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  • Writer's pictureTiffany McBride, LCPC

Healing PTSD (Pt. 4)

Updated: Sep 6, 2020

Integrative Medicines


According to lead researchers, the best approach to treating PTSD is modalities that help the body to release the held energy from the trauma. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, EFT, healing touch, yoga, neurofeedback, and expressive art, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. (Kolk, 2014)


EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was originally designed by Frances Shapiro. EMDR helps survivors suffering from trauma by enabling the victim to face the trauma without having to relive it. EMDR allows the mind to see the bigger picture, exposes the self to relook at the feelings and emotions in a new light, speeds up the trauma healing and builds rapport with the therapist. Tests indicate that EMDR works as good as medications, even better in some cases. (Kolk, 2014) “After successful treatment with EMDR therapy, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced.” (EMDR Institute, 2019)


EFT

EFT is a psycho-physiological intervention that combines CBT, exposure therapy, and somatic stimulation by tapping on acupuncture points. Often EFT is taught by therapists and other practitioners to patients as a method of self-care to use between treatment sessions. According to published reports, most cases of “PTSD are remediated in ten EFT sessions or less”. (Church, 2017) There have been several studies on the use of EFT for PTSD in veterans. The most impressive study showed that “90% of veterans who received 6 sessions of EFT no longer met diagnostic criteria for PTSD”. (Leskowitz, 2016) EFT is a safe, effective, and simple self-help skill and it should be offered to all clients who are diagnosed with PTSD. (Church, 2017)


Acupuncture

Acupuncture is a Traditional Chinese Medicine modality that encompasses therapies in which needles are inserted into the subcutaneous tissue to restore balance, holism, regulation within the body (Lang & Strauss, 2012). According to King, Hickey, & Connelly’s article (2013), acupuncture therapies appear to offer some “benefits to veterans with PTSD. Veterans with PTSD are known to have sympathetic hyper-activation, and acupuncture may have the ability to promote homeostasis for the imbalance that exists between the sympathetic and parasympathetic nervous systems.” (King, Hickey, & Connelly, 2013) Other benefits of acupuncture are that it is noninvasive, affordable, mobile, has little side effects and is being administered in a variety of clinics. It is possible to add this modality to the treatment of PTSD. (King, Hickey, & Connelly, 2013)


Healing Touch

Dr. Kolk (2014), encourages all his patients to engage in some sort of bodywork, be it massage, somatic therapy, or energy healing. Touch is the most natural way to calm down distress in another human. Touch helps with hyper-arousal and makes one feel whole, “safe, protected, and in charge”. (p. 215) It is not possible to recover if one does not feel safe in their skin. (Kolk, 2014) In a study, the largest improvements found with healing touch was an “84% reduction in depression, followed by a 68% reduction in pain. Stress and anxiety were reduced by 49%, and fatigue, by 46%.” (Hendricks & Wallace, 2018) All of these are symptoms of PTSD that can be improved.


Massage

Massage has been known to relieve stress, decrease anxiety, reduce depression, and improvement of mood. (Hou, Chiang, Hsu, Chiu, Yen, 2010). In a 2012 study, it reported a significant reduction in physical pain, tension, irritability, anxiety, worry, and depression. (Collinge, Kahn, & Soltysik, 2012) Another study found that massage therapy provided relief from distressing physical and psychological symptoms attributed to trauma. (Price & Abdullahi, 2013) Research indicates that massage therapy allows the client to experience a more sense of self, feeling of comfort, safety, and control that they are not able to get on their own. Another powerful tool that a massage therapist has is the ability to respond to individual needs during a session and providing clients safe and effective self-care strategies that help self-soothe and manage stress.


