Post Traumatic Stress Disorder Research
Urine Testing
Reveals low levels of cortisol which "suggests a physiological adaptation of the hypothalamic-pituitary-adrenal axis to chronic stress."
J Nerv Ment Dis 1990 Jun;178(6):366-
Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder compared to Holocaust survivors without ptsd. Personally I had a difficult time imagining a survivor of the Holocaust without PTSD.
"...low cortisol levels may persist for decades following exposure to trauma among individuals with chronic PTSD."
Am J Psychiatry. 1996 Jun;153(6):846.
"Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia."
Acta Psychiatr Scand 1998 Oct;98(4):328-35
The results of our study suggest that initial cortisol levels in the immediate aftermath of a traumatic event contribute, in part, to subsequent symptoms of posttraumatic stress disorder.
Biol Psychiatry 2000 Nov 1;48(9):940-7
Behavioral Therapy
CBT: Cognitive Behavior Therapy
Open-label trial of cognitive behavior therapy for insomnia and disturbing dreams in crime victims with PTSD. There was significantly greater improvement.
Am J Psychiatry 2001 Dec;158(12):2043-7
Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees. Both forms of therapy were provided and they were equally very helpful in reducing anxiety and depression in the PTSD refugees.
Behav Res Ther 2001 Oct;39(10):1183-97
Virtual Reality Exposure Therapy for Vietnam Vets
Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Study revealed this form of therapy is very successful in treating Vietnam veterans.
J Clin Psychiatry 2001 Aug;62(8):617-22
Imagery Rehearsal Therapy
"Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial... Imagery rehearsal therapy is a brief, well-tolerated treatment that appears to decrease chronic nightmares, improve sleep quality, and decrease PTSD symptom severity."
JAMA. 2001 Aug 1;286(5):584-8.
EMDR
Eye movement desensitization and reprocessing (EMDR): a meta-analysis.
This article reveals that EMDR was evaluated in 34 studies and it was found to be an effective treatment for non-combat PTSD but it no more effective than other exposure techniques "and evidence suggests that the eye movements integral to the treatment, and to its name, are unnecessary."
J Consult Clin Psychol 2001 Apr;69(2):305-16
Drug Therapy
Efficacy and safety of paroxetine treatment for chronic PTSD: a fixed-dose, placebo-controlled study.
"Doses of 20 and 40 mg/day of paroxetine are effective and well tolerated in the treatment of adults with chronic PTSD."
Am J Psychiatry 2001 Dec;158(12):1982-8
Efficacy of sertraline in preventing relapse of posttraumatic stress disorder: results of a 28-week double-blind, placebo-controlled study.
The study showed that sertraline did provide protection against relapse and provided evidence of improvement in PTSD symptoms.
Am J Psychiatry. 2001 Dec;158(12):1974-81.
Topiramate in posttraumatic stress disorder: preliminary clinical observations.
Topiramate was tested on 3 PTSD patients and it reduced and even eliminated "trauma-related intrusive memories and nightmares and normalizing depressed mood" in these patients. The study says that further study of this anti-epileptic medication for PTSD is warrented.
J Clin Psychiatry 2001;62 Suppl 17:60-3
Chemical Dependency
"An estimated 30% to 50% of cocaine-dependent individuals meet criteria for lifetime PTSD."
J Subst Abuse Treat 2001 Jul;21(1):35-45
More to Come!
http://www.mhsanctuary.com/ptsd/research.htm
Monday, August 27, 2007
Pace: Psychological Wounds Need Same Attention As Physical Wounds
A Soldier's Mind
“The program has done a lot for me and my family,” said a Marine veteran of the second battle for Fallujah. “I didn’t believe there was anything wrong with me when I came back to Kaneohe Baby. By the time I did, I didn’t want to do anything because of the stigma attached.”
Stigma….. that’s been a battle for the Troops who find themselves having difficulty coping with day to day life, due to PTSD. For so many years, our Troops have been told to “suck it up” and led to believe that if they sought psychological help, that they would be ostracized by their peers, or in some way punished. That stigma is something that the Department of Defense and the branches of the Military are fighting hard to overcome. They’re working non-stop to let servicemembers know that it’s alright to ask for help and by doing so, it won’t mean the end of their career. One active duty soldier involved in the program went to Camp Zama, Japan following an especially tough tour for him in Baghdad. He says that he spiraled very quickly, began abusing alcohol and continually making mistakes.
