Madison Baker-Carver

Alternative Treatments for Post-Traumatic Stress Disorder

Many people suffer from Post-Traumatic Stress Disorder (PTSD), whether it be from

previous combat experiences, being a victim of violence, or experiencing other significant

traumatic events. Scientists are researching alternative treatments for PTSD besides

antidepressants medication to help cure PTSD. Alternative treatments include Eye

Desensitization and reprocessing therapy, Basic Body Awareness and Breathing Based

Meditation. I chose to do this topic because both my grandfathers suffer from PTSD and have

been put on multiple antidepressants which they believe are not necessary to help cure their

PTSD. I believe that it is important for people to know about PTSD because when people think

of PTSD they think of military and combat , but it is not just soldiers or military personnel; it is

everyday people that have had traumatic experiences. There are many situations that may trigger

PTSD attacks, for example military that served in combat may be triggered by fireworks that

can sound like gunshots, or when people make jokes or remarks about a specific topic.

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment

that was originally designed to alleviate the distress associated with traumatic memories

(Shapiro, 1989a, 1989b). Shapiros (2001) Adaptive Information Processing model posits that

EMDR therapy facilitates the accessing and processing of traumatic memories and other adverse

life experience to bring these to an adaptive resolution. After successful treatment with EMDR

therapy, affective distress is relieved, negative beliefs are reformulated, and physiological

arousal is reduced. During EMDR therapy the client attends to emotionally disturbing material in

brief sequential doses while simultaneously focusing on an external stimulus.(EMDR Institute

[EMDR], 2016, para. 1). In the the first research article Brief eclectic psychotherapy v. eye

movement desensitisation and reprocessing therapy for post-traumatic stress disorder:

randomised controlled trial(Nijdam, Gersons, Reitsma, Jongh, Olff, 2012), the study recruited

273 patients that were civilians trauma survivors that were referred by general practitioners,

victim support workers , occupational physicians and other academic practitioners (Nijdam J,

2012).I definitely think that when you are performing a study a large amount of patients

participating can get you more accurate results. Once they selected the group of patients which

consisted of male and female (that all had PTSD),they narrowed it down to 140 individuals

through testings, age, not mastering dutch and the simple fact that the people did not want to go

through the treatment.Seventy were allocated to brief eclectic psychotherapy which consisted of

6 sessions. Fifty-two of those patients completed the first phase (74.2%), 10 received 1-5

sessions (14.3%) and 8 did not receive any brief eclectic psychotherapy and the other 70 were

allocated to EMDR total treatment; mean 6.5 sessions, 50 completed (71.4%), 15 received 1-5

sessions (21.4%) and 5 did not receive any EMDR (7.1%) (Nijdam, 2012). The EMDR

treatments were 90 minute sessions which consisted of viewing the most distressing images from

their traumatic experience (Nijdam, 2012). The patients were asked to focus on the image while

doing certain tasks until they had a neutral feeling from the picture (Nijdam J, 2012). I feel that

this type of study would be more effective because it is straight to the point and altho it may be a

more harsh way of doing the study it helps in the end. I also believe that because the sessions

were longer than the BEP they were able to complete the study faster. The BEP sessions were

45-60 minute sessions that consisted of psychoeducation, imaginal exposure,writing assignments

and cognitive restructuring (Nijdam J, 2012).During both studies they had a total of 32 dropouts
(EDMR=20) (BEP=25) for various reasons that included not noticing improvement, patients did

not want to continue the treatments, they experienced a new traumatic event or the patient just

couldn't be located (Nijdam, 2012). I believe that the people that dropped out of the study were

an essential part to the study. They found that EMDR patients PTSD decreased from the original

70/70 patients with PTSD to 4/51 and finally to 3/48 (Nijdam, 2012). In conclusion they found

that the EMDR and BEP had equal effects in terms of reducing PTSD symptoms. The EMDR

definitely led to faster symptom decline and the BEP was a more gradual decline (Nidjam,

2012); both of these treatments proved effective through proper testing.I believe that this was a

good study because they had a very controlled group of patients and they all went through the

exact same treatment for the exact period of time. Altho during the study they had people that

decided not to further their part in it , I believe that it was a necessary part to the study because it

added more information to the procedure.

The next study I read was about Treatment of traumatized refugees with basic body

awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a

randomised controlled trial (Nordbrandt, Carlsson, Lindberg, Sandahl, & Mortensen, 2015).

The first part of the study was to recruit members 310 to be exact, altho they only expected 200

to successfully finish the study (Nordbrandt et al,2015). Altho they only expect 200 to finish the

study in my opinion that that is a good amount of participants to get accurate information for the

study. A majority of the patients were expected to be from the Middle East with the biggest

proportion originating from Iraq followed by Palestinians, Afghans and Irans (Nordbrandt et

al,2015).I believe that this is a good control method because most of the people from the Middle

East have all experienced almost the same type of trauma and have the same type of PTSD. For
this study The patients were randomised into three groupsWhile one of the three groups is a

control group and solely receives TUA , the other two groups receive add-on treatment in the

form of physical activity. One of the groups was assigned Basic Body Awareness Therapy

(BBAT) while the other group is assigned to mixed physical activity (MPA). For all three

groups the treatment period was approximately 6-7 months long (Nordbrandt et al,2015).

