HeartSpace Inner Healing |
|
|
|
|
Miracles from ChimayoPost Traumatic Stress Disorder (PTSD) and TraumaAlternative and Traditional Treatment MethodsJennifer Harris
April 20, 2002 Table of Contents
AbstractIntroduction Literature Review PTSD Symptoms Physiological Symptoms of PTSD Correlation between PTSD and Pain Diagnostic Tests for PTSD Treatment of PTSD with Drugs Treatment of PTSD with Psychotherapy Treatment of Depression and Anxiety with Somatic Therapy Treatment of PTSD with Somatic Psychotherapy Scope of the Problem and Need for Research Methodology Participants Materials Procedure Results Survey Results on Treatment Methods and Philosophy Survey Results on Practitioner Self-Care Survey Results on Healing Time for PTSD/Trauma Survey Results on Completion of Treatment for PTSD/Trauma Character Structures and PTSD Skills and Strategies that are Effective with PTSD/Trauma Clients Skills and Strategies that Do Not Work Well with PTSD/Trauma Clients Practitioner Characteristics/Attitudes Important in Working with PTSD/Trauma Clients Alternative Treatments that Might be Beneficial in Treating PTSD/Trauma Discussion Conclusion References Resources Suggested by Participants Also see: PTSD Signs and Symptoms and Risk Scores Abstract The purpose of this study was to gather data about alternative methods used to treat post traumatic stress disorder and trauma. Practitioners included psychotherapists, massage therapists, a chiropractor, an indigenous healer, and an herbalist, and most participants (77.8 percent) practiced in New Mexico. This availability-style sample comprised mostly practitioners known to the researcher, so generalizability is limited. Participants answered open- and closed-ended survey questions. Most participants said healing time and time in treatment should not be limited. Respondents suggested a variety of alternative treatments for PTSD and trauma, including body-oriented treatments and activities, body-oriented psychotherapy, vitamins and herbs, and spiritual practices. The data might be useful for further inquiry into holistic, alternative treatments and interventions that reduce or prevent PTSD and trauma. Introduction
Currently, the causes, assessment, and treatment of Post Traumatic Stress Disorder (PTSD) are of much interest to researchers as well as to mental health practitioners. PTSD is now more widely recognized and diagnosed than in the past. PTSD was first observed in war veterans, but PTSD can also result when people of any age group experience other traumatic events, such as natural disasters, auto accidents, and rape. PTSD can occur right after someone experiences a traumatic event or PTSD can be a delayed-onset condition that requires treatment long after the trauma occurred. Some important considerations in treatment include processing the trauma and helping the client feel secure in his/her body (Van der Kolk, McFarlane, and Weisaeth, 1996, p. 17). Recent studies of treatment methods for PTSD have primarily focused on mainstream approaches. Alternative methods, many of which address issues by working with the body, have received scant attention in PTSD literature.Research into post traumatic stress disorder began about 25 years ago (Kolb, 1993, p. 424-425), however, soldiers suffering from similar symptoms were observed more than 300 years ago. (Shalev and Rogel-Fuchs, 1993, p. 413). PTSD has variously been called shell shock, combat fatigue, war neuroses, soldier's heart, irritable heart, catastrophic stress reaction, and rape trauma syndrome. (Breslau and Davis, 1987, p. 255), (Foa and Meadows, 1997, p. 449-480), (Shalev and Rogel-Fuchs, 1993, p. 413). PTSD occurs in people who have suffered a range of trauma, including but not limited to, war, rape, auto accidents, natural disasters, and work-related trauma. (Anderson and Grunert, 1997, p. 39-42), (Foa and Meadows, 1997, p. 449-480). Literature Review
