We see clients who were traumatized as children, and yet their experiences may only be bubbling to the surface now. And sometimes, the longer traumatic experiences lie in the subconscious, the more disruptive they can be to our clients’ lives.
But an interesting study conducted by Emory University researchers raises an important possibility. What if we could stop traumatic experiences from taking root earlier? Would our treatments be more effective?
To find the answer, Barbara Rothbaum, PhD and her team offered a behavioral intervention to patients who checked into a local emergency room reporting traumatic experiences like car accidents or sexual assault. After 137 patients accepted, they divided them into two groups – one who received the intervention right away, and another to serve as a control.
The intervention was a modified form of exposure therapy. Over the course of three one-hour sessions, the trauma survivor confronted their anxiety around the experience by describing it to a therapist.
The patients also listened to recordings of their own descriptions every day over the course of the treatment period.
The results were encouraging.
After 4 weeks, they found that trauma survivors who received the treatment had significantly reduced post-traumatic stress reaction compared to the control group. And even 12 weeks after the trauma, the results continued to hold up.
It’s important to note one caveat, though. When you use a wait-list control, you can’t be sure whether patients saw improvements because of the intervention – or simply because they received attention from practitioners. I’d like to see a future study that compares this intervention against another one, so we can rule out the possibility that just spending time with a professional led to the survivors’ improvement.
All the same, this is good news for practitioners who might work with patients soon after they experience traumatic events – possibly physicians, nurses, or maybe even first responders.
But obviously, most of us don’t get the opportunity to treat trauma within days or even months of its occurrence. When clients present with the symptoms of post-traumatic stress, the event may well have occurred years in the past.
So, while it’s good to know that trauma symptoms can be reduced by working with patients immediately after events, we still need more practical tools for helping our clients heal when trauma is buried deep in memory.
That’s the goal behind our Rethinking Trauma Webinar series. We want to make sure practitioners not only know the latest advances, but are able to integrate them into their practice.
And if you’d like to read more about this study, it’s available in Vol. 72, Issue 11 of Biological Psychiatry.
Have you ever worked with a very recently traumatized patient? How was that different from working with a patient who experienced a traumatic event in the distant past? Please share your experience in the comments below.
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I’m a retired School Psychologist who actually got to do therapy – instead of just testing – for 25 years. In that setting I used more traditional “talk therapy”, some gestalt work, and some cognitive behavioral work. However, after I retired I went to several disaster sites – Jonesboro and NYC. In Jonesboro I talked with families who had been frightened but not injured in the shooting. In New York, a team of 3 police officers and 1 mental health specialist used the Critical Incident Stress Debriefing (CISD) model with ALL the police officer who were employed on 9-11 – whether they were on the scene or not. It was a very structured process that involved asking several questions : Where were you working when you heard about the disaster? What is your most vivid memory about the event? If anything good came out of this event, what was it? We also suggested ways to take care of themselves in the following weeks. For first responders (police, fire and emergency personnel) – this seemed to be very effective and effecient way to do a brief intervention with everyone involved. If we deemed any of the participants to be in need of additional counseling, this was readily offered free by professional counselors.
Although the CISD model was designed for first responders, I have often wondered how effective it would be for folks who were more directly affected by a trauma such as a bombing or a natural disaster. I have also wondered about the effectiveness of the body based methods like EMDR and EFT. I understand that a number of EFT faciliators volunteered to do workshops and trainings for the people in Newton. Although the interviews afterward were very positive, no control groups were done.
I’m very interested in reading more about research that actually measures different therapeutic models for dealing with trauma. I think that the sooner we can help people talk about their stress AND do some processes that deal with bodily sensations, the better. An emergency room seems to be an ideal place to do some controlled interventions – if they are not completely overwhelmed by the disaster itself. Thanks for the article and the insightful posts.
I wonder how this intervention is different from CISD, which has been found in some cases to be harmful and generally not effective for preventing PTSD in my understanding.
I have been working with trauma, and stress management for 26 years, as well as teaching workshops of Chi-Aura Integration (www.chiaura.com). I find that a key ingredient of a successful session, and one that may often be overlooked, is the state of being of the practitioner.
When the practitioner enters a deep state of coherency in their heart, as well as enters deep theta brain waves, the fight or flight response in the client can shift when thinking of the traumatic incident. To use EFT terminology, the SUDS level can be reduced to 0 through entrainment with the practitioner.
Traumatic events produce incoherent vibrational patterns in the body. When these incoherent patterns are entrained with a high degree of coherency, and deep theta brain waves in the practitioner, the vibrational pattern changes into coherency. The automatic fight or flight mechanism is no longer activated.
The original event will no longer hold the client hostage in a pattern of panic and anxiety. They can gain a new perspective in their life.
After spending 38 years in aviation, I was witness to many Flight Attendants who had their worldview blown away September 11, 2001. We had the opportunity to set up a peer counseling center at one of the affected airlines Flight Attendant Union Headquarters. Our backup support was from dedicated Mental Health professionals who volunteered with the American Red Cross. Our center consisted of about 15 phone lines and walk in support. It was an amazing way, for me, to spend my last three weeks in the industry and with the company. Still today, over ten years later, I still feel overwhelming gratitude in being able to be a part of such a support for many who were forced to endure and reframe their worklife as they had known it.
Many initial reactions were very emotional and showed tremendous anxiety. Narriatives covered all aspects of many people lives, all trying to find a place to make some sense of the senseless. As time passed, and these people who have very high degrees of flexibility, adaptability, and resilience were able to calm and reassess, or take stock of the situation, the stories became less agitated and emotions ebbed. Not to say that the trauma aspect of 9/11 was ever resolved with many of these persons, however most went on to fly another trip and live another day.
