Books of Therapeutic Interest

Amazon Preview


Readability Level

Statcounter HCT


Google Item

My Photo

See Your IP Address

Miscellaneous

Psychology and Philosophy

October 23, 2008

Center for Mind-Body Medicine Wins DOD Grant to Study Methods for Treating PTSD, Depression in Returning Veterans

DEPARTMENT OF DEFENSE AWARDS GRANT TO THE CENTER FOR MIND-BODY MEDICINE

Date: October 22, 2008

The Washington, DC based Center for Mind-Body Medicine (CMBM) announced today that it has been awarded a $411,000, two-year grant from the newly formed Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, for a randomized controlled trial (RCT) to study the effectiveness of the CMBM’s comprehensive, non-drug approach to treating post-traumatic stress disorder and major depression with troops returning from Iraq and Afghanistan, and their families. This study, whose principal investigator is the CMBM founder and director, James S. Gordon, MD, will be undertaken at the Southeast Louisiana Veterans Healthcare System, and is entitled “A Randomized Controlled Study of Mind-Body Skills Groups for Treatment of War-Zone Stress in Military and Veteran Populations.”

The study will test the effectiveness of CMBM’s model, which includes mind-body approaches (meditation, guided imagery, biofeedback, and yoga) and self-expression in words, drawings, and movement, in supportive, educational small groups. The groups will be led by VA clinicians who have been trained by Dr. Gordon and his CMBM faculty and will be offered to veterans and their families on weekends over the course of three months.

Dr. Gordon’s model is widely used with anxious and depressed people and those with chronic illness in the US, and has already been incorporated as a stress reduction program for students in a dozen US medical schools. Dr. Gordon describes his groundbreaking approach in detail in his new book, Unstuck: Your Guide to the Seven Stage Journey Out of Depression (published by The Penguin Press; June 2008). “This model is educational, non-stigmatizing, and powerfully effective. It can be easily taught and can be used by people of all ages on their own,” Dr. Gordon explains. “Veterans and their families will have the opportunity to share their experiences and challenges in a supportive group and learn techniques which have proved swiftly effective in reducing symptoms of stress and improving mood. They will, often quickly, experience a sense of control and calm and feelings of hope that many of them felt they might never again have.”

The study made possible by the Department of Defense’s grant will further demonstrate that the Center’s model can be used to produce significant and lasting changes in levels of anxiety, agitation, and anger, in flashbacks and nightmares, and in symptoms of withdrawal and numbing in highly traumatized soldiers and their families.

This model, which Dr. Gordon presents in a step-by-step self-help format in Unstuck, is currently being used by CMBM with war traumatized populations in Kosovo, Israel and Gaza as well as in post-Katrina southern Louisiana. In August 2008, CMBM published a landmark study on the use of its model to treat posttraumatic stress disorder in war-traumatized children in Kosovo. The study, which was published online in the Journal of Clinical Psychiatry, is the first RCT ever of any intervention with war-traumatized children, and is also the first RCT of a successful, comprehensive mind-body approach with any traumatized population.

From October 25 - 29, 2008, Dr. Gordon and his CMBM colleagues will begin training more than 100 active duty and VA clinicians from across the country in the CMBM model. These men and women will then be able to incorporate the CMBM approach in their work with US Veterans returning from Iraq and Afghanistan.

Projects Target PTSD-Related Relationship Aggression

"Living with posttraumatic stress disorder (PTSD) can strain any relationship—sometimes to the point of violence against a loved one. University of Arkansas psychologist Matthew T. Feldner, Ph.D., is part of two national research projects aimed at preventing relationship aggression in couples coping with PTSD and treating this type of aggression when it has already developed.

“The main aims of these projects are to reduce the number of new cases of interpersonal violence and reduce the number of cases already existing,” Feldner says. “We teach couples skills for better relationship behaviors, such as how to communicate better and how to manage anger.”

All people receiving these interventions will be closely monitored and referred for more intensive individual therapy should the need arise. Rather than going back to focus on the roots of the PTSD, Feldner says the couples in these interventions “will focus on the here and now of how the PTSD is affecting their relationship.” While teaching couples about the features of PTSD and improving their relationships, the group treatment can also serve as a gateway to further treatment for PTSD and other services.

If these interventions succeed in preventing or treating relationship aggression, Feldner says that these would be groundbreaking, landmark projects. “Ultimately, we are hoping we can conduct these interventions in such a way that they could be useful for the VA and could be extended to community populations as well, for situations that are not specifically military,” Feldner says."