PTSD SymptomsSymptoms of PTSD generally fall into three categories: "reexperiencing, avoidance/numbing, and increased arousal." (Foa and Meadows, 1997, p. 449-480). Symptoms include memory lapses, impaired concentration, muscle tension, flashbacks, frightening dreams, intrusive memories and feelings, paranoia, reaction to and avoidance of events that remind the person of the original trauma, and problems with detachment and estrangement. (Anderson and Grunert, 1997, p. 39-42), (Brende, 1982, p. 352-360), (Davidson, Smith, and Kudler, 1989, p. 337-339), (Foa and Meadows, 1997, p. 449-480), and (Mason, Giller, Kosten, Ostroff, and Podd, 1986, p. 148). Additional PTSD symptoms include problems with alcohol abuse, problems remaining employed, avoiding feelings and thoughts, distrust of others, numbing, denial, psychological amnesia, splitting, problems sleeping, survivor guilt, uncontrollable aggression and "predisposition to attack in anticipation of being attacked," (Mason, et al., 1986, p. 148), anxiety, crying easily, depression, startle response, and perception that the future is shortened. (Anderson and Grunert, 1997, p. 39-42), (Brende, 1982, p. 352-360), (Davidson, Smith, and Kudler, 1989, p. 337-339), (Foa and Meadows, 1997, p. 449-480), and (Mason, et al., 1986, p. 148). Physiological Symptoms of PTSD Three prevalent theories of the causes of PTSD, based on psychophysiological studies, suggest that "external stimuli," "mental imagery," or the "auditory startle" response cause the reactions in people with PTSD. (Shalev and Rogel-Fuchs, 1993, p. 414). The psychophysiological studies have focused on evaluating "heart rate (HR), bl. pressure (BP), skin conductance (SC), and electromyogram (EMG)" readings. (Shalev and Rogel-Fuchs, 1993, p. 414). Other studies have validated psychoneuroendocrine correlations for PTSD. PTSD is characterized by elevated epinephrine and norepinephrine levels, as well as by lowered cortisol levels. (Mason, et al., 1986), (Heim, Ehlert, Hanker, and Hellhammer, 1998), (Blanchard, Kolb, Prins, Gates, and McCoy, 1991), (Yehuda, et al., 1990). Further evidence supports a biological differentiation in PTSD (Yehuda, Lowy, Southwick, Shaffer, Giller, 1991). Researchers found significantly more glucocorticoid receptors in a study of Vietnam veterans with PTSD than in the control subjects. (Yehuda, et al., 1991, p. 499). Correlation between PTSD and Pain A correlation has also been found between PTSD and pain symptoms. For example, one study (Beckham, et al., 1997) found that 80 percent of 129 Vietnam veterans with PTSD being treated as out-patients at a PTSD clinic had chronic pain. The study found that "PTSD reexperiencing symptom severity...was significantly associated with pain disability, overall pain index, and current pain rating" (Beckham, et al., 1997, p. 383). Researchers found in another study that firefighters who had PTSD "complained of more physical symptoms at 42 months, were more likely to have consulted a doctor and consulted doctors more times than the controls" (McFarlane, Atchison, Rafalowicz, and Papay, 1994, p. 717-721). Complaints included musculoskeletal, neurological, and respiratory problems. (McFarlane, et al., 1994, p. 717-721). Veteran high and low users of health care services were evaluated for PTSD, and significantly more high users than low users had PTSD. (Deykin, et al., 2001, p. 835, 838). Diagnostic Tests for PTSD PTSD was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. (Foa and Meadows, 1997, p. 449-480). Several diagnostic tests used to assess PTSD include Structured Clinical Interview for DSM (SCID), Clinician-Administered PTSD Scale (CAPS), Mississippi PTSD Scale (M-PTSD), Revised Impact of Events Scale (RIES), PTSD Interview (PTSD-I), PTSD Symptom Scale-Self Report (PSS-SR), Anxiety Disorders Interview Schedule (ADIS), Structured Interview for PTSD (SI-PTSD), PTSD Diagnostic Scale (PDS), PTSD Symptom Scale Interview (PSS-I), and the Penn Inventory. (Foa and Meadows, 1997, p. 449-480), (Davidson, et al., 1989, p. 337-339). Treatment of PTSD with Drugs PTSD has been treated with various drugs. One study (Faustman and White, 1989) examined drugs used to treat veterans with PTSD, and the drugs used most often were antidepressants, neuroleptics, and B-blockers. Psychotropics were given to half of the veterans with PTSD. This study noted "alleviation of PTSD symptoms with specific or combined psychotropics has not been rigorously tested." (Faustman and White, 1989, p. 154-158). Treatment of PTSD with Psychotherapy Various types of psychotherapy have been used to treat PTSD with mixed results. Some therapies are based on behavior and learning theories. For example, in one discussion of implosive therapy (Stampfl and Levis, 1967), "the basic premise is that anxiety is a learned response to sets of cues based on