“I just didn’t care anymore,” he said. “I had hit rock bottom and I didn’t like to think about what could have happened.”
http://soldiersmind.com/2007/08/21/pace-psychological-wounds-need-same-attention-as-physical-wounds/
“The program has done a lot for me and my family,” said a Marine veteran of the second battle for Fallujah. “I didn’t believe there was anything wrong with me when I came back to Kaneohe Baby. By the time I did, I didn’t want to do anything because of the stigma attached.”
Stigma….. that’s been a battle for the Troops who find themselves having difficulty coping with day to day life, due to PTSD. For so many years, our Troops have been told to “suck it up” and led to believe that if they sought psychological help, that they would be ostracized by their peers, or in some way punished. That stigma is something that the Department of Defense and the branches of the Military are fighting hard to overcome. They’re working non-stop to let servicemembers know that it’s alright to ask for help and by doing so, it won’t mean the end of their career. One active duty soldier involved in the program went to Camp Zama, Japan following an especially tough tour for him in Baghdad. He says that he spiraled very quickly, began abusing alcohol and continually making mistakes.
“I just didn’t care anymore,” he said. “I had hit rock bottom and I didn’t like to think about what could have happened.”
http://soldiersmind.com/2007/08/21/pace-psychological-wounds-need-same-attention-as-physical-wounds/
Posttraumatic Stress Disorder
What's in the future for PTSD?
What is so fascinating about PTSD is that it mirrors the diagnostic and treatment model (paradigm) we've come to know over the years as the Bio-Psycho-Social model. This model was first developed by Franz Alexander of Cedars-Sinai Medical Center and then elaborated on by George Engel (who coined the term) and John Romano at the University of Rochester.
In this model, there is a clear outside cause or external precipitating event, which is the Social part of the model. This event overwhelms our coping processes (mechanisms), which is the Psycho part of the model. These coping mechanisms are brought about (mediated) through the central nervous system (brain), particularly the autonomic nervous system and the HPA axis, which is the Bio part of the model. (The autonomic nervous system regulates the involuntary functions of the body, such as the producing and releasing of hormones by glands. The HPA axis refers to the brain's hypothalamus and the pituitary and adrenal glands.) As a matter of fact, we know that all of these systems interact in PTSD. Furthermore, there is a complex interplay between the different parts of the brain that regulate thoughts, memories, feelings, and behaviors, both healthy and diseased (pathological).
http://www.medicinenet.com/posttraumatic_stress_disorder/page7.htm
What is so fascinating about PTSD is that it mirrors the diagnostic and treatment model (paradigm) we've come to know over the years as the Bio-Psycho-Social model. This model was first developed by Franz Alexander of Cedars-Sinai Medical Center and then elaborated on by George Engel (who coined the term) and John Romano at the University of Rochester.
In this model, there is a clear outside cause or external precipitating event, which is the Social part of the model. This event overwhelms our coping processes (mechanisms), which is the Psycho part of the model. These coping mechanisms are brought about (mediated) through the central nervous system (brain), particularly the autonomic nervous system and the HPA axis, which is the Bio part of the model. (The autonomic nervous system regulates the involuntary functions of the body, such as the producing and releasing of hormones by glands. The HPA axis refers to the brain's hypothalamus and the pituitary and adrenal glands.) As a matter of fact, we know that all of these systems interact in PTSD. Furthermore, there is a complex interplay between the different parts of the brain that regulate thoughts, memories, feelings, and behaviors, both healthy and diseased (pathological).