— Source: University of Arkansas, Fayetteville

October 20, 2008

"Yoga for the Nervous System: Healing Anxiety, Insomnia and PTSD"

Shavasana The above title -- promising, no?! let's hope it also delivers -- is the name of a "weekend intensive" class being given in mid-November at the famous Kripalu Center for Yoga and Health in the Berkshires (Western Massachusetts, close to the New York border.)  Information about the class is linked here.

(For more links to blog posts where we've talked about yoga and PTSD, click here. For more about the larger topic of mind-body medicine, which includes yoga, click here. For more on a yet still more comprehensive topic, PTSD and Complementary and Alternative Medicine, which includes mind-body medicine, click here.)

According to the Kripalu Center's brochure:

"Unlock the power of your mind-body network to relax your physical body, calm your mind, and quiet your nervous system.  Conditions such as anxiety, insomnia and post-traumatic stress disorder (PTSD) involve hyperarousal of the nervous system along with the mental, emotional and physical [aspects of our] bodies.  If this activation becomes chronic, the neuro-emotional patterns that result can compromise your physical health, emotional well-being, and creative potential.

Fortunately, the neural pathways to relaxation and calm exist in each one of us.  Those pathways simply need to be discovered and activated repeatedly to alter the state of the nervous system.

This transformative weekend intensive will include:

  • Elemental Yoga, a transformative, therapeutic, alignment-based, slow vinyasa practice;
  • Meditation;
  • Restorative yoga; and
  • Pranayama (breathing) exercises designed to balance the nervous system and emotional [aspects of the] body;


Psychologist and yoga therapist Bo Forbes will draw from her extensive experience in clinical psychology and mind-body therapeutics to help you learn to activate the neural pathway[s] to relaxation and catalyze the emergence of your extraordinary inner potential.

About Bo Forbes:
Bo Forbes, PsyD, E-RYT500, is a leading clinical psychologist, yoga teacher, and yoga therapistBo Forbes in the Boston area.  She is the founder of Elemental Yoga, director of the Center for Integrative Yoga Therapeutics in Cambridge, Massachusetts, and a contributing writer for Yoga Journal and Body & Soul magazines. 

(There's also an interesting interview with Bo Forbes on the topic of "Narrowing the Gap between Insight and Change: Yoga, Psychotherapy and the Body," linked here.


NOTE: The class says it is for those with "some yoga experience" as a pre-requisite.

Editor's note: For general yoga instructional videos, or yoga for stress videos, see thefollowing, mentioned in the sidebar (column to the left): Gaiam: Yoga For Beginners; Gaiam: Yoga for Stress Relief (With The Dalai Lama); Gaiam: AM/PM Yoga For Beginners (with The Dalai Lama & 10 Routines); and Yoga Journal: Yoga Journal's Yoga for Stress With Dr. Baxter Bell.

The Tao on Transformation: Intentionally Healing Old Wounds

Collage52 Periodically, we quote Deng Ming-Dao's ultra-super-fabulous 365 Tao on various topics.  The reading the other day was a superlative one about the transformational process of healing.  See if you don't agree:

You hurt me years ago;
My wounds bled for years.
Now you are back,
But I am not the same.


"In the past, warriors fought by striking the same points that acupuncturists use. One famous swordsman nearly died in a duel in which his opponent attacked him in such a way. After that, the swordsman became a wanderer and tried to renounce the martial life. Years later, his enemy found him and challenged him to duel again. They fought. In the first flurry of blows, the aggressor stepped back in surprise. The swordsman smiled and said, "I trained for twenty years to move my vulnerable spots." With that, he was finally able to triumph.

Spirituality is a process of inner healing. The wounds of the past can be the greatest obstacles for self-cultivation unless we find them all and heal them. This task can take years, but we must accomplish it.

In many cases, our wounds were inflicted by other people -- enemies. This is subtle. Our enemies can be others on the street, or people much more intimate with us : parents, teachers, siblings, lovers, friends.

If we move away from such people and succeed in our practice, they will have no chance to come back in our lives. How can they? We change whatever made us vulnerable in the first place."

-- Source: 365 Tao, by Deng Ming-Dao.

October 08, 2008

The "Other" Wall: Veterans Walling Themselves Off, and Others Out

Collage54

A while back we wrote that not only veterans have their own personal Vietnams.  One of the key elements in that story is the idea that significant emotions, such as profound grief, strike the individual suffering through them as almost "too powerful" to experience fully in the moment, out of a fear that they will be overwhelmed with such a powerful flood of emotion, and incapable of coping.  The defense mechanism then is to block experiencing so much painful emotion (i.e., grief).  Of course, the unfortunate truth is that grief doesn't go away...it just waits for another, inconvient time to intrude -- becauseit must be dealt with to actually move on (by moving through).