previous trauma in the patient's life. If these cues elicit the anxiety response in the absence of primary reinforcement, the anxiety response will extinguish after repeated evocations." (Stampfl and Levis, 1967, p. 500). Other cognitive-behavioral treatment methods include Exposure Therapy and Anxiety Management. In Exposure Therapy, clients are desensitized by facing traumatic memories in therapy (called imaginal exposure) and in situations the client usually avoids because the situations in some way remind the client of the trauma (in vivo exposure). (Foa, et al., 1999, p. 194). In Anxiety Management, clients are taught skills to cope with anxiety, and some of these skills include "relaxation training, thought stopping, cognitive restructuring, and positive self-statements." (Foa, et al., 1999, p. 194), (Ost, 1987, p. 397). Stress Inoculation training is a type of Anxiety Management. Treatment of Depression and Anxiety with Somatic Therapy Massage alone apparently is effective in cases of anxiety, depression, and ADHD teenagers. (Jones and Field, 1999), (Field and Quintino, 1998). Treatment of PTSD with Somatic Psychotherapy Because of the somatic nature of PTSD symptoms and because physiological pain and PTSD are correlated, somatic psychotherapies may be effective in treating PTSD. Somatic psychotherapy has been used to treat people with PTSD and depression. Somatic psychotherapy is useful in helping clients get in touch with their feelings and their bodies. (Van der Kolk, 2001, p. 18). One task of therapy can be to provide an environment conducive to the client exploring and becoming more comfortable with safe touch (Van der Kolk, 2001, p. 18). Anecdotally, therapists have used somatic psychotherapies to reduce clients' symptoms of PTSD (Eckberg, 2000), (Ogden and Minton, 2000) and depression (Lowen, 1972). Bioenergetics is one such somatic psychotherapy that might be used to treat PTSD. This therapy is based on the work of Wilhelm Reich and was founded by Alexander Lowen and John Pierrakos. (Young, 1997, web). Although few empirical studies with Bioenergetics have been carried out, therapists have written about using Bioenergetics with complex PTSD, with sexually abused clients, and with babies. (Frechette, 1998), (Laschinsky, 1998), (Wendelstadt, 1998). Scope of the Problem and Need for Research The risk of developing post traumatic stress disorder at some time during a lifetime seems quite significant. Although researchers have begun studies into PTSD, much more research is needed. Because of the somatic and pain symptoms that are frequently associated with the PTSD condition, further investigation into treatment methods for PTSD, especially those that emphasize somatic treatment, may be valuable. "...(T)here is a long standing tradition of specific body-oriented treatment techniques, first articulated by Wilhelm Reich...Those traditions are widely practiced outside of academic and medical settings. Unfortunately, at present reimbursement for such techniques is difficult, and grants to study them impossible to come by." (Van der Kolk, 2001, p. 18). One area of investigation that might be useful for further study is to query current alternative practitioners about body-oriented therapies in the treatment of PTSD and trauma. Methodology Participants The data for this study was collected from an availability, snowball-style sample in October and November 2002. A list of 32 possible participants was compiled from professional contacts known to the researcher. This initial list of practitioners included psychotherapists, herbalists, an acupuncturist, chiropractors, massage therapists and practitioners of indigenous medicine. Additionally, 14 people were referred by survey participants or associates of the researcher. Altogether, 17 men and 29 women were contacted, and eighteen completed surveys were returned (a return rate of 39 percent). Completed surveys were primarily from participants in New Mexico (77.8 percent). Fourteen women (77.8 percent) and 4 men (22.2 percent) completed surveys. Practitioners' clients were primarily female (38.9 percent), primarily male (11.1 percent), or about an equal number of males and females (50 percent). Ten of the respondents had been practicing between two and seven years. Seven of the respondents had been practicing between 10 and 55 years. For the number of years in