Dealing WIth Trauma

FreePsychArticles#24    NEW PERSPECTIVES OF TRAUMA

I use the word “New” because these observations are new to me, and may have been discussed by others already. My handle on PTSD and other trauma-related disorders has recently come in contact with a broader view. Treatment of these disorders has always been limited by my own conventional clinical view. I think I always knew current psychiatric biological approaches were limited.

Treating symptoms of PTSD or character disorders with medications certainly has merit to reduce many of them. The treatment is generally chronic and requires other disciplines often not available in public psychiatry clinics.

Some very frank conversations with a 50 year old woman patient with a diagnosis of Bipolar Disorder II and PTSD were eye opening to me. The treatment with Lithium helped to reduce her mood swings and both hypomania and depression,  but flashbacks of severe childhood molestation by her father increased. She wasn’t histrionic and complied well with treatment but was left with the question I had no answer real answer: “What do I do about the memories?”

At that stage of treatment I finished my temporary assignment at the clinic.   The patient’s psychiatric disorder had responded well to the medications but, unfortunately failed to ameliorate some very distressing subjective symptoms.

I have been talking with Rabbi Immanuel Legomsky of Tzfat,  Israel about Emotional Freedom Techniques (EFT) and other “alternative therapies” for PTSD. He showed a film called “Operation Freedom” that showed a group of clinicians trained in EFT working with several Viet Nam veterans suffering from an array of classic symptoms for 20-25 years over a five day workshop. The results were remarkable and it presented a compelling view of a very different approach to treatment.

Within the treatment is a kind of training in which each patient can “treat themselves” and maintain a level of wellbeing for decades.  Effects of chronic traumatic stress, endemic to populations exposed to chronic terrorist attacks or threats of the same are often undiagnosed due to many factors. The reasons why some people are clinically effected and show blatant traumatic stress disorders while others appear unscathed are obviously complex. Armed with more adequate psychological defense mechanisms, many “normal” subjects show subclinical effects.

Due to economic, political and personal dynamics it is assumed all but the most effected victims fall outside the range of clinical relevance. The diagnostic limitations tend to miss many suffering from levels of stress reaction that directly effect their relationships, daily behavior and social interactions. An example is an 87 year old Army veteran who suffered hyper vigilance, vivid nightmares, moodiness and irritability for over 50 years until his family insisted he come for an evaluation for PTSD stemming from his experiences at Pearl Harbor in 1941!

In the development of EFT based treatment for Traumatic Stress Disorders there is much to be said for conceptualization as an educational tool. With the de-medicalization of PTSD, addictions, and Attention Disorders among others new delivery models must be developed due to the increasing demand and diagnosis of such conditions. Another facetrelevant to delivery systems and denial is the stigma of these conditions as”mental illnesses.” When, in the case of EFT, the “treatment is training” in that it benefits both the teacher and the student. There is a considerable reduction in the obstacles of embarrassment and associations with disease.

The medical management model aspect is not replaced. Since many of the above disorders or “variations from the bell’s curve” frequently have significant findings of depression, psychosis, mania or hypomania and other conditions that can require psychotropic medications. Chronic distressing or debilitating mental states especially respond well to medications. Issues of metabolism, internal organs integrity and function, electrocardiograms, laboratory studies and appropriate medical examinations continue to serve as prudent routine aspects of holistic health maintenance. In fact it is prudent to have patients under consideration to receive EFT be seen first by a psychiatrist to screen for underlying disorders if possible. Improved diagnostic ability of trainers can reduce the need of initial psychiatric evaluations.

At this point the road map to relief from chronic stress and addictions is to convert psychophysiologic syndromes into conscious learning and training exercises. This is the shift from the medical model to sphere of education. It’s important to keep in mind it is not an all or nothing framework, rather it is a paradigm shift. Conditions amenable to EFT are, without a doubt the largest and most under-diagnosed sub-group in society. PTSD, Chronic Traumatic Stress Disorder, and addictions are all under-reported due to the medical diagnostic criteria. The broad view reveals certain populations, geographical, ethnic or politically compromised groups are effected in ways considered normal or acceptable and yet undermine relationships, interaction in and out of the home, temperance and fulfilling social and professional life.

EFT training is a parallel model to learning and living a Torah life. The serious study of Jewish Scriptures that includes actual changes in temperament and behavior has a social consciousness as well. Although Torah covers all aspects of living well in specific detail on all levels of the individual,  family and nation the particular “unblocking effects” within the traumatized person with EFT helps to establish a holistic comfort enabling one to take full advantage of his life and potential. Education ,in both, is the principle learning (therapeutic) tool. Torah learning is done in groups, with a 1:1 learning partner or alone which is paralleled in EFT by group exercises, mentor-student work and self-practice as the need arises.

In summary, there is a vast and growing field of practices that address a nitch in personal growth. This field falls between debilitating medical and psychiatric disorders and optimal health. The biomedical model’s risk/benefit ratio begins to tip to render it’s use risky or possibly harmful in this theoretical “field” of subclinical mental states. Those who occupy this field suffer quietly seeking treatment after treatment that fails to help. Due to the dominant western cultural hold on the general population the biomedical model tends to be placed at the pinnacle of disease treatment casting a shadow of doubt about the efficacy of so-called alternative therapies. EFT and other non-invasive modalities either belong to this shadowy field or can be viewed in another light, that of life education.

Gershon Freedman, M.D.

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