One study published in the American Psychiatric Association found that "PTSD has been shown to predict poor health not only in veterans of the 1991 Gulf War but also in veterans of World War II and the Korean War. Our study extends these findings in a group of active duty soldiers returning from recent combat deployment to Iraq, confirming the strong association between PTSD and the indicators of physical health independent of physical injury" (Hoge, Terhakopian, Castro, Messer & Engel, 2007). From this study one can certainly glean that PTSD has a somatic component to it, or at least there is a prevalence in which persons afflicted with PTSD also suffer from physical health problems. One can also assume that the somatic component was downplayed or overlooked in prior studies, as most treatments for PTSD do not seem to address the physical aspect of the disorder.
To elaborate on this assumption one should consider CBT, as mentioned, one of the most researched and most studied treatments for PTSD. To provide a little more clarification on what CBT is, it's an integrated approach that blends cognitive therapy, therapy that address the thoughts that produce and lead to maladaptive behaviors with behavioral therapy, therapy that focuses on curbing behavior (Gelso & Fretz, 2001). In a study conducted to find out how effective multiple-session psychological interventions were at preventing and treating traumatic related stress symptoms shortly after the event had occurred (within 3 months), the researches found that "Trauma-focused CBT was the only early intervention with convincing evidence of efficacy in reducing and preventing traumatic stress symptoms, but only for symptomatic individuals and particularly for those who met the diagnostic criteria for acute stress disorder or acute PTSD" (Roberts, Kitchiner, Kenardy & Bisson, 2009). In other words, despite all the other intervention techniques that were tested and analyzed in this study, only CBT was effective at mitigating stress symptoms for individuals who had manifested symptoms of PTSD and those, in a particular subset, suffering from acute PTSD. Although this may sound like CBT is a formidable treatment against PTSD, it is really not maximally effective as an early-intervention treatment (especially for those who are asymptomatic and who fall outside that subset). But to be honest, there are no real known cures for PTSD or early interventions that will completely eradicate (latent) symptoms.
This study concludes by stating this, "Given the modest overall effects of trauma-focused CBT, the development and trialing of other psychological treatments are important" (Roberts, Kitchiner, Kenardy, & Bisson, 2009). Although the orthodox approach of CBT is modestly effective, more research is surely needed. Psychologists have miles to go before they sleep with regards to finding a super effective treatment for PTSD.
With that said and to address what I alluded to earlier, there are other unorthodox treatments that show signs of promise. One pilot study published by The Journal of Nervous and Mental Disease in 2007 found that acupuncture might help mitigate symptoms of PTSD. Of the 73 people diagnosed with PTSD and examined in the study, those who received acupuncture treatment and those in a separate group who were part of group-CBT treatment both achieved similar results that faired better than the control group (Hollifield, Sinclair-Lian, Warner, Hammerschlag, 2007).
What's interesting about this study is the fact that a treatment methodology was used (acupuncture) that addressed the patient's body. As mentioned above, most treatments (including trauma-focused CBT) neglect a tactile, literal "hands on" approach. Before one jumps to conclusions, I should acknowledge that the findings in the acupuncture study are tenuous. For starters it was a small sample size, it was a pilot study, and acupuncture -- as many practitoners of acupuncture hate to admit -- is not grounded in empirical science or biology. Nevertheless the proposition of combining and integrating trauma-focused CBT with acupuncture and other forms of physical treatment (exercise, running, etc.) is an enticing one. More research needs to be conducted to determine how this two-pronged treatment approach (CBT and physical techniques) can work to maximize PTSD treatment efficacy.
This is the stuff that...
Even during my first placement, I might have been a little to eager to suggest unconventional approaches to helping my clients. Again, "unconventional" in the sense that I tend to approach things from a macro-position -- body, mind, and spirit. Conventional wisdom is that psychology and therapy are disciplines only reserved for the mind. I disagree. I think that is a narrow way of looking at human beings. I believe that everything is connected. However, I am also keenly aware of how thinking along these lines can be troublesome as I continue my journey.