Hopefully, those who were randomized into the control group did eventually receive trauma intervention, paid for by the study, after the study was completed.
Very interesting post. I wonder about how this new finding is placed in the context of the controversy around Critical Incident Stress Debriefing. And utilizing a more mind-body and resource-oriented integrative approach may be an interesting comparison to the more conventional narrative exposure therapy. I also agree that a longer-term follow-up would be warranted to help determine whether the “average” person starts to show PTS symptoms.
Thanks, Ruth, for your continued work in this area!
I read somewhere that some drugs, when taken shortly after the trauma, can prevent or reduce PTSD. I think the drug mentioned in the study was Avlocardyl (Propanolol)
I am a retired RN, disabled. I have had severe, on going trauma with repressed memory from years of sexual abuse, torture, and all the rest of the abuses that come along with the traumatic experiences. I have found that for people like myself who have no memory in their conscious mind but have memory in their cells and energy systems that have caused DIS_EASE, that talking and talking at first, in the beginning of the REMEMBERING the trauma is essential. I imagine it is the shock of the whole experience. Wanting to connect to someone, anyone who could help or perhaps just tell you that you are not in-sane.
In the beginning of my complete breakdown I had no understanding what was happening to me. I knew I had been abused but could not really imagine the horrific nature of the abuse. I believe that once the initial (TRUTH) comes forth and the shock of OMG, no way, this isn’t happening to me wears off that the need to talk excessively about the trauma subsides a bit.
Then the real work of letting go of the trapped energy that has been left behind by the perpetrator or the experiences needs to be confronted and released. Not and easy task, for sure. I personally don’t think that traditional psychotherapy is enough to facilitate full, whole healing, if full healing is to take place then the entire energy system needs an overhaul, if you will.
In answer to your question, YES! The sooner the people/children/animals, etc.. Confront the trauma the less likely it will fester into Real life DIS_EASE! Which has been my experience that the longer the energy systems are blocked, which in turn messes with our other vital systems, as our chakras, meridians, acupressure points, bodily and emotional systems, etc.., the longer treatment will take. However, if not caught before a complete breakdown of our systems occur then there is other issues that have been realized and need to be treated as well. So many victims at this point (SADLY) don’t make it back to wholeness. Treatment for trauma should be started immediately upon remembering or when symptoms come forward, (possibly before symptoms appear) This prevents the stagnant energy from getting stuck in our bodies causing DIS_EASE! This is what I have learned from my studies and life experiences. I hope this helps! Sincerely, Catherine McMartin
It would also be interesting to compare TRE (Trauma Release Exercises) devised by David Bercelli which is entirely body based and not psychological intervention at all.
I agree the study wasn’t very well designed. Didn’t I just see a quote from Dan Siegel saying that relationship, not technique is what works in therapy? Don’t Bessel van der Kolk, Pat Ogden and others say that talk therapy is relatively ineffective for trauma if you don’t also engage the body/brain? It would be interesting to compare a somatic trauma therapy approach with this study results and also a relationship based “supportive therapy” to see how they compare.
Hi Ruth and colleagues,
Thanks for a valuable post asking a very important question! I’ve been a psychotherapist/trauma specialist for 25 years and using EFT (Emotional Freedom Techniques) as a modality for the last 17. A major benefit of knowing EFT/tapping is that it puts a powerful trauma release techniques right at our own ‘fingertips’. I’ve watched both myself and my clients learn how to use this simple tool to address trauma in the moment as it is happening or shortly thereafter with outstanding results across all manner of wellness measurements. Not only does it facilitate the release of current trauma but it also provides a sense of empowerment that is protective against further traumatization.
Warm regards.
Hello All. Well, I think the post-test after 4 weeks is not long enough to tell whether the treatment was because of the attention and connection with the therapists or actually had longer-lasting effects. Other studies have shown that prolonged exposure does not continue long-term to show significant effect on the victims of trauma. I have read of longer-lasting effects of body-based interventions that work with the more slow and gentle methods of, say, the Trauma Resiliency Model (Peter Levine’s short form of Somatic Experiencing) designed as an immediate intervention for victims of Natural Disasters. See traumaresourceinstitute.com for more info on TRM. Thanks NICABM for all your helpful work.
I m sometimes concerned about re-traumatisation. One must be sure about one owns interest. Talking about patients in hospital, no severe trauma. (What about to specify when we talk about trauma? Severe trauma, bad experience?) Is it useful for patients just to talk? What kind of reaktion do they need from nurses and their surroundings? Special contact. When they talk and talk again, what does it mean? Talking about a trauma you can make bad experiences again! I want to respect. And the patients themselves are not sure, they can not control, they are in search for someone, they are struggeling to find somebody who understands.
I am a Humanitarian Aid worker and I have worked in Taliban Afghanistan as well as after 9/11 Afghanistan, altogether for about 6 1/2 years. There is too much to say here. However, according to my experience even older traumatic experiences lost some of their power because recent traumatic experiences of the same person had been addressed soon after the incident. I truely believe in the power of resourcing a person. Re-connecting him/her even for a short time, for a moment makes a big difference if consciously experienced. As if the body which focuses on physical and mental survival prepares the nerveous system to take any chance there is to get better and to restore self regulation. – I think integrating SE (also) in Humanitarian work would be such a benefit, for aid providers and the people in need. I am working on it.