practice for all respondents, M equals 14, SD equals 14. Participants were given an informed consent form to sign. Materials The survey instrument contained 31 questions, plus a demographic inventory of 9 questions. The instrument contained 11 questions with a 5-point scale to collect information on attitudes about treatment methods for trauma and PTSD. The instrument contained 7 questions covering practitioner self-care using a 4-point scale plus 1 yes-no question. The instrument also contained 7 fill-in-the-blank questions to collect data on attitudes about time needed to heal trauma, therapy completion rate for clients with trauma/PTSD, and which character structures are present in PTSD. Five additional open-ended questions were included to collect data about: (1) Skills and strategies that are effective with PTSD/trauma clients. (2) Skills and strategies that do not work well with PTSD/trauma clients. (3) Practitioner characteristics or attitudes that are important in working with PTSD/trauma clients. (4) Alternative treatments that might be beneficial for PTSD/trauma clients. (5) Books or PTSD/trauma resources for practitioners and clients. A section for any further comments and one for referrals of other potential participants was also included at the end of the survey. Procedure Potential subjects on the initial list were contacted by telephone or in person. Telephone contact was followed up with a mailed survey. Surveys were hand-delivered for in-person requests for participation. Other practitioners who were referred were then contacted in a similar manner. Two postage-paid envelopes were included in the survey packet, one for the survey and one for the signed informed consent to be returned separately. A list of contacts was kept, and the list included telephone numbers and addresses of the potential participants, the date of contact, and the date a survey was mailed or delivered. Results Frequencies for quantitative and qualitative data were analyzed using SPSS Version 11.0. Qualitative data was evaluated and placed into large categories by the assistance of groups of three to six colleagues. Percents are based on completed responses. Survey Results on Treatment Methods and Philosophy All of the participants work with trauma clients and 88.9 percent work with clients who have PTSD. Participants use an alternative approach to treating trauma/PTSD (88.3 percent), and participants use a combination of mainstream and alternative approaches to treating trauma/PTSD (68.8 percent). Participants agreed that touch is sometimes appropriate in treating trauma/PTSD client (94.1 percent) and that transformation and healing are possible for trauma/PTSD clients (100 percent). Survey Results on Practitioner Self-Care Practitioners get adequate rest 4-7 times per week (77.8 percent), eat nutritiously and moderately 4-7 times per week (94.5 percent), get adequate exercise 2-7 times per week (94.4 percent). Participants spend time with supportive friends and family 2-7 times per week (88.2 percent), spend time doing hobbies 2-7 times per week (82.3 percent), use a support system to prevent secondary trauma 2-7 times per week (70.5 percent), and currently are working on their own issues 2-7 times per week (58.9 percent). All participants had worked on their own issues in the past (100 percent). Survey Results on Healing Time for PTSD/Trauma Participants thought lesser emotional trauma (i.e. loss of a pet, moving) should not have a time limit for healing (83.3 percent). All participants thought major emotional trauma (i.e. war, rape, or disaster) should not have a time limit for healing. Participants thought that the modality or therapy they practiced should not have a time limit (87.5 percent). Survey Results on Completion of Treatment for Trauma/PTSD The range of estimates of clients who complete treatment varied from 10 percent to 100 percent. About half of the participants (45.5 percent) thought that about 50-80 percent of trauma clients complete treatment. The range of estimates of clients who complete about one-quarter of treatment was between 2.5-50 percent. About half of the participants (55.6 percent thought that about 10-20 percent of PTSD/trauma clients complete about one-quarter of treatment). Character Structures and PTSD This open-ended question was about usual character structures for PTSD clients, responses