http://www.medicinenet.com/posttraumatic_stress_disorder/page7.htm
Scientists Find PTSD Brain Molecule
A new study by scientists in the US has found a molecule in the brain of mice that when suppressed appears to make them forget the fear associated with a traumatic shock. It is hoped one day that this could lead to a drug to "cure" Post Traumatic Stress Disorder (PTSD).The study is published in the advanced online edition of the journal Nature Neuroscience and is the work of researchers from MIT's Picower Institute for Learning and Memory, based in Cambridge, Massachusetts.Led by Li-Huei Tsai, Picower Professor of Neuroscience at MIT, the scientists showed that inhibiting an enzyme called Cdk5 (a protein kinase) in the hippocampus, the centre in the brain that stores emotional memories, helps to extinguish fear learned in a particular context. But when Cdk5 activity is increased, the fear persists.PTSD results from an extreme stress reaction to an event that is perceived as highly threatening, where symptoms don't lessen with time, but remain for months and years afterwards, sometimes even getting worse. It is thought to arise from the brain's inability to extinguish the fear triggered by memories of the event. Symptoms of PTSD include flashbacks, overwhelming feelings of anger, anxiety and sometimes depression can follow too.Current psychological treatments for PTSD rely on learning to extinguish the fear triggered by memories of the trauma. This can be supported by drugs like antidepressants to help ease some of the symptoms, but there is currently no drug that addresses the underlying chemical processes directly, and they aren't well understood anyway, said the researchers. But, they said some research suggests that the mechanism that encodes memories of the trauma may also, in part, control their extinction.Tsai and colleagues already knew that Cdk5, when paired with another protein, p35, helps new neurons to grow and travel to their correct positions when the brain is developing. The aim of the current work with Cdk5 was to look into how the enzyme affected the formation and extinction of fear-related memories.They conducted an experiment where genetically engineered mice were given mild foot shocks in a certain environment. Then they put the mice in the same environment without giving them foot shocks and found that the mice with increased levels of Cdk5 continued to "freeze" with fear. But the mice in which the Cdk5 was inhibited were able to learn that they no longer needed to fear that environment any more. They were able to "let go" of the memory of the foot shock.Tsai said that:"Remarkably, inhibiting Cdk5 facilitated extinction of learned fear in mice. This data points to a promising therapeutic avenue to treat emotional disorders and raises hope for patients suffering from post-traumatic stress disorder or phobia."Explaining their findings, Tsai suggested that it could be because when Cdk5 is active, it prevents another key kinase from helping the extinction to take place.According to the National Center for PTSD in the US, 1 person out of every 12 experiences PTSD at some point in his or her life; this equates to over 5 million Americans living with PTSD at any one time. And a study by the US Army in 2004 showed that 1 in 8 soldiers returning from duty in Iraq had symptoms of PTSD. "A hippocampal Cdk5 pathway regulates extinction of contextual fear."Farahnaz Sananbenesi, Andre Fischer, Xinyu Wang, Christina Schrick, Rachael Neve, Jelena Radulovic and Li-Huei Tsai.Nature Neuroscience Published online: 15 July 2007doi:10.1038/nn1943Click here for Abstract.Click here for National Center for PTSD (US).Written by: Catharine PaddockWriter: Medical News Today Copyright: Medical News Today Not to be reproduced without permission of Medical News Today
http://www.medicalnewstoday.com/articles/76943.php
http://www.medicalnewstoday.com/articles/76943.php
Saturday, August 25, 2007
Relection and Presence
The Dialetic of Wakening
John Welwood
Professional Biography for John Welwood
John Welwood, Ph.D., is a clinical psychologist, psychotherapist, teacher, and author. He originally studied philosophy at Bowdoin College, and spent two years at the Sorbonne in Paris studying existentialist thought. As a graduate student he trained in existential psychology and worked closely with Eugene Gendlin at the University of Chicago, where he received his Ph.D. in clinical psychology in 1974. He has also been a practicing student of Buddhism and Eastern contemplative psychologies for thirty-five years. It is these two streams of influence that have shaped, in equal part, his innovative psycho spiritual approach. In the 1980s John Welwood emerged as a major figure in the leading-edge fields of transpersonal psychology and East/West psychology. The former Director of the East/West psychology program at the California Institute of Integral Studies in San Francisco, he is currently Associate Editor of the Journal of Transpersonal Psychology. He trains psychotherapists in "psychotherapy in a spiritual framework" and "the healing power of unconditional presence" and leads workshops on psychospiritual work and conscious relationship throughout the world.
I have come to a point in my healing journey where I see this study to be the truth for myself and I see myself changing from the abused victim to a thriver survivor.
