7 ms·

A Revolutionary Approach to Treating PTSD (2014)

33 points by agronaut 10y ago

acconrad 10y ago
> Psychomotor therapy is neither widely practiced nor supported by clinical studies. Well if this dancer-turned-psychologist is so hellbent on his methods, shouldn't he subject them to the rigor of clinical research? If I were in his shoes and I had a method that showed promise, I'd want to evaluate it against my peers to ensure I have the most eyes available to make it the most effective - in the same way a crypotographer testing a new algorithm would open-source his work to find as many exploits as early as possible to strengthen his work. I want to believe, because my dad suffers from real bad PTSD from Vietnam, but it's quotes like these that immediately suck the life out of any hope I had for ways to help him.
- agronaut 10y ago
  The article goes into that. It's hard to get funding.
  - imagist 10y ago
    Is it, though? Science isn't always an expensive endeavor. Certainly checking in with clients a few years after and comparing outcomes with a control group could be done with volunteers. Setting up a blind can be done with basic survey tools which are available at low cost. The expensive parts of this research are getting facilities and people willing to take an untested treatment. But he already has both those, so I really can only attribute the lack of scientific evaluation to a lack of will to do it.
    - tudorw 10y ago
      while you are essentially correct, I would imagine that a therapy such as this would be hard to 'own' and profit from after successful development, so the sources of funding may well be quite limited compared to the funding available to develop a new drug therapy.
      - Turing_Machine 10y ago
        There's a much higher bar, too, to any form of research that involves human subjects. There's a whole regulatory regime that must be complied with to even get permission to do this kind of research. If the possible downside is high (as it is here... what if the treatment makes the subjects worse and a bunch of them wind up more suicidal than they were before?) the level of required oversight is pretty high. I'm not saying that's a bad thing -- unethical and/or misguided researchers have actively harmed their subjects too many times in the past. Nonetheless, it's something that people who haven't done human subjects research often overlook, and something that can add a huge amount of expense and delay. If you're doing generic CS research* the worst that usually happens is that you have to reboot. We can't reboot people, at least not yet. :-) *If you're doing research on, say, human computer interaction, you generally do have to get human subjects approval, but not usually for compilers, algorithms, or the like. Edit: "people willing to take an untested treatment" That's exactly the rub. The potential subjects for something like this are what's known in the jargon as a "vulnerable group". You have to be very, very sure (and be able to convince a skeptical oversight committee) that your subjects are, in fact, giving their active and informed consent for an experimental treatment. That's quite hard to do for people with severe psychological problems (again, rightly so... some of the abuses of the past make for sobering reading).
        imagist 10y ago
        But he's already performing the treatment on people. He's already skirting the regulations. Merely collecting data on what he's already doing doesn't make it worse.
      - imagist 10y ago
        Let's be clear here: I don't think outside funding is needed. As I described, this isn't expensive. The cost is small enough that it could be paid for out of his pocket and he'd easily recoup the investment if it proves that his technique works. I think the reason he hasn't done studies isn't because of lack of funding, it's because scientifically validating his claims isn't a priority.
    - agronaut 10y ago
      I don't think a small ad hoc study would be taken seriously. The dynamics here are institutional.
      - imagist 10y ago