included schizoid (22.2 percent), psychopathic, oral, rigid/frozen, masochistic, (11.1 percent each), and all of the structures (33.3 percent). Skills and Strategies that are Effective with PTSD/Trauma Clients This question was open-ended and responses were placed into three categories for analysis: traditional, alternative, or combination of traditional and alternative methods. Skills and methods in all three categories included body awareness, practitioner skills, natural remedies, spiritual practices, and various therapies. Body awareness included bodywork and helping the client get in touch with his/her body. Practitioner skills included empathy, patience, creating safety, listening, acceptance, and other skills included helping the client with self-esteem issues, boundary work, and building a support system. Natural remedies included herbs, diet, and homeopathic medicine. Spiritual practices included meditation and prayer. Therapies included both traditional and alternative, such as group therapy, hypnotherapy, family work, regressive work, EMDR, Bioenergetics, drug and alcohol treatment, past life regression, and biofeedback. Skills and Strategies that Do Not Work Well with PTSD/Trauma Clients This question was open-ended and responses were placed into three categories: not pushing the client, lack of practitioner skill, and structured/traditional therapies. The category for not pushing the client included moving too quickly in therapy or rushing. The category for lack of practitioner skill included directives, shaming, blaming, lack of caring, being preoccupied, being over-talkative, the therapist not doing his/her own work, imposing therapist's agenda on the client, confrontation, and lack of confidence. The category for therapies that do not work included primal, cognitive, analyzation, behavioral, short-term, drugs alone and certain drug therapies, EMDR with children, non-altered and non-subconscious therapies. Practitioner Characteristics/Attitudes Important in Working with PTSD/Trauma Clients This question was open-ended and responses were placed into five categories for analysis. The categories included empathetic connection, knowledge, self-awareness, skills, and traits. The category for empathetic connection included love, caring, gentleness, trustworthiness, openness, acceptance, intuition, respecting the client, support, patience, handling strong emotional discharge, and having good boundaries. The category for knowledge included knowledge of human growth and development, knowledge of PTSD, and knowledge about addictions and 12-Step programs. The category for self-awareness included self-actualization and spirituality. The category for skills included listening, having a referral system, being flexible regarding client needs and process, not encouraging long-term dependence, placing the client in charge with the therapist as facilitator, having a good support system to prevent secondary trauma, and being committed to long-term therapy as needed. The category for traits included being grounded, having good boundaries, and being soft-spoken. Alternative Treatments that Might be Beneficial in Treating PTSD/Trauma This was an open-ended question and responses were placed into five categories for analysis, including body-mind therapies, body touch, unconscious therapy, physical activity, natural remedies, spiritual practices, and other. The category for body-mind therapies included breath-work, visualization, and tapes. The category for body touch included bodywork, body-centered psychotherapies, acupuncture, physiotherapy, and chiropractic. The category for unconscious therapy included hypnotherapy and EMDR. The category for physical activity included yoga, martial arts, exercise, dance, spending time in nature, walking, physical work (such as chopping wood, but activity without a deadline). The category for natural remedies included vitamins, herbs, essential oils, flower essences, natural supplements, nutrition, homeopathy, and naturopathy. The category for spiritual practices included prayer, meditation, ritual, sweat lodges, Native American healing ceremonies, shamanic soul retrieval, spiritual healers, indigenous medicine treatments. The category for other included creating a safe environment and awareness and willingness. Discussion The purpose of this research project was to make a