support the troops who went to war and donate to the Iraq and Afghanistan Veterans Administration so that these men and women could get the help they so desperately need.  I couldn't agree more.  Please donate if you can.  This is a tragedy unfolding before our eyes and we as a society need to do something to help these folks heal their wounds.  Politics aside, these men and women sacrificed their very lives for their country, and we as a country, who collectively put them in harms way, must do all that we can to shore up and glue back together the fractured lives war inevitably brings upon those who fight them.  It is our moral obligation.

What's being done now for PTSD?

Here's a list I've compiled of the treatment therapies being utilized now for PTSD.  This information comes from the Department of Veteran Affairs, the National Center for PTSD, and the PTSD Forum, a website dedicated to getting help to those who suffer from PTSD through others experiences, and offers guidance and education.  There are four Tier 1 treatments which are considered by the government to be the best at treating cases of PTSD.  They are as follows:

Cognitive Behavioral Therapy:  also know as Cognitive Processing Therapy (CPT), helps you to understand and change the way you think about your trauma, becoming aware of your thoughts and feelings about the trauma and how it is affecting your life now, and teaches you skills to help question those thoughts and feelings which are causing you stress.  It's goal is to help the sufferer change the way he or she feels and thinks about a traumatic event, and replace these underlying beliefs with more accurate and less distressing thoughts.  Cognitive restructuring helps to alleviate the emotional toxicity of the event and helps the sufferer to remember the incident on a more acceptable level.  By managing the memories remembered by becoming aware of our thoughts and feelings associated with it, we can change how we feel and think about something by changing how we think about it, and thus, changing our reactions to it.  According to the PTSD Forum, "CBT on average across clinical studies, demonstrates an overall effectiveness of above 80%."  However, in the very same article, towards the end it states, "The major let down to 99% of the studies, is that they control the conditions of the study to exclude PTSD patients, being those with co-morbid diagnosis, ie. CPTSD (personality disorders), major depression, etc., also those at the severe end of the symptom threshold." [2]  CBT is an assertive therapy, and, according to many PTSD experts, you must be assertive with those who sufferer from it. [2]  Here is where I vehemently disagree.  If my counselor had pushed me before I was ready, I would have been filled with anger and rage, and all the progress I made, would have been flushed down the toilet.  You don't push people who have PTSD.  You have to create the conditions where they feel safe and felt which will allow them to open up and express the deep emotional and psychological scars that the anger and rage is covering up.  

Prolonged Exposure Therapy:  is a type of therapy that helps you decrease the distress you feel about your trauma by helping you approach trauma-related thoughts, feelings, and situations that you have been avoiding.  The goal is to have less fear about your past memories and to reduce the power they have to cause you distress.  In exposure therapy, the client or patient is asked to purposely re-experience the trauma over and over again - in the doctor's office or in the outside world in a setting similar to the one they experienced.  Repeated exposure to these thoughts, feelings, and situations, helps the person to become less distressed about the trauma and teaches the individual how to master stressful situations.  The idea is to gain control over your life and not let your memories control you.  And, according to the PTSD Forum, Exposure Therapy "to date is the most efficacious treatment for the treatment of Posttraumatic Stress Disorder." [2]  It is encompassed as a part of the more robust treatment for PTSD, which is CBT (Cognitive Behavioral Therapy).  This, in my opinion, is not completely accurate when it comes to PTSD sufferers, and I'll tell you why.  I was constantly exposed to the trauma I experienced every single time I walked into my apartment, I kept reliving it every single time I opened the door, and it didn't decrease the symptoms, it made it exponentially worse.  I couldn't avoid the trauma because I lived where the trauma happened.  There was nowhere I could go, and so the PTSD was made worse, not better.  This approach, although valuable in many ways, especially in aiding the sufferer to reduce the irrational fear associated with past traumatic events, does not help someone with chronic, complex, or a severe case of PTSD.  For some cases, you don't go into the fear over and over again; you go into the love.

