Overcoming the Past

by F.

A newish treatment for PTSD:

Developed by Edna Foa, a University of Pennsylvania psychologist, this controversial treatment plunges patients into a painful memory in an attempt to restart the healing process. For it to work, patients have to re-experience the stark terror by repeatedly describing the incident in vivid detail. The aim is that, over time, they become desensitised to the narrative and the memory’s harmful hold starts to weaken.

The treatment is designed for trauma survivors still tormented by nightmares, anxiety, flashbacks or irritability more than three months after an event. Therapists all over the world are being trained in the technique to help victims of sexual assault, combat, car crashes, terrorist attacks and natural disasters. They have already treated survivors of Hurricane Katrina and the Pakistan earthquake.

How does it work? Here’s a description of how a survival of the recent Asian tsunami got over her traumatic memories:

Adi sobbed and shook as she told Nacasch about the most harrowing moments. When she finally finished, the doctor said, “Tell it again.” Afterwards, she handed Adi a taped recording of the session and instructed her to listen to it at home. By the end of the 12 weekly sessions, Adi lost track of how many times she had told the story.

Today, she recounts the story with as much emotion as if she were ordering a take-away. To complete her treatment, she had to face difficult situations, such as going to crowded places, finally working her way up to a trip to the beach. Slowly, the nightmares and phantom pains stopped. “The tsunami is somewhere in my head, but I don’t have to think about it every day.”

More in the FT. JAMA has endorsed this treatment, though remember than medical studies generally aren’t that reliable. According to a paper on the reliability of medical studies,

Of 49 highly cited original clinical research studies, 45 claimed that the intervention was effective. Of these, 7 (16%) were contradicted by subsequent studies, 7 others (16%) had found effects that were stronger than those of subsequent studies, 20 (44%) were replicated, and 11 (24%) remained largely unchallenged. Five of 6 highly-cited nonrandomized studies had been contradicted or had found stronger effects vs 9 of 39 randomized controlled trials (P = .008).

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