        It's not about being taken seriously, it's about finding out whether what he's doing actually helps people. You don't need institutions to prove your hypothesis, you need evidence.
    - 0xcde4c3db 10y ago
      It might be hard for Van der Kolk specifically to get funding. The article mentions that he's kind of a pariah because he endorsed the "recovered memory" stuff that led to a lot of lawsuits based on very questionable allegations of child abuse. The leading consensus on this phenomenon is that recovered-memory therapy mostly creates the "recovered" memories. See also the Mandela Effect/Berenstein Bears/Shazaam stuff, where people have seemingly done this to each other spontaneously.
      - imagist 10y ago
        You're missing my point: I think that this could be studied cheaply enough that he wouldn't need outside funding. I'll add that I think the reason he hasn't performed studies on the technique isn't lack of funding, but that validating his claims isn't a priority for him. His background only makes me believe more firmly that evidence is not a priority for him.
heimatau 10y ago
I know this isn't 'exactly' the same but I can't help but find a coloration to this and Somatosensory Therapy [1]. I've had a traumatic past and I've volunteered at a place that uses Soma. Essentially it's 'creating new memories through play'. It was used for abused/molested children. I hope Kolk can get some finding for clinical research because I do think there is a possible benefit to role-playing. Psychology knows that when a child is developing to role-play verbally/physically specific situations, to train a child. I learned this through my college course 'Child Psych.'. I was surprised that there is research on role-playing but...no one in my circle seems to know it's value. Or in other words, if your child can't be quiet waiting at a doctors office, while you are at home, you'll 'recreate' the situation and talk out what you and the child can do in the situation next time. "I'll play with this toy that I like so much. This will help me pass the time because it's so boring in the waiting room." Etc. I know what I'm saying isn't the exact situation but there are parallels to role-playing with little humans and adult humans. :) [1] - https://www.amazon.com/Doodles-Dances-Ditties-Trauma-informed-Somatosensory/dp/098927070X/ref=sr_1_1_twi_2?s=books&ie=UTF8&qid=1423258834&sr=1-1&keywords=doodles+dances+and+ditties https://www.amazon.com/Doodles-Dances-Ditties-Trauma-informe...
- BipolarElsa 10y ago
  Sorry but without the rigors of scientific testing, this is just more woo-woo nonsense that isn't effective. I think the journalists mention that this form of therapy wouldn't "get a second glance from Psychiatrists" is telling. There's more rigorous work being done on PTSD and MDMA and it is actually working compared to this bogus bullshit "therapy" being peddled. Utter nonsense. Psychiatrists know what they're doing. There's no need to follow cultish fads because they helped a dozen yahoos.
dark_star 10y ago
I'm reading van der Kolk's best-selling book on trauma right now - The Body Keeps the Score [1]. It's good. My therapist recommended it to me as the best book on trauma out there right now. Lots of good, current research, his personal experiences actually healing trauma, and hope that people can get better. My wife has PTSD (veterinary school and previous relationships) so I'm trying to understand, and it's helping. [1] https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/0143127748 https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/01...
itaifrenkel 10y ago
I've just recently performed in a psychoplayback evening for a small group of veterans with PTSD for hanuka. "Psychoplayback method uses playback theatre as the basic method that enables participants to enter a psychotherapeutic space." We obviously did not recreate scenes nor change them, as that would have been too close of an expirience. However it did allow to show them others can get a glimpse of what they are going through, and show other angles such as their family's. Not being able to understand them was a common theme. Psychiatrists included

