New Treatments for PTSD
Reprinted from the June 2001 issue of Vietnam Magazine
Post-traumatic stress disorder (PTSD) has always existed, but the name has changed with the times. So have methods of treatment. One authority on PTSD is the National Center for PTSD, which was created in 1989 within the Veterans' Administration (now the Department of Veterans' Affairs). The most common treatment methods listed by the NCPTSD include cognitive-behavioral treatment, pharmacotherapy, group treatment, psychodynaic treatment and the relatively new eye-movement therapies described below.
Eye-movement therapies may be the quickest way to relieve PTSD symptoms, which commonly include flashbacks, nightmares, anxiety, anger or aggressive feelings, difficulty controlling emotions, and trouble concentrating or thinking clearly. Therapists guide the client's eye movements by giving verbal instructions or with hand gestures. Two popular eye-movement therapies that have been used with veterans and others suffereing from PTSD are eye-movement desensitization and reprocessing (EMDR) and eye-movement integration (EMI).
In EMDR, originated by Francine Shapiro in 1987, a therapist uses relatively rapid sideways or diagonal hand movements that are tracked by a client's eyes. The process has been demonstrated to elimated the effects of PTSD in a very short period of time. According to the EMDR Institute, with this form of therapy it is "unnecessary to delve into decades-old psychological material, but rather, by activating the information-processing system of the brain, people can achieve their therapeutic goals at a rapid rate, with recognizable changes that don't disappear over time."
EMI also uses eye movements. Developed by Robert Dilts and Steve Andreas in 1981, it is currently being taught by Ron Klein in Silver Spring, MD. There are, however, some important differences between EMDR and EMI. EMDR is done in in the associated state, meaning the client relives the traumatic experience. EMI can be done in either the associated or the dissociated state.
The most common form of the dissociated state is the "movie theatre metaphor", where the client is asked to remove himself from the situation but may still view himself in it. The main thrust of EMI is that there is no need for the client to experience any discomfort. If the trauma is relatively manageable, treatment in the associated state is attempted. If the eyes start to get moist or the facial muscles get tense, then the associated-state exercise is most likely not comfortable for the client. At this point, the exercise is temporarily stopped and the dissociated state is utilized.
The other difference between the two techniques is that in EMI, hand and eye movements are done more slowly, and there are a variety of EMI patterns, including combinations of side-to-side motions (which addresses visual and auditory memories), diagonal motions (which may access internal dialog or emotional and feeling areas), and circular motions. After a short time, the clinician can become very adept at gauging which hand-eye movements to use to treat individual patients. The patient will immediately know what is comfortable or uncomfortabel.
These techniques are flexible and can be used directively (to treat PTSD or phobias) or generally (to treat free-floating anziety or depression). They can also be used over the phone or with blind people (using sounds). Typically, treatment takes as few as one to four sessions.
For more information about EMDR, visit www.emdr.com or call (831) 372-3900. for information on EMI, call Ron Klein at (301) 565-0103. More information can also be found by visiting www.mcptsd.org, or by calling the NCPTSD at (802) 296-5132. Copyright Vietnam Magazine.