PTSD: Treatment–Part Six
Thus far, I’ve enumerated several PTSD treatments, such as Cognitive Behavioral Therapy and the beta-blocker medication Propranolol.
Fortunately, the field of psychotherapy is constantly evolving. New advances are made each year.
One such advancement was made by Dr. Bessel van der Kolk, a specialist at the Trauma Center in Boston. His story, and treatment techniques, are described in detail in a New York Times Magazine article (see link below). It’s worth reading in its entirety, but I will provide a synopsis here.
Dr. Van der Kolk, who himself experienced trauma as a child, initially utilized traditional techniques to treat PTSD survivors. However, he soon grew disenchanted with both CBT and talk therapy. He felt that forcing people to voice their most traumatic recollections only made things worse.
Instead, he embraced something called Psychomotor Therapy.
The Pesso Boyden System Psychomotor website describes it as follows:
Created in 1961 by Albert Pesso and Diane Boyden-Pesso, Pesso Boyden System Psychomotor (PBSP) is the most advanced therapeutic system available for emotional re-education or reprogramming. PBSP heals past emotional deficits using unique processes called ‘Structures’ and ‘Microtracking™’ that help clients to identify emotional deficits and create ‘new memories’. These ‘new memories’ provide symbolic fulfillment of the basic developmental needs of place, nurture, support, protection and limits. With the inclusion of ‘Holes and Roles,’ the latest innovation in PBSP theory and technique, therapists learn how to provide a highly effective and streamlined approach to reducing resistance, negative transference, and somatic overload. Many aspects of PBSP theories and techniques have close parallels in recent neuroscience findings about mirror neurons, empathy, morality, and the impact of language on the theory of mind.
This practice is rather controversial. Some psychotherapists embrace it, while others swear by “traditional” treatment methods. Its holistic nature sometimes repels those who adhere to a more strict empirical mindset.
Personally, I have never tried it in my own recovery–all I know is what little I’ve gleaned from the rather sparse literature on the subject.
In the article, Van der Kolk leads a group session for trauma and PTSD survivors. His main subject is an Iraq War veteran named Eugene, who endured the full horrors of war and returned home a scarred and broken man.
One of his most painful memories involves killing an innocent man.
The treatment would proceed thus:
Eugene would recreate the trauma that haunted him most by calling on people in the room to play certain roles. He would confront those people — with his anger, sorrow, remorse and confusion — and they would respond in character, apologizing, forgiving or validating his feelings as needed. By projecting his “inner world” into three-dimensional space, Eugene would be able to rewrite his troubled history more thoroughly than other forms of role-play therapy might allow. If the experiment succeeded, the bad memories would be supplemented with an alternative narrative — one that provided feelings of acceptance or forgiveness or love.
In this case, the memory to be dealt with is his killing of an innocent Iraqi man, then seeing the anguished mother wail over his body.
The group participants are now drawn into the story. Each assumes the role of a protagonist, with Dr. Van der Kolk playing “the witness” to Eugene’s pain, allowing him to acknowledge and validate his suffering.
One person plays the role of a “contact person,” gently squeezing Eugene’s hand if the pain becomes unbearable. Another becomes Eugene’s ‘ideal father,’ “a character whose role is to say all the things that Eugene wished his real father had said but never did.”
Lastly, and most crucially: one person assumes the role of the man Eugene killed, while another acts out the part of the victim’s mother.
Now, Eugene finally gets a chance to speak to the man he killed, and to his mother. He can tell them how truly sorry he is, how he wishes he could take it all back. He can express the full range of his emotions–anguish, sadness, regret, guilt.
There is no condemnation or judgment here. He can say all the things he has held back which were eating him alive inside.
The participants playing the victim and his mother then gently reassure Eugene. They tell him they forgive him, that wartime is unpredictable and uncontrollable, and that things happen that are beyond anyone’s control. They give Eugene the emotional release he has been denied for so long.
(Read the article to find out more about the aftermath of this therapy session.)
Personally, it strikes me as legitimate, but I cannot be certain unless I experience it myself. It may still be best to take “the safe route” and try the more tried-and-true methods (Cognitive Behavioral Therapy, Cognitive Processing Therapy, medication, or a combination thereof).
However, for those whose trauma remains unaffected by this treatment, Psychomotor Therapy may work. It goes without saying that it should be done in a serene, nurturing environment, under the guidance of a qualified therapist who can gently bring the client to a place of healing and recovery.
Thank you for reading…and be well.