Eye Movement Desensitization and Reprocessing (EMDR):  is a therapy where while you are thinking about your traumatic memories, you will focus your eyes on other stimuli like eye movements, tones, or hand taps.  So, for example, your therapist will move his or her hand across your face, and you'll follow the motion with your eyes.  Basically, the process attempts to bring together fragmented aspects of the trauma stored in various regions of the brain so that the brain can process the traumatic memory, and then associate a more positive thought with it for future use.  It involves inducing the trauma, it re-imprints the trauma on the brain, and it does work.  There are better models though, ones that are less assertive, less forceful, and more expansive.  There are some issues inherent with EMDR.  For one, the majority of the studies done exclude severe and complex cases from participation, and so, although it is placed equally among the four Tier 1 treatments for PTSD, "it is also placed equally alongside their similar failings within the area of statistical validation." [2]  When EMDR has been used on more severe cases, the success rate had decreased significantly. [2]  Secondly, there is one known negative to EMDR, and that is there is a minor risk of cognitive impairment.  As the brain is involved with inducing the trauma, which overrides the brain's natural ability to piece traumas together, there is the risk that a more disturbing memory could become associated with the trauma, overwhelming the sufferer and possibly causing mild to severe cognitive impairment. [2]  This is a risk with those who have combat or complex PTSD.

Stress Inoculation Therapy (SIT): this therapy is used in conjunction with the more broadly encompassed Cognitive Behavioral Therapy (CBT) solution, but is also effective when combined with Exposure Therapy and EMDR to attain long term symptom management.  By itself though, it will achieve little long-term effect with PTSD.  SIT is a technique that educates the sufferer about stress, how it effects them and creates the negative outcomes experienced.  The real core of SIT is skill building, which any therapy for PTSD has to include.  Stress inoculation can range from improving self-confidence and self-esteem to a complete reconstruction of core foundational belief systems.  SIT, by itself, can not undo the trauma, and until the trauma itself is resolved, uprooted, and healed, the sufferer will constantly challenge the new beliefs, and often unravel the progress made to rebuild and improve their lives.  In my experience, there is no set limit for skill building, especially when rebuilding from the effects of PTSD.  It continues as needed.

Medications for PTSD: Often times, a combination of counseling and medications are used to treat PTSD.  Prescription drugs are intended to reduce the symptoms of PTSD and make the patient more receptive to counseling.  One type of drug is known as selective serotonin reuptake inhibitors (SSRIs), which has been shown to reduce depression and anxiety.  Its most widely recognized brand names are Prozac, Zoloft, and Paxil.  There is a serious down side to taking antidepressants.  Side effects include, but are not limited to: nausea, insomnia, anxiety, tremors, sweating, sleepiness or fatigue; it also depresses your ability to have sex; worst of all, is the risk of suicide. [4,5]  By administering these type of drugs so routinely for PTSD, we are actually increasing the possibility of suicide because we are giving people who are already in pain drugs that increase the risk.  We are treating them with the very thing that is causing them to do it!

The military is also investigating techniques to "inoculate" soldiers from PTSD. [6]  When I spoke to Rich Rudnick, the Director of Operations at the National Veterans Foundation, last summer, he told me they were giving tranquilizers to the soldiers out in the field in Afghanistan to reduce their hyper-awareness and take the edge off of the soldiers' anxiety.  This is crazy!  Inoculating the soldiers is essentially desensitizing them so they will have less brain function.  There's no one home.  They become robots.  By "inoculating" soldiers, you cut out their ability to feel love, to feel joy; not only are you cutting out their experience to feel pain, but you are cutting out their experience to enjoy life.  You cut out their ability to feel anything.  Then you send these guys and gals back home to their families, and before they went, they had loving wives, husbands, children, possible relationships, and when they come back they are not able to feel.  So, what are we going to do then?  Give them more drugs so that they can feel again?

Effectiveness of treatment options for PTSD:  According to the National Academy of Sciences Office of News and Public Information, dated October 18, 2007, "Effectiveness of most PTSD therapies is uncertain; research urgently needed to determine which therapies work."  It also goes on to say that "while several drugs and psychotherapies are used to treat PTSD, many of the studies concerning their effectiveness have problems; as a result, they do not provide a clear picture of what works and what doesn't, says a new report from the institute of medicine." [7]

With so much doubt concerning the effectiveness of the current treatment options available for PTSD, there just has to be a better way.

Other Therapy options:  Acceptance and Commitment Therapy, Acupuncture, Art Therapy, Body-Mind Psychotherapy, Somatic Experiencing Therapy, Emotional Freedom Technique; Massage Therapy

What makes mine better than what's already out there?

I'm going to give it to you all here, in this blog, everything that I do.  I want you to have this so much, and as time allows, I'm going to share it all with you, on this blog, all that I have done, everything that I do.  So you can do it for yourself too.  It will be faster with me, if you come in, but I'm going to give it to you regardless.  At the foundation of my program are the principles of non-violence and peace.  It uses Gandhi's principles of non-violence, along with the principles of a Course in Miracles, a spiritual meditation practice rooted in love, forgiveness, and peace.  This is what makes mine different from all other approaches.  From this foundation does my program draw its inspiration.  Although it is rooted in spirituality, it does not demand you believe in God, what it does require is a genuine desire to transform your life.  Without that deep desire, no program will work, regardless which one it is.