33 points by agronaut 10y ago

> Psychomotor therapy is neither widely practiced nor supported by clinical studies. Well if this dancer-turned-psychologist is so hellbent on his methods, shouldn't he subject them to the rigor of clinical research? If I were in his shoes and I had a method that showed promise, I'd want to evaluate it against my peers to ensure I have the most eyes available to make it the most effective - in the same way a crypotographer testing a new algorithm would open-source his work to find as many exploits as early as possible to strengthen his work. I want to believe, because my dad suffers from real bad PTSD from Vietnam, but it's quotes like these that immediately suck the life out of any hope I had for ways to help him.

agronaut 10y ago
The article goes into that. It's hard to get funding.
- imagist 10y ago
  Is it, though? Science isn't always an expensive endeavor. Certainly checking in with clients a few years after and comparing outcomes with a control group could be done with volunteers. Setting up a blind can be done with basic survey tools which are available at low cost. The expensive parts of this research are getting facilities and people willing to take an untested treatment. But he already has both those, so I really can only attribute the lack of scientific evaluation to a lack of will to do it.
  - tudorw 10y ago
    while you are essentially correct, I would imagine that a therapy such as this would be hard to 'own' and profit from after successful development, so the sources of funding may well be quite limited compared to the funding available to develop a new drug therapy.
    - Turing_Machine 10y ago
      There's a much higher bar, too, to any form of research that involves human subjects. There's a whole regulatory regime that must be complied with to even get permission to do this kind of research. If the possible downside is high (as it is here... what if the treatment makes the subjects worse and a bunch of them wind up more suicidal than they were before?) the level of required oversight is pretty high. I'm not saying that's a bad thing -- unethical and/or misguided researchers have actively harmed their subjects too many times in the past. Nonetheless, it's something that people who haven't done human subjects research often overlook, and something that can add a huge amount of expense and delay. If you're doing generic CS research* the worst that usually happens is that you have to reboot. We can't reboot people, at least not yet. :-) *If you're doing research on, say, human computer interaction, you generally do have to get human subjects approval, but not usually for compilers, algorithms, or the like. Edit: "people willing to take an untested treatment" That's exactly the rub. The potential subjects for something like this are what's known in the jargon as a "vulnerable group". You have to be very, very sure (and be able to convince a skeptical oversight committee) that your subjects are, in fact, giving their active and informed consent for an experimental treatment. That's quite hard to do for people with severe psychological problems (again, rightly so... some of the abuses of the past make for sobering reading).
      - imagist 10y ago
        But he's already performing the treatment on people. He's already skirting the regulations. Merely collecting data on what he's already doing doesn't make it worse.
    - imagist 10y ago
      Let's be clear here: I don't think outside funding is needed. As I described, this isn't expensive. The cost is small enough that it could be paid for out of his pocket and he'd easily recoup the investment if it proves that his technique works. I think the reason he hasn't done studies isn't because of lack of funding, it's because scientifically validating his claims isn't a priority.
  - agronaut 10y ago
    I don't think a small ad hoc study would be taken seriously. The dynamics here are institutional.
    - imagist 10y ago
      It's not about being taken seriously, it's about finding out whether what he's doing actually helps people. You don't need institutions to prove your hypothesis, you need evidence.
  - 0xcde4c3db 10y ago
    It might be hard for Van der Kolk specifically to get funding. The article mentions that he's kind of a pariah because he endorsed the "recovered memory" stuff that led to a lot of lawsuits based on very questionable allegations of child abuse. The leading consensus on this phenomenon is that recovered-memory therapy mostly creates the "recovered" memories. See also the Mandela Effect/Berenstein Bears/Shazaam stuff, where people have seemingly done this to each other spontaneously.
    - imagist 10y ago
      You're missing my point: I think that this could be studied cheaply enough that he wouldn't need outside funding. I'll add that I think the reason he hasn't performed studies on the technique isn't lack of funding, but that validating his claims isn't a priority for him. His background only makes me believe more firmly that evidence is not a priority for him.

heimatau 10y ago

I know this isn't 'exactly' the same but I can't help but find a coloration to this and Somatosensory Therapy [1]. I've had a traumatic past and I've volunteered at a place that uses Soma. Essentially it's 'creating new memories through play'. It was used for abused/molested children. I hope Kolk can get some finding for clinical research because I do think there is a possible benefit to role-playing. Psychology knows that when a child is developing to role-play verbally/physically specific situations, to train a child. I learned this through my college course 'Child Psych.'. I was surprised that there is research on role-playing but...no one in my circle seems to know it's value. Or in other words, if your child can't be quiet waiting at a doctors office, while you are at home, you'll 'recreate' the situation and talk out what you and the child can do in the situation next time. "I'll play with this toy that I like so much. This will help me pass the time because it's so boring in the waiting room." Etc. I know what I'm saying isn't the exact situation but there are parallels to role-playing with little humans and adult humans. :) [1] - https://www.amazon.com/Doodles-Dances-Ditties-Trauma-informed-Somatosensory/dp/098927070X/ref=sr_1_1_twi_2?s=books&ie=UTF8&qid=1423258834&sr=1-1&keywords=doodles+dances+and+ditties https://www.amazon.com/Doodles-Dances-Ditties-Trauma-informe...

BipolarElsa 10y ago
Sorry but without the rigors of scientific testing, this is just more woo-woo nonsense that isn't effective. I think the journalists mention that this form of therapy wouldn't "get a second glance from Psychiatrists" is telling. There's more rigorous work being done on PTSD and MDMA and it is actually working compared to this bogus bullshit "therapy" being peddled. Utter nonsense. Psychiatrists know what they're doing. There's no need to follow cultish fads because they helped a dozen yahoos.

dark_star 10y ago

I'm reading van der Kolk's best-selling book on trauma right now - The Body Keeps the Score [1]. It's good. My therapist recommended it to me as the best book on trauma out there right now. Lots of good, current research, his personal experiences actually healing trauma, and hope that people can get better. My wife has PTSD (veterinary school and previous relationships) so I'm trying to understand, and it's helping. [1] https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/0143127748 https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/01...

itaifrenkel 10y ago

I've just recently performed in a psychoplayback evening for a small group of veterans with PTSD for hanuka. "Psychoplayback method uses playback theatre as the basic method that enables participants to enter a psychotherapeutic space." We obviously did not recreate scenes nor change them, as that would have been too close of an expirience. However it did allow to show them others can get a glimpse of what they are going through, and show other angles such as their family's. Not being able to understand them was a common theme. Psychiatrists included