PTSD
Post Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.
American military clinicians say this. But is there as has been implied, a difference between the effects of wars in the past, World War v1 and Wold War II when PTSD was called “shell shock” and the plethora of cases seen today following the hostilities in Iraq and Afghanistan?
There has also been a change in the way PTSD is viewed in DSM-5 over the distinctions in DSM-IV. This has been largely proposed by Canadians, Ruth Lanius and Paul Frewen at the University of Western Ontario, suggesting that there is a Dissociative form of PTSD and a non-dissociative form. This differentiation has been in clouded in the recent DSM-5.
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This is complex. Their colleagues and sometimes co-authors van Huijstee J Vermetten E add:
While individuals with non-dissociative PTSD exhibit an increased heart rate, decreased activation of prefrontal regions, and increased activation of the amygdala in response to traumatic reminders, individuals with the dissociative subtype of PTSD show an opposite pattern. It has been proposed that dissociation is a regulatory strategy to restrain extreme arousal in PTSD through hyper-inhibition of limbic regions. In this research update, promises and pitfalls in current research studies on the dissociative subtype of PTSD are listed. Inclusion of the dissociative subtype of PTSD in the DSM-5 stimulates research on the prevalence, symptomatology, and neurobiology of the dissociative subtype of PTSD and poses a challenge to improve treatment outcome in PTSD patients with dissociative symptoms.
“The concept of a PTSD-DS is supported by evidence from studies using latent class and confirmatory factor analysis, where approximately 15–30% of individuals with PTSD can be classified as belonging to a dissociative subtype featuring symptoms of depersonalization and derealization…”
Then in a subsequent article: Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions
Ruth A. Lanius, Paul A. Frewen, and Margaret C. McKinnon citing research which connects PTSD to three distinct brain regions the Central Executive Network (CEN) The Salience Network(SS) and the Default Mode Network (DMN) propose that Neurofeedback shows promising results in regulating the SA and DMN network, saying:
…A similar investigation was subsequently conducted in PTSD patients who had suffered repeated childhood trauma. The results of this study indicated that voluntarily reducing alpha rhythm amplitude was associated with decreased alpha amplitude during training, followed by a significant increase (“rebound”) in resting-state alpha rhythm amplitude. This rebound was related to increased calmness, greater default mode network connectivity, and enhanced SN connectivity (Kluetsch et al., 2014). They call this metaplasticity.
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I don’t mean to become overly technical here, so if the former page daunts you I will summarize it here for a more lay audience. Bessel van der Kolk’s The Body Keeps the Score tells the story of two of Lanius and Frewen’s patients, Stan and Ute, who were traumatized in a 80 car crash on the 401, during which they both observed another car passenger burn to death. The U of WO researchers did neuroscience brain tracings (fMRI) on both, finding that one had increased tracings and the other had reduced tracings. Why? This was a new observation, and begged explanation. The answer seems to be that one had non-dissociative trauma, and the other had dissociative trauma, discovered HeartMath’s emWave2 and had a recovery.
In February 2015 I was showing my colleague of many years, Dr. Ted Leyton, the workings which underlay AcuDestress, when I learned, in passing, that his entire practice had become completely oriented around HeartMath’s emWave2. I did not yet have a good answer to PTSD other than an exercise called Defending Against The Superego, which I’ll return to later. I hadn’t heard of Lanius’ patient’s success with either Ute or Lanius’ emWAve2. As a matter of fact I hadn’t heard of Lanius.
But I was very taken with Bessel van der Kolk, as will be seen on my video The Territory Beyond Talk Therapy. I had already been working with three present-at-birth personality types who also had different patterns of Bowlby’s attachment types. I had a bead on one type, with a lifetime tendency to withdraw I called BLUE (for no other reason than to give it a name for no value attached to it) in which dissociation was present - maybe even omnipresent. I had two other personality types who were more social, but one altruistically so and the other aggressively so.
It’s very easy to slip back into talk therapy if you respond to it yourself, as I do, so until emWave 2 I was caught between a rock and a hard place. If someone had a flare-up on PTSD I took them aside in an individual session. But it didn’t work. But once I had a training piece to use, I could use it, but if I didn’t I slipped back into talk therapy “ Just try to imagine what it was that set you off.” Once I had Ted’s magic little tool (many others have lauded it too) all of that went by the wayside. We now test for alexithymia the first day of our groups, get those scoring over 100 on the device before our exercise in combined mindfulness and neuroplasticity, which you’ll also see Dr. van der Kolk extol elsewhere below. This isn’t a full answer to PTSD but it’s a start - a very promising one.