Somatic Psychotherapy

“Psyche” means mind and “soma” means body in the Greek language. Therefore, Somatic Psychotherapy is the study of the mind-body. Somatic psychotherapy is an integrative approach to treating the whole person. The somatic psychotherapist views the body and mind and “investigates how the person expresses themselves in posture, gesture, muscular patterns, emotional patterns, and physiological arousal; and then helps facilitate self-regulation processes when the body-mind has become imbalanced.” (Mischke-Reeds, 2018, p. 14) This is highly effective for those who have PTSD because the past trauma may become trapped within the body and show through these gestures. Somatic psychotherapy uses “mindfulness, body awareness, breath awareness and body-oriented tools to guide the client towards their inner and outer resources to stabilize any dysregulated symptoms. Clients can then mindfully explore options for resolving emotional and physiological patterns.” (Mischke-Reeds, 2018, p. 16)


Yoga

Yoga is a common complementary treatment for PTSD. Physical activity is a major element in yoga and psychical activity alone seems to improve PTSD. Yoga can directly reduce the amygdala's hyper-activation thereby reducing symptoms. (Cramer, Anheyer, Saha, & Dobos, 2018). When someone has been traumatized, there is a distortion in the relationship of the body. Trauma is a somatic issue. Yoga has a great connection because it goes directly to sensing and connecting to the body. There are neuro-imaging studies of the brain before and after regular yoga practice that show areas of the brain involving self-awareness became activated by doing yoga, and those are the areas that get locked out by trauma and that are needed to heal it. (Kolk, 2014) Kolk quotes (2014) that, “ten weeks of yoga practice markedly reduced the PTSD symptoms of a patient who had failed to respond to any medication or any other treatment.” (Kolk, 2014, p. 207) However, it is important to find trauma-informed yoga practitioners or classes to get the appropriate approach for trauma.


Meditation

Studies of meditation techniques such as transcendental meditation and mantra repetition have some positive effects and improvements in symptoms of depression and PTSD. (Lang & Strauss, 2012) A Mindfulness-based stress reduction (MBSR) technique has been utilized for PTSD. This intervention incorporates mindfulness practices, including meditation and yoga. Research states that this has had a medium effect on PTSD and depression. (Lang & Strauss, 2012) Mindfulness practices help to increase body awareness and be in touch with feelings and perceptions. Mindfulness suggests that “through the practice of shifting attention and assuming a nonjudgmental stance, patients may learn to be less reactive to intrusive or ruminative thoughts. Mantra meditation has more commonly been linked to decreasing physiological arousal.” (Lang & Strauss, 2012) Practicing mindfulness calms down the sympathetic nervous system so that one is less likely to be thrown into flight or fight. (Kolk, 2014) Mindfulness is a great coping strategy for PTSD, especially during a time when triggers and flashbacks happen. (Lang & Strauss, 2012)


Expressive Arts

Expressive arts therapies include art, music, movement, play, writing, and drama interventions. It is an approach that assists the individual to self-regulate and modulate the body’s reactions to traumatic experiences. It can re-connect the safety of attachment and self-soothing resources. This eventually builds strength by using art to normalize and enhance resiliency (Malchiodi, 2012). According to Kolk (2014), “Dance movement adds the element of rhythm, which can help people attune to their heartbeat and bodily rhythms, and then to others. Singing is like sending out restful waves and relaxes the nervous system. Singing has also been found to increase Oxycontin I think you mean oxytocin – Oxycontin is the opioid prescription medicine, also known as the love hormone because it makes people feel closer to one another.” (Kolk, 2014, p. 333)


Neurofeedback

Neurofeedback, also called EEG biofeedback, is a research-supported treatment to sharpen attention, relieve anxiety, enhance mood, and improve learning and behavior without the use of medication. Neurofeedback is a way to train brain activity through a computer-aided training method. By using sensors on the scalp, one can measure and monitor brain activity. This brain activity shows how one feels, their thought habits, stress levels, underlying mood, and overall brain function. It can identify what specific activity is giving rise to symptoms. Once the areas of concern are discovered, then neurofeedback can provide positive feedback to increase desired brain activity to teach self-regulation of brain function. These new patterns of neuronal communication tend to result in changes in thinking, emotions, and behavior. Over time, these changes can continue without the use of neurofeedback. (Kolk, 2014)


Continue reading onto Part 5 Stress Response Disorders in PTSD.


Resources:


American Psychological Association. (2019). Trauma. Retrieved November 15, 2019, from https://www.apa.org/topics/trauma/.


