After reading Dr. Norman Doidge's remarkable book, The Brain that Changes Itself, I tracked Doidge down by phone at his office in the University of Toronto to ask whether neuroplasticity (see my previous blog, "The Plastic Brain") could be used as a therapy for post-traumatic stress disorder (PTSD).
"Yes," he said immediately, adding that EMDR was the most promising treatment that he was aware of.
A number of counselors are already using eye movement and desensitization reprogramming with promising results. EMDR involves remembering a painful incident, but stripping it of its emotional content by asking the patient to follow the therapist's fingers with his or her eyes. Then when the memory is stored away again, it's in a less threatening form. Dr. Francine Shapiro, the founder of EMDR, found that three 90-minute sessions could alleviate symptoms of civilian PTSD in more than 77 percent of the patients she treated.
Several years ago, I interviewed Heather Krysak, who had recently ended a nine-year career with the New York National Guard in which she had been involved in heavy combat in Iraq that left her battling anxiety, fear, nightmares, depression and anger.
"Eye movement desensitization was really weird," she told me. "It brought things out of my memory that I had been totally repressing from Iraq. One moment I was laughing, and the next moment I was crying."
While she still experiences nightmares, she said, they were less intense and much less frequent after her EMDR therapy.
A related alternative is emotional freedom techniques (EFT), which involves remembering a painful incident. Four elements are generally components of this trauma: 1) it's a perceived threat to survival; 2) it overwhelms the coping capacity, creating a sense of powerlessness; 3) it violates expectations; and 4) it creates a feeling of isolation and aloneness. While remembering this trauma, the vet puts a positive spin on it and begins tapping a series of acupressure points (the same points that the Chinese have used for acupuncture over the past five millennia). A vet might say, "I had to shoot the kid who ran toward my Humvee wearing an explosive vest, but I completely and fully accept myself" and begin tapping his way through five acupressure points on his face and three on his torso. For exact locations, check out the EFT Web site: http://www.EFTuniverse.com/
One of the most passionate advocates of EFT is Ken Self of Boston, a veteran of 11 years in the Marine Corps who served two tours of duty in Afghanistan and two more tours in Iraq. He had three issues that were crippling him emotionally, including being forced to shoot a child. "That came back to me night after night for years," he told me recently. Before he started the therapy, he rated his anxiety levels as 8 on a scale of 10, but after tapping them out, they were reduced to 0, he said.
"After tapping, you still have the emotion, but it doesn't own you," he said. "It's not overwhelming. It's just a memory."
The Veterans Stress Project has completed a study in which 59 vets with PTSD received EFT. EFT is a drug-free coaching technique which can be done via Skype. It involves brief cognitive and exposure protocols but adds the novel element of the vet's own physical stimulation by light tapping. Before treatment, the group averaged 66 on the Traumatic
Stress Disorder Checklist-Military (PCL-M) test on which 50 or above is considered PTSD, but after six one-hour coaching sessions, the average score dropped to 35. On follow up, average scores remained far below the clinical criteria for PTSD at 35 on three-month follow-up and 38 on six-month follow up.
Dawson Church, founder of the non-profit, concluded: "The wait-list group's results were unchanged over time, while the EFT group demonstrated statistically significant drops in PTSD, from clinical to subclinical scores, as well as improvement in the severity and breadth of a range of comorbid psychological problems such as depression and anxiety. The results of the present study are consistent with previous trials showing that brief EFT interventions improve PTSD as well as co-occurring conditions, with gains maintained over time."
The Veterans Stress Project is looking for vets with military-related stress who are willing to participate in further studies, including an exact replication of the trial described above. For more information, visit the Veterans' Stress Project Web site, listed above, or call 707-237-6951.
While I'm not affiliated with EFT in any way, I should say that I have personally benefited from it. In 1997, I was driving my rig along a frontage road outside of Great Falls, Mont., when a battered old car slowed down in the approaching traffic lane and the left turn signal came on. Just as I approached it, the car edged into my lane and broadsided me on the driver's side door. My rig dropped into the ditch, came up over a driveway and became airborne. It landed on its passenger side wheels and rolled; I remember seeing the windshield blow out in slow motion. The rig was totaled. I was unharmed but very shaken up.
For the next few years, I had an unusual reaction every time I approached a car signaling to cross my lane of traffic. My heart started pounding, my throat constricted, my mouth got dry and my gut twisted. I generally had a strong urge to stop dead in the road and wave the guy in front of me across the road.
Then a friend introduced me to EFT. The next time an approaching car signaled a left-hand turn, I told myself, "This scares me, but I totally believe that driver will obey the traffic laws." Tapping seven pressure points seemed too complicated, so I just tapped my own breastbone, right over my thumping heart. After four or five encounters, I was totally surprised to realize that I no longer needed to do it. And it has not been a problem since.
I wondered at the time if that was like PTSD so I asked a local counselor about it. "You were probably suffering a small stress disorder, but a tiny one compared to most vets," he said. "You were in an accident, but you weren't harmed, nor was anyone else. You weren't out in the field, picking up pieces of your friends and putting them in body bags. And this happened to you once, not two or three times a day for 12 or 15 months."
That gave me a whole new appreciation for what our combat vets are going through.