Posts Tagged ‘PTSD’

What if PTSD Is More Physical Than Psychological?

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A new study supports what a small group of
military researchers has suspected for decades:
that modern warfare destroys the brain.
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By ROBERT F. WORTHJUNE 10, 2016
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In early 2012, a neuropathologist named Daniel Perl was examining a slide of human brain tissue when he saw something odd and unfamiliar in the wormlike squiggles and folds. It looked like brown dust; a distinctive pattern of tiny scars. Perl was intrigued. At 69, he had examined 20,000 brains over a four-decade career, focusing mostly on Alzheimer’s and other degenerative disorders. He had peered through his microscope at countless malformed proteins and twisted axons. He knew as much about the biology of brain disease as just about anyone on earth. But he had never seen anything like this.
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The brain under Perl’s microscope belonged to an American soldier who had been five feet away when a suicide bomber detonated his belt of explosives in 2009. The soldier survived the blast, thanks to his body armor, but died two years later of an apparent drug overdose after suffering symptoms that have become the hallmark of the recent wars in Iraq and Afghanistan: memory loss, cognitive problems, inability to sleep and profound, often suicidal depression. Nearly 350,000 service members have been given a diagnosis of traumatic brain injury over the past 15 years, many of them from blast exposure. The real number is likely to be much higher, because so many who have enlisted are too proud to report a wound that remains invisible.
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For years, many scientists have assumed that explosive blasts affect the brain in much the same way as concussions from football or car accidents. Perl himself was a leading researcher on chronic traumatic encephalopathy, or C.T.E., which has caused dementia in N.F.L. players. Several veterans who died after suffering blast wounds have in fact developed C.T.E. But those veterans had other, nonblast injuries too. No one had done a systematic post-mortem study of blast-injured troops. That was exactly what the Pentagon asked Perl to do in 2010, offering him access to the brains they had gathered for research. It was a rare opportunity, and Perl left his post as director of neuropathology at the medical school at Mount Sinai to come to Washington.
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Perl and his lab colleagues recognized that the injury that they were looking at was nothing like concussion. The hallmark of C.T.E. is an abnormal protein called tau, which builds up, usually over years, throughout the cerebral cortex but especially in the temporal lobes, visible across the stained tissue like brown mold. What they found in these traumatic-brain-injury cases was totally different: a dustlike scarring, often at the border between gray matter (where synapses reside) and the white matter that interconnects it. Over the following months, Perl and his team examined several more brains of service members who died well after their blast exposure, including a highly decorated Special Operations Forces soldier who committed suicide. All of them had the same pattern of scarring in the same places, which appeared to correspond to the brain’s centers for sleep, cognition and other classic brain-injury trouble spots.
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Then came an even more surprising discovery. They examined the brains of two veterans who died just days after their blast exposure and found embryonic versions of the same injury, in the same areas, and the development of the injuries seemed to match the time elapsed since the blast event. Perl and his team then compared the damaged brains with those of people who suffered ordinary concussions and others who had drug addictions (which can also cause visible brain changes) and a final group with no injuries at all. No one in these post-mortem control groups had the brown-dust pattern.
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Continued in response section
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The Nine-Step Method for Transforming Trauma: Peter Levine

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The first thing is to create a sense of relative safety. You have to help the person feel just safe enough to begin to go into their bodies.
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Then, from that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations. And we do it, again, only a little bit at a time, so they “touch into their sensations” then come back into the room, into themselves.
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“From that sense of relative safety created by the therapist and the environment, we help the person to support initial exploration and acceptance of sensations.” The third step is a process I call “pendulation.” That’s a word I made up – what it means is that when people first begin to experience their body sensations, they actually feel worse for a moment. It is probably largely because they have avoided their sensations. So when they feel them, they feel worse.
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This is like a contraction. But what I have discovered is when you help support people, they discover that with every contraction there is an expansion. So if they learn to stay with these sensations just momentarily long enough, it will contract but then it will expand. And the rhythm between contraction and expansion, that gives people the sense of, “Oh my God, I’m going to be able to master this!” you know?
“Pendulation is the rhythm between contraction and expansion . . . titration is about carefully touching into the smallest drop of survival-based arousal.”
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So, again, when they get the sense or rhythm of contraction/expansion, it needn’t then become threatening. It just becomes, “Oh, okay, I’m contracting, and now I’m expanding.”
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The fourth step, which is really the first, and the second, and the third, and the fourth, fifth, sixth, seventh and eighth, is what I call “titration.” And by titrating, by just dosing one small amount of experience at a time, this creates an increase in stability, resilience, and reorganization of the nervous system. So titration is about carefully touching into the smallest drop of survival-based arousal.
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Dr. Buczynski: So sort of like a homeopathic approach to trauma? A homeopathic dose level of approaching body experiences?
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Dr. Levine: Yes! Yes, that’s it! Yes, that is a really good analogy – and it may be more than just an analogy. You know, we have a number of homeopaths, particularly in the European and South American trainings – and, you know, they get it, they really get it; you know, the idea of the smallest amount of stimulus that get the body engaged in its own self-defense mechanisms.
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Then the fifth step is to provide corrective experiences by helping them have active experience that supplants or contradicts the passive response of collapse and helplessness. So as they recover active responses, they can feel empowered – they develop active defensive responses.
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“As they recover active responses, they can feel empowered – they develop active defensive responses.” When animals are in the immobility response, when they are in the shut-down state, it’s normally time-limited.
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Continued in response section.
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Somatic Experiencing