preliminary investigation into methods used by alternative practitioners that might be beneficial in treating clients with PTSD/trauma. Regarding general attitudes toward healing trauma, most participants thought touch is sometimes appropriate in treating trauma/PTSD clients (94.1 percent) and that transformation and healing are possible for these clients (100 percent). Additionally, the majority of participants thought healing time for trauma and time in treatment should not have time limits. For healing lesser emotional trauma, there should be no time limit (83.3 percent), for healing major emotional trauma, there should be no time limit (100 percent), and for the modality practiced by the participant, there should be no time limit (87.5 percent). In general, participants had very high quality self-care practices and all had worked on their own issues in the past. Generalizability of this study is limited because of scope and size of the study and because the study was based on an availability sample. Overall, treatments suggested included a variety of alternative as well as some traditional methods. The holistic methods encompassed an overall approach that addressed body, mind, and spirit. For practitioner characteristics and skills, empathy, professional skills and knowledge, and self-knowledge emerged as some of the most important qualities in working with trauma/PTSD clients. Conclusion Current research on PTSD has focused more on traditional treatment methods and specific, isolated aspects of PTSD. Perhaps an alternative, unifying perspective could be beneficial in working with PTSD/trauma clients. A body-mind-spirit approach might be utilized according to each client's needs to help each client regain balance and wholeness. Practitioners might work together to help clients reconnect and to heal in community. And perhaps an alternative vision of healing could be used to create preventive programs in schools or for people in high-risk populations in a way that all people can recover and maintain balance. References Anderson, R.C., and Grunert, B.K. 1997. A cognitive behavioral approach to the treatment of post-traumatic stress disorder after work-related trauma. Professional Safety, Volume 42, Number 11, Pages 39-42. Beckham, J.C., Crawford, A.L., Feldman, M.E., Kirby, A.C., Hertzberg, M.A., Davidson, J.R.T., and Moore, S.D. 1997. Chronic posttraumatic stress disorder and chronic pain in Vietnam combat veterans. Journal of Psychosomatic Research, October, Volume 43, Number 4, Pages 379-389. Blanchard, E.B., Kolb, L.C., Prins, A., Gates, S., and McCoy, G. 1991. Changes in plasma norepinephrine to combat-related stimuli among Vietnam veterans with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, June, Volume 179, Number 6, Pages 371-373. Brende, J.O. 1982. Electrodermal responses in posttraumatic syndromes, a pilot study of cerebral hemisphere functioning in Vietnam veterans. The Journal of Nervous and Mental Disease, June, Volume 170, Number 6, Pages 352-361. Breslau, N., and Davis, G. 1987. Posttraumatic stress disorder, the stressor criterion. The Journal of Nervous and Mental Disease, May, Volume 175, Number 5, Pages 255-264. Davidson, J., Smith, R., and Kudler, H. 1989. Validity and reliability of the DSM-III criteria for posttraumatic stress disorder, experience with a structured interview. The Journal of Nervous and Mental Disease, June, Volume 177, Number 6, Pages 336-341. Deykin, E., Keane, T., Kaloupek, D., Fincke, G., Rothendler, J., Siegfried, M., and Creamer, K. 2001. Posttraumatic stress disorder and the use of health services. Psychosomatic Medicine, September-October, Volume 63, Number 5, Pages 835-841. Eckberg, Maryanna. 2000. Victims of Cruelty, Somatic Psychotherapy in the Treatment of Posttraumatic Stress Disorder. Berkeley, California, North Atlantic Books. ISBN 1556433530. PUBLIC LIBRARY 616.8521, ECKBERG. Faustman, W.O., and White, P. 1989. Diagnostic and psychopharmacological treatment characteristics of 536 inpatients with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, March, Volume 177, Number 3, Pages 154-159. Field, T., and Quintino, O. 1998. Adolescents with attention deficit hyperactivity disorder benefit from massage therapy. Adolescence, Spring, Volume 33, Number 129, Pages 103-108. Foa, E.B., and Meadows, E.A. 1997. Psychosocial treatments for posttraumatic stress disorder, a critical review. Annual Review of Psychology, February, Volume 48, Pages 449-480. Foa, E.B., Dancu, C., Hembree, E., Jaycox, L., Meadows, E., and Street, G. 1999. A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, April, Volume 67, Number 2, Pages 194-200. Frechette, Louise. 