Church, D. (2017). Emotional Freedom Techniques to Treat Post-traumatic Stress Disorder in Veterans: Review of the Evidence, Survey of Practitioners, and Proposed Clinical Guideliness The Permanente Journal. doi: 10.7812/tpp/16-100


Collinge, W., Kahn, J., & Soltysik, R. (2012). Promoting Reintegration of National Guard Veterans and Their Partners Using a Self-Directed Program of Integrative Therapies: A Pilot Study. Military Medicine, 177(12), 1477–1485. doi: 10.7205/milmed-d-12-00121


Cramer, H., Anheyer, D., Saha, F. J., & Dobos, G. (2018). Yoga for posttraumatic stress disorder – a systematic review and meta-analysis. BMC Psychiatry, 18(1). doi: 10.1186/s12888-018-1650-x


Crocker, R. L., Grizzle, A. J., Hurwitz, J. T., Rehfeld, R. A., Abraham, I., Horwitz, R., Weil & Maizes, V. (2017). Integrative medicine primary care: Assessing the practice model through patients’ experiences. BMC Complementary and Alternative Medicine, 17(1), 490. (11pp).


Ford, J. D., & Courtois, C. A. (2009). Defining and understanding complex trauma and complex traumatic stress disorders. Guilford Press, New York, NY.

Hendricks, K., & Wallace, K. F. (2018). Pilot study: Improving patient outcomes with healing touch. Nephrology and Renal Diseases, 3(1). doi: 10.15761/nrd.1000135


Hou, W.-H., Chiang, P.-T., Hsu, T.-Y., Chiu, S.-Y., & Yen, Y.-C. (2010). Treatment Effects of Massage Therapy in Depressed People. The Journal of Clinical Psychiatry, 71(07), 894–901. doi: 10.4088/jcp.09r05009blu


Karren, K. J., Smith, L., Gordon, K. J., & Frandsen, K. J. (2014). Mind/body health: The effects of attitudes, emotions, and relationships, 5th edition. San Francisco, CA: Pearson.


King, H. C., Hickey, A. H., & Connelly, C. (2013). Auricular Acupuncture: A Brief Introduction for Military Providers. Military Medicine, 178(8), 867–874. doi: 10.7205/milmed-d-13-00075


Kolk, B. van der. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. San Francisco: IDreamBooks Inc.


Kolk, B. van der (2005). Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408. doi: 10.3928/00485713-20050501-06


Lang & Strauss. (2012). Complementary and Alternative Treatments for PTSD. PTSD Research Quarterly: Advancing Science and Promoting Understanding of Traumatic Stress, 23(2), 1050-1835


Leskowitz, E. (2016). Integrative Medicine for PTSD and TBI: Two Innovative Approaches. Medical Acupuncture, 28(4), 181–183. doi: 10.1089/acu.2016.1168


Levine, P. A. (1997). Waking the tiger - healing trauma: the innate capacity to transform overwhelming experiences. Berkeley, CA: North Atlantic Books.


Malchiodi, C. (2012). Trauma-Informed Expressive Arts Therapy. Retrieved from https://www.psychologytoday.com/us/blog/arts-and-health/201203/trauma-informed-expressive-arts-therapy.


Mischke-Reeds, M. (2018). Somatic psychotherapy toolbox: 125 worksheets and exercises to treat trauma & stress. Eau Claire, WI: PESI Publishing.


PESI Publishing & Media. (2012). Trauma Treatment: Psychotherapy for the 21st Century [DVD Series]. Available from https://www.pesi.com/Store/Detail/RNV044380


Price, CJ & Abdullahi. (2013) A Community Massage Program for Somali Women Immigrants. In: International Massage Therapy Research Conference; Boston, MA.


Shapiro, F., & Forrest, M. S. (2016). Emdr: the breakthrough therapy for overcoming anxiety, stress, and trauma. New York: Basic Books.


What is EMDR?: EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY. (2019). Retrieved November 15, 2019, from https://www.emdr.com/what-is-emdr/.




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