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Dr. Levine: When I first started developing my approach to trauma, I noticed how many different kinds of seemingly ordinary events could cause people to develop symptoms that would be later defined as trauma, as PTSD.
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I also was really curious why animals in the wild don’t develop the same symptoms – because the parts of the brain that respond to stress are quite similar in all mammals, including humans. And if animals became so easily traumatized, they probably would never survive because they would lose their edge. They wouldn’t survive, nor would the species survive.
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So I realized there must be some powerful innate mechanism that helps people rebound; that sort of resets our nervous system after highly arousing encounters with stress. And I discovered that these reactions that reset the nervous system are identical with animals and with people. The difference is that we learn to override it because of our fear of powerful sensations.
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“I discovered that these reactions that reset the nervous system are identical with animals and with people. ”
I know it is an oversimplification, but the basic idea is to guide people to help them recapture this natural resilience. We can do this through helping them become aware of body sensations. And as they become aware and are able to befriend their body sensations, they are able to move out of these stuck places.
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I realized that trauma was about being stuck in these high levels of arousal or in low-level, shut-down levels of arousal and dissociation. So it really became a matter of learning how to help the people to contain these sensations and help them to move through, back into life, to discharge, as it were, these high-levels of activation.
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“It really became a matter of learning how to help the people to contain these sensations and help them to move through, back into life, to discharge, as it were, these high-levels of activation.”
In animals – and in humans – I noticed that trauma has a particular type of sequence involving shaking and trembling.
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We can help move these people out of these high states of hyper-arousal back into balance, back into equilibrium, and how to help people come out of shut-down and dissociation, and come back into life. We discovered that it was possible to do this in a safe way; in a way that really largely ensured that people weren’t overwhelmed.
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Back in the 1970’s, there were some cathartic therapies that would lead to really big reactions, and often people would feel better after that – probably, at least in large part, because there was a releasing of endorphins and catecholamines, adrenalin-like hormones, and neurotransmitters, and so people, in a way, felt a tremendous relief, even a high. But then they would go back into the same trauma patterns afterward.
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So I realized that, if you just overwhelm the person, the nervous system really can’t tell the difference between the trauma and just being overwhelmed/overloaded in the same way.
“If you just overwhelm the person, the nervous system really can’t tell the difference between the trauma and just being overwhelmed/overloaded”
So that really is the basis of the core aspects of somatic experiencing. And because it was a naturalistic way of approaching things – learning from animals in the wild, from ethology (I actually called my first book Waking the Tiger, dealing with trauma) – to awakening those resilient instincts that exist within us because we are mammals.
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Lifes challenges

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King Bird of Paradise, New Guinea
Photograph by Tim Laman, National Geographic
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Life’s challenges are endless, our ability to let go must mirror that.
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Set backs, struggles, losses, and suffering visit all of us at different times.
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Resilience is needed.
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Daily Mindfulness practice builds a resilient soul.
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We practice when things are going well, to endure when things blow up.
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Mindfulness therapy works as well as anti-depressant drugs, major new study finds

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Ian Johnson:
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Therapy based on the controversial concept of ‘mindfulness’ works as well as some anti-depressant drugs, according to a major new study.
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Inspired in part by Buddhist philosophy, mindfulness involves training the brain to deal with negative emotions using techniques such as meditation, breathing exercises and yoga.
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Some critics have claimed mindfulness techniques can bring on panic attacks and lead to paranoia, delusions or depression.
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But the new study – the largest-ever analysis of research on the subject – found mindfulness-based cognitive therapy (MBCT) helped people just as much as commonly prescribed anti-depressant drugs and that there was no evidence of any harmful effects.
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People suffering from depression who received MBCT were 31 per cent less likely to suffer a relapse during the next 60 weeks, the researchers reported in a paper in the journal JAMA Psychiatry.
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Professor Willem Kuyken, the lead author of the paper, said: “This new evidence for mindfulness-based cognitive therapy … is very heartening.
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“While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term.”
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Professor Kuyken, an Oxford University clinical psychologist and director of the Oxford Mindfulness Centre, and other experts around the world have set themselves an ambitious target.
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“We need to do more research, however, to get recovery rates closer to 100 per cent and to help prevent the first onset of depression, earlier in life,” he said.
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“These are programmes of work we are pursuing at the University of Oxford and with our collaborators around the world.”
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He stressed that while mindfulness may share a “lineage” with Buddhism and other “contemplative traditions”, the way it was used in mindfulness-based cognitive therapy was “entirely secular”.
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“It makes complete sense to me that this wonderful faculty of thinking can both get us into trouble and also get us out of trouble,” Professor Kuyken said.
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“It’s a sort of mental training. It’s about training the mind so people can see negative thoughts, negative feelings, the early signs of a depressive relapse, and learn the skills to respond to those in a way that makes them more resilient.”
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A woman in one of his classes would start to have thoughts such as “I’m no good, I’m not a very good mother, I’m going to mess up my children and they are going to suffer from depression as I do”, he said.
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But, after the training, Professor Kuyken said the woman was “able to recognise her negative thoughts as negative thoughts not facts, and not engage with them as much”.
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“She developed a metaphor of a wrecking ball. Instead of being knocked over, she’d stand back and let the wrecking ball swing through her mind,” he added.
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Mindfulness has won the backing of NHS advisory body, the National Institute for Health and Care Excellence (Nice), and the Mental Health Foundation research charity. A study published in the Lancet last year also found mindfulness could be as effective as drugs.
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Nothing can be changed, altered, improved until awareness arrives

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Beech Forest, Germany: Photograph by Martin Hertel, Your Shot
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“Awareness is the greatest alchemy there is.
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Just go on becoming more and more aware,
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and you will find your life
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changing for the better in every possible dimension.
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It will bring great fulfillment.”
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Osho

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The Self

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Pieter de Molijn, Dutch, 1595-1661
Prince Maurits and Prince Frederik Hendrik Going to the Chase, 1625
Oil on wood panel
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“Buddhas Brain”
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“The point is to see through the self and let it relax and disperse.”
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