How Would This Work If the subject, instead of acupuncture, was doing The Citadel?
While we’ll talk about this in later chapters, this online book is meant for both people who come for 5-point ear acupuncture and those who come at times when it’s not available. The Citadel has three powerful exercises which also act as a neuromodulator, a subject we’ll talk about later. Suffice it to say, in subjects who don’t respond to talk therapy (which mine don’t) one needs to do something in the realm of training them to access hidden talents - and the combination of Silva Mind Control, Emotional Freedom Technique (Tapping) and Lynne McTaggart’s Power of Eight are a powerful threesome. So yes, in short, if you suspect PTSD you can profit learning these.
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Dr. Bessel van der Kolk is the grand old man of PTSD. I can call him the “grand old man of…” because I’m the grand old man of treating serious mental illness with low cost neuromodulators, namely ear acupuncture, and because we are the same age. We both avoid talk therapy, while both have a longstanding grounding in it. Bessel van der Kolk has strong opinions on things - like COVID-19 and Donald Trump.
Bessel and I (you’d think I knew him) hold similar opinions on things, but for differing reasons. I‘m a person who dissociates. He’s not (he likes to tell the story of his first response to the Twin Towers falling - he told a joke.) Then he made sure he
contacted everyone in his family, made sure they were all OK. Do I like this? Yes! That’s pretty out there - a way to look after everyone by making them laugh.
When I knew Bessel was going to appear on this page, and I did because there’s no one out there except perhaps Bessel’s friend Judith Herman who holds a candle to him, I checked precisely what he believes - today. I don’t care about yesterday as we’ve all made mistakes along the way. If we don’t make any we won’t get ahead, If we hadn’t boobed, we wouldn’t be where we are.. Bessel gets results. He also takes no prisoners, so somebody like me would have to stand up to him. So why not start here. I completely agree with his take on trauma seen in the The Limits of Talk Bessel van der Kolk wants to transform the treatment of trauma by Mary Sykes Wylie.
Like van der Kolk I find “ … what was the treatment that he felt was not really helping his patients to move on? It was standard talk therapy 101-helping them explore their thoughts and feelings-supplemented with group therapy and medications. During individual sessions with clients, he often focused intensely on patients’ past traumas, in the interest of getting them to process and integrate their memories. “I very quickly went to people’s trauma, and many of my patients actually got worse rather than better,” he says. “There was an increase in suicide attempts. Some of my colleagues even told me that they didn’t trust me as a therapist.”
And I agree when he says. “It seemed to me then that we needed to find some way to access their trauma, but help them stay physiologically quiet enough to tolerate it, so they didn’t freak out or shut down in treatment. It was pretty obvious that as long as people just sat and moved their tongues around, there wasn’t enough real change.” Touché - I’m right there with you, Bessel.
My Approach to PTSD Bessel van der Kolk’s Approach to PTSD
I think van der Kolk’s been saying that something needs to occur to “prime the pump,” whether its exercise, yoga, theatre or the like - or emWave2 - but I wouldn’t so as far as the sensorimotor people like Pat Ogden go, where patients are urged to act out their repressed feelings. I provide exercises, for example for people to do when they’re angry which is not acting out and is not repressing their anger but “being with it” mindfully, until it spawns something that would be very useful to them. I encourage patients who have material from the past arise and “haunt them” to use mindfulness to “be with” the material, but, as Jeffrey Schwartz would say: It’s important to get that “you are not your thoughts and feelings.” But you have to get there first by dismantling alexithymia so the person has full and total access and an accurate picture of what’s unfolding.
Bessel is delightfully always trying to bring something new through. ( in this case in January 2020 with neurobiofeedback. I also speak of biofeedback, recalibrating the brain, in the case of emWave2 (and even with Frank Lawliss’ Bioacoustic Utilization Device,) so that the first steps are not trying to talk things through, but learning to switch the brain into a receptive state, a parasympathetic state if you will, where one can stand outside, as Schwartz suggests, at which point if our demons surface we can see them for what they are. If one practices always doing this, even for a short period of time the demons will stop coming. In my treatment mode, this may require repeating a session. In the first round the alexithymia goes, and the second, the PTSD. And if instead of 5-point ear acupuncture you’re doing The Citadel, the EFT (tapping) will do it.
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