Traumatic Brain Injury
With older adults, the use of psychoactive medications becomes problematic. Side effects of these drugs can worsen age related health issues such as fall risk, memory problems, gait and balance issues, and sleep disturbance. Are there evidence-based therapies that can address the emotional and physical toll of traumatic memories, and are not dangerous medications?
Originally developed for combat veterans who were suffering the effects of combat induced PTSD, memory reprocessing therapies have been used extensively and with good efficacy for refugees, victims of sexual violence, those who have suffered torture and great loss, and other life events that become overwhelming. These overwhelming experiences manifest as both physical and mental health that interferes with a person living to their full potential. For many years, we treated these sort of situations with medications. But over time, new-evidence based therapies have emerged.
Evidence-based is a criteria that is important. It means that the research has been done to show that the treatments work, and because the treatments work, insurance companies can cover the cost of the therapies. The NIH, or National Institute of Health, determines if scientific research is done properly, and broadly enough, that the treatment can be recommended for use across populations.
There are several therapies that are broadly classified as types of psychotherapy, but are quite different from mainstream psychotherapy. These therapies are memory reprocessing therapies, and are therapist led short interventions over a number of sessions that allow the brain to reprocess and reframe traumatic memories.
ART is Accelerated Resolution Therapy. This short therapist guided therapy works with components of memory, but the person does not have to talk about or write about the painful memories. In a safe place, and while relaxed, the person calls up images, sensations, feelings and thoughts associated with the trauma, and by using hand and eye movements guided by the therapist, reprocesses these memories from hidden and dangerous to something from the past. The scientific background includes the use of cognitive science that shows how physical eye movements allows us to process and hide traumatic memories. New associations are processed between the traumatic event and newly developed cognitive insights, and physiological triggers for anxiety and panic are targeted. This therapy has been successfully used with victims of military sexual trauma, combat veterans, and refugees, and studies are ongoing across the country. The VA is using ART at multiple locations.
EMDR is an acronym for Eye Movement Desensitization Resolution, and this therapy also uses eye movements while remembering past traumatic events. Through the guidance of a therapist, and the eye movements, past events are reframed with new adaptive associations. The physiological symptoms that elicit distress are specifically targeted, and triggers are desensitized. New cognitive insights allow for developing new coping skills. Image templates can be used to imagine new stressors and adaptive coping.
Cognitive Behavioral Therapy, or CBT, is the oldest, and involves a number of structured sessions in which a therapist guides a person through understanding of traumatic memories. Many times, CBT involves a person writing about the event, or talking about it. Through a number of sessions, the therapist helps a person reframe the event with other, more positive memories.
In all of these evidence-based short psychotheraputic interventions, patients are given the control and power over life-events that have been previously viewed as destructive and overwhelming. They learn how the brain tries to protect itself from traumatic events, and how to use the ability of the memory to retrieve those destructive and traumatic memories and reframe them into new associations that are manageable.
With the evidence-based label giving these therapies widespread acceptance among medical professionals, and the brief and non-invasive nature of the therapies gaining acceptance among patients, we may find many people who are able to address the consequences of traumatic life events in ways that are safer than traditional medication based therapy.
For more information on therapies for traumatic memories, please contact us.