During the study every patient was assigned one regular physiotherapist during the whole

course of the treatment. To ensure consistency regarding the treatment both physiotherapist are

manualized and the physiotherapist have been trained in using the manuals (Nordbrandt et

al,2015). BBAT is a body-oriented psychotherapeutic approach. BBAT uses perspective on

physiotherapy treatment directed toward an awareness of how the body is used, in terms of body

function, behavior and interaction with the self and others (Nordbrandt et al,2015). While the

patients attended their weekly interviews they would fill out the Harvard Trauma Questionnaire

And the Hopkins Symptom Checklist which are both self administrating rating scales assessing

the severity of anxiety and depression symptoms as well as severe PTSD symptoms; all the data

was collected through the self administration rating charts (Nordbrandt et al,2015).I feel that this

is an excellent way to collect data because the patients can fill out the questionnaire in private

and not be worried about what someone else thinks of them and they can be open and honest.The

results of the study I found in a different article Refugee experiences of individual basic body

awareness therapy and the level of transferences into daily life. An interview study. (Madsen,

Carlsson, Nordbrandt and Jensen, 2016) The results of the study were that The participants

experienced the movements in the BBAT as small and simple with big effects.BBAT was found

to relieve pain and tension, bring peace of mind and body, and make it easier to sleep. Regular
practice was necessary, as were instructions from physiotherapists, to get the effect from the

BBAT. Positive changes in the contact to oneself and others were experienced and new coping

strategies were developed. Over all the participants in the study had positive effects from the

BBAT which they could transfer to their everyday lives.

The final study was about Breathing- Based Meditation Decreases Post-traumatic Stress

Disorder Symptoms In U.S. Military Veterans: A Randomised Controlled Longitudinal Study.

(Seppala, Nitschke, Tudorascu, Hayes, Goldstein, Nguyen...Davidson, 2014).In the beginning of

this procedure they chose to only use men that were 18 years or older that served in Afghanistan

or Iraq (Seppala, 2014).This study had 21 participants that were separated into two groups.I feel

that having only 21 patients is not enough to give proper information for this type of study, I

think it should have more participants to get more accurate results. The patients were allocated

into two groups the Active group and the Control group, both groups participated in the same

treatment just at different times.All participants completed a self-report assessment...One

Participant In the active group dropped out after the third day because he disliked the

intervention (Seppala, 2014). The active group participated it Sudarshan Kriya yoga which is

A group-oriented, manual-based, controlled breathing meditation intervention that focuses on

several types of breathing exercises with periods of discussion and stretching (Seppala, 2014). I

find this meditation to be one of the better types because it's not just sitting in peace and quiet, it

gives you a chance to have discussion and stretch in a comfortable environments. They

performed tests on the participants of the study that consisted of Reexperiencing, Avoidance,

Startle in the light and dark and respiration, the patients were recorded two times. For the first

trial all the patients had high levels of PTSD, Reexperiencing, Avoidance,Etc , the second trial
showed that they had a decrease as the patients began to feel more comfort with the exercise

(Seppala, 2014). The results of this study had a positive outcome as the patients felt that this was

a realistic practice they could continue throughout their live to reduce their PTSD. In conclusion

Sudarshan Kriya yoga showed the strongest effect on hyperarousal, and reexperiencing

symptoms, and consistent with improvements in hyperarousal symptoms, also on generalized

anxiety and arousal symptoms. These findings are promising given that all of these PTSD

symptoms, hyperarousal yields the strongest influence on health-related quality of life in

returning veterans ( Doctor, Zoellner & Feeny, 2011). Furthermore, the lack of a correlation

between continued practice and changes in PTSD and anxiety symptoms suggests...the benefit of

Sudarshan Kriya yoga program for PTSD (Seppala, 2014). I personally believe that this is the

best method to help treat PTSD because it gives the patient time to think and focus on the

positives and negative feelings that they are experiencing as well as giving them the opportunity

to talk about it after.

These procedures are the new ways to treat PTSD. They will give more options to people

that suffer from PTSD that can be cheaper in cost than the prices of multiple antidepressant

medications. These Procedures are similar in a way because they all focus on bringing peace of

mind to PTSD patients by discussion and Weekly sessions of therapy. I noticed that throughout

the procedures all of the patients from completely different studies filled out the same type of

paperwork to chart their progress of anxiety and depression and how they improved through their

participation in the procedure. I believe that the Breathing Based Meditation is the best option

because it can be done in the comfort of the patients home with their family and it will cost

nothing for the families that have family members with PTSD. I believe it is important for PTSD
patients to have the knowledge of theses different types of treatments because antidepressants

aren't always the answer to mental pain, the pain is inside of the patient and only they know how

they truly feel. In the end it is the patient's choice if they choose antidepressant medication or try

the alternatives.
 References

Nijdam, M. J., Gersons, B. P., Reitsma, J. B., de Jongh, A., & Olff, M. (2012). Brief eclectic

psychotherapy v. eye movement desensitisation and reprocessing therapy for

post-traumatic stress disorder: randomised controlled trial. The British Journal of

Psychiatry, 200(3), doi: 10.1192/bjp.bp.111.099234

Nordbrandt, M. S., Carlsson, J., Lindberg, L. G., Sandahl, H., & Mortensen, E. L. (2015).

Treatment of traumatised refugees with basic body awareness therapy versus mixed

physical activity as add-on treatment: Study protocol of a randomised controlled trial.

Trials, 16(1), 1. doi: 10.1186/s13063-015-0974-9

Seppl, E. M., Nitschke, J. B., Tudorascu, D. L., Hayes, A., Goldstein, M. R., Nguyen, D. T., ...

& Davidson, R. J. (2014). Breathing-based meditation decreases posttraumatic stress

disorder symptoms in US Military veterans: A randomized controlled longitudinal study.

Journal of traumatic stress, 27(4), 397-405. doi: 10.1002/jts.21936.

DOI:http://dx.doi.org/10.1016/j.jbmt.2015.10.007

URLhttps://www.emdr.com/what-is-emdr/

Website TitleEMDR Institute EYE MOVEMENT DESENSITIZATION AND

REPROCESSING THERAPY

Article TitleWhat is EMDR?

Date AccessedMarch 16, 2017