John talks of a felt shift that is when movement in the body revealing a new sense of meaning and direction and the old fixation goes away.
He also speaks of satori which is a zen Buddhist meaning sudden awakening at the heart of zen.
He compared these two to see if they were the same thing or if they were different forms of ways to heal.
In his research as a psychotherapist he uncovered that the therapeutic process involved stepping back from one's felt experience in order to inquire into it in a dialogical manner. What he found to be different about the zen way of healing was that instead of stepping back and then looking at the trauma and having a felt shift like in psychotherapy that zen approached a more radical opening to whatever experience was at hand, instead of stepping back from it you directly recognize and meet ones experience as it is without concern for what it means where it comes from or where it leads. Zen believe this way you let go of the fixation on whatever arises in the mind and this eventually develops the capacity to relax and abide wakefully in the midst of whatever experience is arising. When there is no identification either with the observer or what is observed awareness remains undisturbed by any divisions and a new freedom, freshness, awareness, clarity and compassion become available.
I have seen this happening to me. I see from afar now instead of the experience up close and lets me evaluate what the reality of the situation is, taking apart layer by layer to reproduce a new understanding of the trauma I suffered and instead of internalizing it as in the past I have it now away from me reading it like a book so the logical part of my mind can develop whereas in survival mode it never developed grew due to only being able to focus on survival mode.
Part II Meditative Tradition of Tibetan Buddhism will continue in the next post.
You can go here and learn more of John Welwood.
http://www.johnwelwood.com/biography.htm
John Welwood
Professional Biography for John Welwood
John Welwood, Ph.D., is a clinical psychologist, psychotherapist, teacher, and author. He originally studied philosophy at Bowdoin College, and spent two years at the Sorbonne in Paris studying existentialist thought. As a graduate student he trained in existential psychology and worked closely with Eugene Gendlin at the University of Chicago, where he received his Ph.D. in clinical psychology in 1974. He has also been a practicing student of Buddhism and Eastern contemplative psychologies for thirty-five years. It is these two streams of influence that have shaped, in equal part, his innovative psycho spiritual approach. In the 1980s John Welwood emerged as a major figure in the leading-edge fields of transpersonal psychology and East/West psychology. The former Director of the East/West psychology program at the California Institute of Integral Studies in San Francisco, he is currently Associate Editor of the Journal of Transpersonal Psychology. He trains psychotherapists in "psychotherapy in a spiritual framework" and "the healing power of unconditional presence" and leads workshops on psychospiritual work and conscious relationship throughout the world.
I have come to a point in my healing journey where I see this study to be the truth for myself and I see myself changing from the abused victim to a thriver survivor.
John talks of a felt shift that is when movement in the body revealing a new sense of meaning and direction and the old fixation goes away.
He also speaks of satori which is a zen Buddhist meaning sudden awakening at the heart of zen.
He compared these two to see if they were the same thing or if they were different forms of ways to heal.
In his research as a psychotherapist he uncovered that the therapeutic process involved stepping back from one's felt experience in order to inquire into it in a dialogical manner. What he found to be different about the zen way of healing was that instead of stepping back and then looking at the trauma and having a felt shift like in psychotherapy that zen approached a more radical opening to whatever experience was at hand, instead of stepping back from it you directly recognize and meet ones experience as it is without concern for what it means where it comes from or where it leads. Zen believe this way you let go of the fixation on whatever arises in the mind and this eventually develops the capacity to relax and abide wakefully in the midst of whatever experience is arising. When there is no identification either with the observer or what is observed awareness remains undisturbed by any divisions and a new freedom, freshness, awareness, clarity and compassion become available.
I have seen this happening to me. I see from afar now instead of the experience up close and lets me evaluate what the reality of the situation is, taking apart layer by layer to reproduce a new understanding of the trauma I suffered and instead of internalizing it as in the past I have it now away from me reading it like a book so the logical part of my mind can develop whereas in survival mode it never developed grew due to only being able to focus on survival mode.
Part II Meditative Tradition of Tibetan Buddhism will continue in the next post.
You can go here and learn more of John Welwood.
http://www.johnwelwood.com/biography.htm
Friday, August 24, 2007
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