Interestingly, Arthur Egendorf has something to say about this, too, and how it gets folded into a diagnosis of PTSD, perhaps unfairly:

"At such times, vets may decide to let go, to allow a sensitivity that was formerly taboo.  What happens for some, however, is that they then fall prey to a long-held belief that once they let themselves respond [to something] emotionally, the flood of feeling will be too much for them to handle.  Believing that if they really open up they’d be overwhelmed, men worry all the more over emotional outbursts and haunting memories.  The various correlates of this distress, from troubled sleep, to loss of interest in life, to guilt and other complaints, are now lumped together and called “stress disorder.” [now, PTSD.]  What the diagnosis doesn’t say is that if you’re convinced that extremely strong feelings are a sign that you’re sick or weak, then the only options you’ve got are to make yourself numb, or let it all out and think of yourself as crazy…"

-- Source: Healing from the War: Trauma & Transformation after Vietnam, by Arthur Egendorf.  Boston: Shambhala Press (1986)

Egendorf returns to this same theme of veterans freeing themselves up to cultivate a healthy sensitivity to what they've experienced when he writes:

“The tendency among many veterans and the public is to respond to talk of “stress disorder” with the seemingly logical but mistaken idea that what veterans need is to reduce their level of stress.  This idea has the unfortunate effect of encouraging veterans and well-meaning supporters to think that men in pain should shrink from life.  Or one might think that veterans need to change or reprogram their responses, when in fact their horror, rage, guilt and desperation may be quite genuine, [as well as] the signs of a re-emerging sensitivity.  Taking the direction implied by Jung and others, we can simply invite troubled veterans to revise their notions of what kinds of responses are admissible.  For once a man grants himself the freedom to be appropriately upset by what he has seen and done, his reactions subside quite naturally, and he experiences himself as “more himself.” 

Sounds promising...especially since often the veteran's tendency is, to wall one's self off from life and from others, rather than proceeding gingerly, tentatively but nevertheless purposefully -- in a supportive, loving, acceptng and nonjudgmental environment -- to begin to process what's actually been experienced -- at ever step, checking to see whether it's too much, too little, or just enough to integrate. For rather than seeing him or herself as separate entities -- the pre-war and the post-war self -- whatever gets integrated allows the veteran, as Egendorf writes, to experience him or herself as "more" of who they really are.  Wonderful...and the goal.

September 21, 2008

A Hand across the Abyss - How Openness Helps Heal - A Therapist Talks with His Patient, both Vets

Compassion I've recently started reading a very interesting book from the Vietnam era, by Arthur Egendorf, a Ph.D. psychologist who was first a veteran - and later tried to piece together what he had experienced in a way that could also help others.  There may be a sad professional end to the story -- it appears that Egendorf has since lost his license to practice -- however, his work at the time, and the motivation behind it, really seems exceptional. 

Gerald Nicosia writes about him, too, in the excellent "Home to War: A History of the Vietnam Veterans Movement," because Egendorf was instrumental in establishing the veterans' "rap groups" which were an early feature of attempts made to cope with the combat trauma and PTSD Vietnam vets experienced. 

This passage, from Egendorf's book, is remarkable to me for several reasons: Egendorf's own intuitions about healing; his humility, openness and vulnerability with his patient (and friend); their nuanced dance together; and of course, best of all, the effects it actually had on the Marine he helped.  Egendorf's book is out of print, but here and there copies are available used, including on Amazon.  Here's what he wrote:

“If you look, it’s not hard to find veterans who are engaged in healing.  I met one of them eight years ago while visiting a VA hospital.  His name was Jim, an ex-Marine from the Bronx recovering from his latest breakdown, back for another of the hospital visits that began a year after he returned from Vietnam.  I introduced myself as a fellow vet, now a psychologist, who wanted to interview him for a study that would help Vietnam vets.

 
“You want to help me?” he asked.  “For six years I’ve been in and out of this hospital, and I’ve heard enough of shrink talk.  I want to know how you made it.  That’s how to help me.  Tell me how did you get it together?”

 
I responded by making him an offer.  If he would let me interview him, he could ask me anything he wanted.  He accepted and spent ten hours telling me his story.  Before the war he was the kind of youngster teachers like.  He behaved well in class and worked part-time after school.  During his teens he had seen a psychiatrist for “nerves,” but generally had held his own.  In 1969, when he was eighteen, Jim was drafted and goaded into “volunteering” for the Marines, then sent to combat duty in Vietnam.  He saw action in I Corps, in the north of South Vietnam.