I suppose this is where gaps exist in my education. I'm I still awaiting a life-alter disillusionment that fundamentally changes the way I think? Maybe. As the controversial figure Donald Rumsfeld once said, "there are knowns, known unknowns, and unknown unknowns" (Press Conference, 2002). So if I had to do a quick breakdown of what I know, what I know I don't know, and what unknown unknowns lie ahead, I would suggest that a life-altering disillusionment that fundamental changes the way I think would probably fit into that last category. However, as logic permits, I can at least remark on the first two. For example, I know or I think I know (this can easily devolve into a whole intellectually nihilistic discussion over what I think I know vs. what I actually know, which, of course, begs the question of "what can I really know about anything?") many of the fundamental precepts of the aforementioned therapies such as CBT, PCT, etc. I know that therapy works (Cooper, 2008). Although, to varying degrees, which are contingent upon varying factors: client-therapist relations, style of therapy used, and most importantly client factors, i.e. does the client believe that what he/she is doing will help him/her (Cooper, 2008). What I don't know, but need to know is will my heavy-handed theoretical background translate into quality therapy? In short, will all this stuff I learned make me a good counselor/therapist? My first placement went well, but it was limited in many ways. I facilitated the support for those two ladies. And I times, I did employ some fundamental interventions. But, I still have yet to really spread my wings to see if I can actually fly, and fly well. This, though, will come in due time.
Cooper, M. (2008). The Facts are Friendly. Therapy Today.net. Retrieved from http://www.therapytoday.net/article/15/8/categories/
Frost, R. (1923). Stopping By Woods on a Snowy Evening. New Hampshire. Retrieved from http://www.ketzle.com/frost/snowyeve.htm.
Gelso, C., Fretz, B. (2001). Counseling Psychology Second Edition. Orlando, FL:
Gustave, F. (n.d.). BrainyQuote.com. Retrieved from:
Heine, R.W., Trosman, H. (1960). Initial Expectations of the Doctor-Patient Interaction
As a Factor in Continuance in Psychotherapy. Psychiatry. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14400696
Hoge, C.W., Terhakopian, A., Castro, C.A., Messer, S.C., Engel, C.C. (2007).
Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health
Care Visits, and Absenteeism Among Iraq War Veterans. American Psychiatric
Association. Retrieved from http://ajp.psychiatryonline.org/cgi/content/full/164/1/150?maxtoshow=&hits=10 &RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=
Hollifield, M., Sinclair-Lian, N.,Warner, T.D., Hammerschlag, R. (2007). Acupuncture
for Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial. The Journal of Nervous and Mental Disease. Retrieved from http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&
Parsons, C. (2008). The Dignity of Risk: Challenges in Moving On. Australian Nursing
Journal; 15, 9. ProQuest Central.
Roberts, N., Kitchiner, M., Kenardy, J., Bisson, D. (2009). Systematic Review and Meta-Analysis of Multiple-Session Early Interventions Following Traumatic Events. American Psychiatric Association. Retrieved from http://ajp.psychiatryonline.org/cgi/content/full/166/3/293?maxtoshow=&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=Postraumatic+Stress+Disorder&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
Socrates (399 BCE). Apologia. Retrieved from http://en.wikiquote.org/wiki/Socrates
"He gives his harness bells a shake / to ask if there is some mistake." The horse's action portrays the tendency of people to question those choices they don't understand. This scene can be interpreted as the disapproving voice of society voicing its demands on those of a more sensitive bent. In much the same vein as the previous stanza, Frost shows a depth of human understanding (and misunderstanding). Our
Robert Frost Both of Robert Frost's poems, "The Road Not Taken," and "Stopping by Woods on a Snowy Evening" use natural imagery to illustrate the narrator's train of thought. However, the theme and tone of the two poems differ. In "The Road Not Taken," the narrator is caught at a crossroads. The poem deals with the difficulties of the decision he faces, and the mild regret that he experiences once he
Frost Home Frost's Sense of Home Robert Frost is one of the most prominent American poets of the twentieth century, with poems that manage to evoke elegance and wisdom while remaining earthy and true to the straightforward American character at the same time. At the same time, there is often a sense of seeming directionless and uncertain, which is of course the flipside of the freedom and self-determination of the American way.
The last stanza is the protagonist's projection of what he thinks the future will hold. He imagines himself relating this day with a sigh to another, and letting them know that when he came to the fork in the road he took the road less traveled, and that made all the difference. We must remember two things the author said, first it is the story of his friend, Edward Thomas, and
Frost's piece "Fire and Ice" is also rich with metaphors about the human condition. Frost begins his piece with "Some say the world will end in fire, some say in ice." Again at first glance, frost appears to be discussing the end of the world. However, his next line "From what I've tasted of desire, I'll hold with those who favor fire." Frost appears to be discussing the end of
The remainder of the poem assumes a more regularly rhythmic form, although the meter is not strict. Some of the remaining lines and stanzas follow an iambic hexameter, such as stanza three. However, many of the lines are in anapestic hexameter, or contain combinations of various meters. The poet inserts dactylic and anapestic feet along with iambic and also trochaic ones for intensity and variation, much as one would