While it's invisible to the naked eye, post-traumatic stress disorder (PTSD) has become the signature wound of the fighting in Iraq and Afghanistan and has already had a negative impact on hundreds of thousands of American soldiers and their families.
An often disabling anxiety disorder that can develop following exposure to one or more traumatic events, PTSD, studies show, has affected at least 30 percent and as many as 50 percent of combat veterans in this war, and we're now beginning to see the affects: increases in depression, spousal abuse, drug and alcohol abuse, homelessness and even suicide.
Yet there is still raging disagreement as to how to best to treat PTSD. Late last year, when for a Newsweek story I interviewed Dr. Matthew Friedman, who runs the Veteran Administration's National Center for PTSD, he told me that extensive research by the agency has concluded that two approaches appear to be the most effective. One, called cognitive-processing therapy, seeks to help the sufferer by identifying and changing dysfunctional thinking, behavior, and emotional responses. The other, prolonged-exposure therapy, consists of reliving and confronting the trauma and learning to think differently about it.
In his Seattle PI Military Wire blog, Michael Schindler flatly states that those methods for treating PTSD are simply falling short and mentions a new book by psychologist Dr. Frank Lawlis titled 'The PTSD Breakthrough: The Revolutionary, Science-based Compass RESET Program,' in which Lawlis offers a new paradigm for PTSD:
Matthew Kiernan of the Hartford Courant suggests that another new PTSD treatment may spring out of a new two-year University of Connecticut study funded by the Dept. of Justice that will compare the effectiveness the more traditional and widely used "prolonged exposure" therapy, in which patients face their fears while concentrating on hurtful memories, with a newer treatment that focuses on increasing a veteran's skills for controlling anger and other emotions.
The UConn researchers say they hope that the new TARGET therapy - an acronym for Trauma Affect Regulation: Guide for Education and Therapy ' which helps to deal with stress when it arises, will be found as effective as the well-established prolonged exposure method.
But a fast-growing number of therapists believe the most effective treatment for PTSD is something called EMDR (Eye Movement Desensitization and Reprocessing). Dr. Adrienne McFadd, a San Diego psychologist who's been in practice in San Diego for many years and has always worked with military families, currently works with with a number of veterans with traumatic stress conditions. She believes EMDR, of which some therapists remain skeptical despite a growing list of studies that show its efficacy, is the most effective therapy for PTSD.
'EMDR is an approach which helps the person and their brain 're-process' the traumatic experience in a way which finally neutralizes it of its disturbance,' explains McFadd. 'The brain and the self both want to heal. Trauma is stored with memories of the images, smells, sounds, actions, feelings and negative thoughts about self, all of which are so disturbing that the brain veers away from it, avoids it, but doesn't effectively 'digest' it, so it's stuck and unable to heal. EMDR provides a much safer format for the person to 'digest' what happened mentally and emotionally, so that it gets into the past. It's kind of like the trauma is stored in a mental closet, and it's in there banging around, leaking out, and making trouble for the person. EMDR gets it out of the closet and into a history book up on the shelf.'
McFadd, who is planning a trip to Liberia next month to do some training about trauma and trauma treatment for people affected by the recent civil war there, adds that EMDR does this with a carefully written treatment plan. 'The EMDR therapist helps the person re-tell the story, but with sensory distractions and supports that actually assist the brain in dealing with it without being overwhelmed all over again,' she says. 'It's scary to think of doing it, but the person is in so much control throughout that they actually sometimes wind up feeling almost triumphant by the end of the process.'