The core of my program is modeled similar to Mind-Body therapy, and is a complete mind, body, and soul healing.  It takes the mind, body, soul connection, it builds belief systems, it improves what is already there, it teaches emotional regulation, and problem solving.  It begins by really connecting to who you were before PTSD.  Who were you?  What were your dreams? etc., a lot of time is spent reconnecting to your true self.  Then, we look at what your life would have been like if this didn't happen.  What would you have done?  From there, we begin to remove the obstacles to becoming that.

Once we've realigned with who you really are, set that as our guide and destination, we then begin to approach the trauma or traumas keeping you held back from being that ideal version of yourself.  This space is completely loving, non-judgmental, and safe for you to go to where you can be completely felt, be completely yourself, completely human.  We completely deconstruct anything that has kept you from being who you truly are and which has kept you separated from another human being.  Whatever you might be ashamed of, angry about, guilty of, etc., anything that you have compartmentalized.  We learn to understand the good that came out of it, and the lessons you learned.  You learn how to make peace with the past so that it doesn't control and destroy your present.  We break down the belief systems that have kept you imprisoned in your own mind.  You learn how to let go of attachments and all that does not serve you in the fulfillment of your life.  You learn how to replace negative thoughts and feelings with positive ones, and you incorporate meditation to create space in the mind and slow down the thoughts that invade your peace.  What meditation does is it also allows you to experience the present now.  By becoming consciously aware about right now, how you feel in the present moment, and using several meditation techniques to assist you, will help you to bring clarity and peace to the mind.  We also remember and re-discover the things that brought you joy and take the time to do them.  Yoga, movement meditation, massage therapy, and energy cleansing is also encouraged to augment and speed up the healing process.

There is no fear in my program.  No drugs or medications.  Medicine didn't create this problem.  It didn't come from a disorder in the body.  This disorder got created with the mind.  It's not a chemical imbalance.  We don't need medicine to heal it or cure it.  What heals this is a miracle.  Wait, before you say anything or think anything, let me put what I mean by miracle in context.  The miracle is recognizing who you really are. And then, growing bigger than any event that might have happened. Part of the skill set of remembering who you are is that you've got to accept everything in your life.  You've got to take responsibility for it all and be at the source of creation.

This program also uses the latest science in quantum physics theories and epigenetics, especially the works of Candace Pert, Bruce Lipton , and Valerie Hunt.  These works, along with others in the field of higher consciousness like Byron Katie, Wayne Dyer, Eckart Tolle, and David Hawkins, remind us of our connectedness to each other and who we actually are.  This program embodies the energy that we were never born, and we never died for energy is never destroyed.  
  
The skill set building includes and is very similar to what an actor does for a role.  An actor must embody the role he or she is playing with every cell of his being.  We are going to establish who you truly are (the role you want to play), then we're going to build skill sets to allow that to come through, and at the same time, remove, let go of, and eliminate all that isn't you.

This is how you transform yourself out of the trauma(s) that have imprisoned you.  It takes dedication, commitment, and a willingness to see things differently.  Friends, we re-live the same problems over and over again until we transform them!  And, you can't approach a problem that was created by fear thoughts with solutions based on fear thoughts.  Love and fear can not co-exist.  A new approach, a more advanced approach is called for, one based on love and the thoughts generated from the energy of love.  This is what my program is all about.

What you can do if you have it or your friend has it

The average backlog for veterans at the VA is 273 days!  If you have a friend with PTSD, don't wait.  Call them, talk to them.  If you even suspect this, don't wait.  Get them help.  Refer them this blog, or any website.  Let them know you care and are there for them.  Take action.

If you have it, don't let this fester inside.  Take action, get some help now.

I will write more about this in future blogs.  Share with me what you are interested in.  Leave me a comment. Like me or find me on Facebook.  I want to hear from you.  I care.

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References
1.  www.va.gov
2.  www.ptsdforum.org/c/wiki/therapy
3.  www.ptsd.va.gov/public/pages/treatment-ptsd.asp
4.  www.helpguide.org/mental/medications_depression.htm
5.  www.health.harvard.edu/press_releases/ssri_side_effects
6.  www.howstuffworks.com/ptsd.htm
7.  www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11955
8.  www.nvf.org