1、Healing Mechanisms in Critical Incidents & PTSD and the “Power Therapies”,This program was presented in symposium, “PTSD Institute,” at the 1999 St Louis County Human Service Conference, October 19-20, Duluth MN.The purpose of this slide series is to identify some of the mechanisms that contribute t
2、o the management of and recovery from PTSD, and to take a critical view of emerging therapies that do not subject themselves to conventional standards of inquiry or treatment efficacy.Questions and comments can be sent to David X. Swenson PhD LP DABPS at dswensoncss.edu,Healing Mechanisms in Critica
3、l Incident Intervention,CulturalPreoccupation with and immediate service for trauma, emergency, crises, violenceBelief that everyone deserves a good life (entitlement)Belief in and need for quick fixes & immediacySocial/InterpersonalImmediate action communicates importanceNormalizing reduces isolati
4、on, broadens acceptanceLink with community & resource utilizationConfidentiality (trust & safety)ProtectionCognitiveEngage cognitive skills to contain and channel emotionsUnderstanding process reduces fear of “going crazy”Reframe experience as useful, survivorExpectation of recoveryReestablish a bel
5、ief in controlAnticipate delayed reaction to minimize impact,EmotionalDischarge & reduce intense emotionsEmotional containment & stabilitySafety, support, nurturanceDesensitization to cuesPhysiological/neurologicalInduce relaxation/self regulationDecrease pain & anxietyLower ANS arousalMinimize pref
6、rontal-limbic disconnect,Pressures to Develop New Treatment Modalities,Cultural factorsRecognition of potentially lasting effects of traumaBelief that everyone deserves a good life (entitlement)Belief in and need for quick fixes & immediacyPreoccupation with trauma, emergency, crises, violenceWidesp
7、read uncritical acceptance of Magical thinking, paranormal phenomena, New Age, etc.Managed CareCompetitive service environmentGenerate revenues with high client loads and rapid turnoverCost-effective treatmentReimbursement for some non-traditional methodsClient FactorsPain, desperation, sufferingReq
8、uests for advertised/popular approachesLow financial resources,Therapist factorsGood intentions to be effectivePower “become the Ultimate Therapist”Faith in utility: Belief that “if it works” so what?Extreme belief in constructed reality: “If you can think of it, its real”So long as it works its OK,
9、Proliferation of “McTherapies”,Therapeutic Touch (TT): Delores Kriegers nursing technique for healing by brushing & balancing your bodys energy fields (no touch)Applied Kinesiology/Touch for Health (AK/TFH): George Goodhearts chiropractic approach to acupressureThought Field Therapy (TFT): Roger Cal
10、lahans algorithmic tapping to balance body energiesEmotional Freedom Techniques (EFT): Gary Craigs modification of TFTTapas Acupressure Technique (TAT): Another modification of TFT by Tapas Fleming.Miracle Acupressure Tapping Technique (MATT): more of the sameEnergy Psychology (EP): still more by Fr
11、ed Gallo.Ear Tapping Desensitization & Remobilization (ETDR). Ear tapping.Touch and Breathe (TAB). John Diepolds combination of tapping and breathing techniqueLimbic Emotional Release (LER). Joan Lonsers methodAttractor Field Therapy (AFT): Acupressure to deal with universal energy fields that affec
12、t usAcupressure Chakra Technique (ACT): acupressure combined with yogic energy centersCreating, Allowing, Receiving Technique (CART): Tapping 1-2 meridians for the futureBe-Set-Free Fast (BSFF): Larry Nims four-step tapping algorithm to resolve unconscious energiesEye-Movement Desensitization & repr
13、ocessing (EMDR): Shapiros Desensitization and resolution of trauma by thinking of the trauma while moving the eyes laterallyNeuro-Linguistic Programming (NLP): Changing our internal sensory representations of trauma,Addictions (food, cigarettes, alcohol, drugs) AllergiesAnxiety and Panic Attacks Ang
14、er CancerCompulsions & obsessionsDepression and sadness DyslexiaEating disordersFears and phobias FibromyalgiaGrief and lossGuilt Immune deficiency problems Insomnia,Conditions Treated by Energy Therapies: One size fits all?,Migraine headacheNegative memoriesNightmaresObsessive-compulsive disorders
15、Pain management Peak performancePTSDSelf imageSexual abuse issuesSexual problems,McTherapy Claims,Work rapidly, often within minutes; “instant relief”Non-invasive, painless process with little or no discussion of painful memoriesLong lasting or permanent resultsResults where others fail; 85%-99% suc
16、cess rateEliminates problems even when you dont know what the problems areDramatic testimonialsBased on centuries old traditional techniques of healing, new discoveries in neurology or physics One size fits all regardless of type of disorderSimple, easy, painless, anyone can do itTraining available
17、to anyone who wants to be a healer; certification available,Alternate explanations to McTherapy cures: Likely but not fancy,Natural history and cyclicity of diseaseCondition runs it courseRegression to the meanSuggestionCounter-irritationDistractionAudience demand characteristicsHawthorne EffectStoc
18、kholm Effect (please powerful figure)FatigueAvoidance of painful memories HabituationReinforcementDesensitizationPlacebo Effect,Problems with the Approaches Conceptual & Research Concerns,Demand characteristics of stage performance & Hawthorne Effect of studiesFew or no articles in peer reviewed, re
19、fereed, conventional, professional journalsInsufficient design controls Unclear and insufficiently established diagnoses Faulty logic & pseudoscientific comparisons Reliance on self report rather than more objective measuresUnfounded transfer of concepts from physics to psychological & physical proc
20、essesSale and use of quasi-scientific instruments at high pricesDiagnosis through unestablished proceduresPoorly defined and untestable concepts Denial and rejection of established explanationsNonfalsifiability of approach Defiance and claimed irrelevance of established science procedures,Problems w
21、ith McTherapy Approaches: Ethical Concerns,Professional ethics usually prescribe services that fall within conventional practice unless there is reason & evidence for diversion.Although telecommunication treatment is not now unethical, it requires application of proper diagnostic procedures and soun
22、d basis for scientific and professional judgements.Workshops and brief certification programs usually do not meet the requirements for competency standards for treatment.Although testimonials are an accepted form of promotion, solicitation of testimonials can also present an unethical dual relations
23、hip.Experimental forms of treatment require informing consent and keeping records on outcomes & followup.Trauma increases vulnerability and susceptibility to direction and manipulationEven if the methods do no direct harm, experimental approaches used may prevent the person from seeking more establi
24、shed treatmentTrauma often changes in world view, and unconventional therapies install an alternate view of reality.,Recommendations,Keep looking for innovations-better ways to serve clientsWhen a novel approach is presented, ask:How do you know it works?What are the assumptions that underlie the te
25、chnique and how do you know they are sound?How do you know that some other mechanism isnt operating?If you use these methods make sure the client knows they are experimental keep good recordskeep partialing out what the mechanism is (use good science)publish/share your results (+/-)Challenge proliferation of unconventional approaches without sound evidence,