 
Ever since he came back, his mother and his wife had been trying to tell him that something was wrong,  For the first year all he did was stay in the apartment, smoke dope, and listen to music.  Then one day while looking out the window he saw a junkie trying to steal the radio from his car.  Jim grabbed a baseball bat, ran after him, and started po8unding the guy so fiercely it took three people to tear him away.  After that he knew he was out of control and went for help.

 
Seven years after coming back, Jim described his burdens this way: “Before I went, I worked for six years.  I was the best assistant manager Martin’s Bargain Store ever had.  I can’t work now.  They messed up my head.  How the hell are you supposed to concentrate after all I’ve been through?  Reality sucks.  It’s not what you know, it’s who you know.  That’s why a nineteen-year-old acidhead or college guy gets out of it.  Who do I know?  My shrink from before the war said I was fine.  Now the VA says I was always cuckoo and my problem’s got nothing to do with the war.  My wife is scared of me.  My family thinks I’m nuts.  We were supposed to be over there fighting for freedom, killing people who never did us any harm.  What are you supposed to do after that?

 
I listened, particularly to what was left unsaid.  He had just started to find some direction in life when the war crashed in.  Then it was “pussy,” as his drill instructors called him, and thirteen months of being constantly threatened with death, and seeing a dozen guys he knew pulverized into heaps of bloody flesh.  Others made fun of him, mocking a grunt from New York who resented the practice of calling Vietnamese “slopes” or “dinks” or “gooks.” When the time came to go home and he looked forward to leaving the mess behind, he found that things didn’t work as he expected.  After coming back he wasn’t anybody’s hero, the afterimages of shattering brutality stayed fixed in his mind, and the business-as-usual reality at home had no room for what he carried inside.


For Jim and many like him, it was not them but the world that was crazy.  What was keeping all of it from blowing up, just like the people and placed he had seen “wasted”?  Presidents give the orders and people die.  It’s like a primitive ritual with human sacrifices to bloodthirsty gods.  Jim was sure about only one thing: The people pulling the strings didn’t care what happened to him.

 
“How’d you get it together? That’s what I want to know,” he kept asking.  Our backgrounds were different, but the war gave us a common bond.  Jim was a ghetto kid who didn’t finish high school before entering the service, whereas I had gone to private school, Harvard, and then Europe for a year of postgraduate study before my draft board notified me.  Unlike him, I never saw a psychotherapist while growing up and was never seriously upset until after I came back, and then never so bad that I couldn’t go to school and hold a job, too.  All the same, he knew.  “Something got to you too, huh?”

 
He tested me to see if I’d open up with him. “People like you go into psychology to straighten themselves out, right?”  Yes, I told him, he was right about that.  After years of taking pills and hearing therapists interpret his past and try to modify his behavior, Jim wanted to “relate.”  It was the same hunger that led a dozen of us to form the veteran rap groups that began meeting in New York City in 1970.  In these groups we asked each other and the therapists who volunteered to assist us in gaining the same openness Jim now wanted.

 
After a few meetings Jim asked to be a regular client.  At the beginning he couldn’t take much – he would miss appointments and “forget” to return my phone calls. Eventually, though, we met more regularly, and he began to thrive on the questions I raised.


What had gotten to him?  What was so troubling?  What made him so vulnerable?  What was he going to do about it now?  How was he going to handle his life?  I didn’t intend for him to answer my questions the way elementary pupils answer their teacher’s drill.  Rather, the idea was for him to use the questions to orient himself, to direct his energies where the questioning pointed.  It was time for Jim to stop telling the same story over and over and to begin living out a new one.

 
The more we worked together, the more he saw opportunities to make himself useful – a gesture that would help his wife, an odd job to pick up some cash, a game he could play with his kids.  He studied enough to distinguish his sensitive reactions from his deluded flights of fancy.  And when he was ready, he acknowledged that his suffering would never make sense o its own.  It would only be valuable if he took it as a lesson, something he could use to remind himself that how he handles his life is up to him.

 
After a few months of groundwork, Jim was out of the VA for good.  Then he got off tranquilizers and stayed away from pot.  In the next year, he and his wife stopped fighting and started talking, and soon after that he was holding a job for the first time since he left the Marines.  Two years after we began meeting he bought his own house and was holding down two jobs.  Instead of complaining about his two kids, which is all he had done when we first met, he’d brag about them.

 
The time came when he raised a more ambitious question.  Given his suffering, and what he’d learned, what purpose would he devote himself to?  “People, I want to do something for people,” he’d say.  One of his dreams was to save enough money to start a summer camp for ghetto kids.  In the meantime, he began seeing the people in his daily lives as the ones to serve.

 
Jim still has bad da