1998. Complex post-traumatic stress disorder, putting the pieces back together. Bioenergetic Analysis, The Clinical Journal of the International Institute for Bioenergetic Analysis, Winter, Volume 9, Number 1, Pages 43-64. Heim, C., Ehlert, U., Hanker, J., and Hellhammer, D.H. 1998. Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal-axis in women with chronic pelvic pain. Psychosomatic Medicine, May-June, Volume 60, Number 3, Pages 309-318. Jones, N.A., and Field, T. 1999. Massage and music therapies attenuate frontal EEG asymmetry in depressed adolescents. Adolescence, Fall, Volume 34, Number 135, Pages 529-534. Kolb, L.C. 1993. A perspective and future dreams of PTSD as a psychosomatic disorder. Psychosomatic Medicine, September-October, Volume 55, Number 5, Pages 424-425. Laschinsky, Dorte. 1998. Working with sexually abused people, how to discover and deal with these clients. Bioenergetic Analysis, The Clinical Journal of the International Institute for Bioenergetic Analysis, Winter, Volume 9, Number 1, Pages 71-81. Lowen, Alexander. 1972. Depression and the Body, the Biological Basis of Faith and Reality. New York, New York, The Penguin Group. ISBN 9780140217803. PUBLIC LIBRARY 616.8527, LOWEN. Mason, J.W., Giller, E.L., Kosten, T.R., Ostroff, R.B., and Podd, L. 1986. Urinary free-cortisol levels in posttraumatic stress disorder patients. The Journal of Nervous and Mental Disease, March, Volume 174, Number 3, Pages 145-149. McFarlane, Alexander C., Atchison, M., Rafalowicz, E., and Papay, P. 1994. Physical symptoms in post-traumatic stress disorder. Journal of Psychosomatic Research, October, Volume 38, Number 7, Pages 715-726. Ogden, Pat, and Minton, Kekuni. 2000. Sensorimotor psychotherapy, one method for processing traumatic memory. Traumatology, October, Volume 6, Number 3, Article 3. Archive, https://web.archive.org/web/20030811074950/http://sensorimotorpsychotherapy.org/articles.html Ost, Lars Goran. 1987. Applied relaxation, description of a coping technique and review of controlled studies. Behaviour Research and Therapy, Volume 25, Number 5, Pages 397-409. Shalev, A.Y., and Rogel-Fuchs, Y. 1993. Psychophysiology of the posttraumatic stress disorder, from sulfur fumes to behavioral genetics. Psychosomatic Medicine, September-October, Volume 55, Number 5, Pages 413-423. Stampfl, T.G., and Levis, D.J. 1967. Essentials of implosive therapy, a learning-theory-based psychodynamic behavioral therapy. Journal of Abnormal Psychology, December, Volume 72, Number 6, Pages 496-503. Van der Kolk, Bessel A. 2001. The assessment and treatment of complex PTSD. In Rachel Yehuda, editor, Traumatic Stress (Chapter 7). American Psychiatric Press. Archive, https://web.archive.org/web/20101224232900/http://traumacenter.org/products/pdf_files/Complex_PTSD.pdf Van der Kolk, Bessel A., Alexander C. McFarlane, and Lars Weisaeth. 1996. Traumatic Stress, the Effects of Overwhelming Experience on Mind, Body, and Society. New York, New York, Guilford Press. ISBN 1572300884. PUBLIC LIBRARY 616.8521, VAN. Wendelstadt, Silja. 1998. Emotional first aid, healing a birth trauma. Bioenergetic Analysis, The Clinical Journal of the International Institute for Bioenergetic Analysis, Winter, Volume 9, Number 1, Pages 85-96. Yehuda, R., Southwick, S., Nussbaum, G., Wahby, V., Giller, E., and Mason, J. 1990. Low urinary cortisol excretion in patients with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, June, Volume 178, Number 6, Pages 366-369. Yehuda, R., Lowy, M.T., Southwick, S.M., Shaffer, D., and Giller, E.L. 1991. Lymphocyte glucocorticoid receptor number in posttraumatic stress disorder. The American Journal of Psychiatry, April, Volume 148, Number 4, Pages 499-504. Young, C. 1997. Body psychotherapy, it's history and present day scope, an address to the European association for psychotherapy's congress, Rome 1997, common ground and different approaches in psychotherapy. Retrieved January 27, 2002, from web site, Archive, https://web.archive.org/web/20011211142145/http://www.usabp.org/definition.htm Archive of this page, 2006 |
|
|