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Article of the Week: Week Eight

Posted Feb 24 2010 12:35pm

The first article I’d like to look at this week is from the excellent After Silence blog, which is about regaining one’s confidence, hope, life – one’s voice – after rape or sexual assault.  This particular entry discusses the physiological effects of post-traumatic stress disorder, which in the author’s case was of course caused by her own rape, but which is applicable to PTSD brought on by any type of trauma.

The author, Kimberley, discusses an article on the phenomenon from Pandora’s Project , which is a support site for those effected by sexual abuse (interestingly, ‘Pandora’ is the name currently leading my poll on what I should be ‘called’).  Firstly, Kimberley discusses the symptoms that are commonly seen in this illness, such as hypervigilance, flashbacks, severe anxiety and dissociation, though she then moves on to outline the biological research undertaken into PTSD.

The bottom line is this: PTSD is not just a psychological illness, but a physical one too.  Trauma does not just damage our psyche, it can actually change the physiology of our brains.  In particular, traumatic events seem to affect the hippocampus (a part of the brain that has responsibility for a lot of memory functions) and the medial prefrontal cortex (responsible for cognitive functions such as personality expression and decision-making).

I have come across information like this before, but Kimberley’s analysis of the Pandora article is worthy of particular note for her eloquence and understanding of this subject.

PTSD and Your Brain

Now, this I like.  Anyone who has followed this blog in the long-term knows about my complete disdain about all forms of cognitive behavioural therapy.  I think it’s the biggest pile of toss in the history of psychology, at least for people like me.  To say that I have faith in the psychodynamic and analytical schools of therapy would be false, because I am not sure that I really believe any form of psychotherapy works entirely.  Nevertheless, I hold the latter in much higher regard than the ‘newer’, in-vogue, supposedly cost-efficient therapies.

The problem in this position in the last few years has been that the psychodynamic schools have lacked empirically-based evidence for their effectiveness, whereas (surprisingly for me) CBT and its kindreds are backed by a myriad of studies supposedly supporting their effectiveness in treating various forms of mental illness and distress.

Well, finally it seems the psychoanalyst types have sought to prove the efficiency of their practice.  This article from Scientific American (reported prolifically elsewhere too) discusses a recently published journal article apparently demonstrating that psychoanalysis and psychodynamic therapy not only work, but keep working after cessation of treatment.

The piece claims that psychodynamic therapy has been shown in controlled trials to effectively treat anxiety, depression, eating disorders and, crucially for yours truly who is in psychodynamic therapy, personality disorders.  According to the author of the original journal article, this type of therapy enables patients to develop tools to better function in the “real world”, increases self-confidence and decreases the symptoms of their illness(es).  A key ingredient in achieving this is, of course, the therapeutic relationship.

Like the preceding article above on PTSD, there’s a wee bit of neuroscience thrown in here; current research seemingly suggests that psychodynamic therapy can produce changes in the prefrontal cortex of the brain, as patients begin regulate emotional health.

Naturally this isn’t a faultless paper; for one thing, the studies therein simply aren’t numerous enough in number.  But, not unsurprisingly in my view, most of the main detractors of the article’s findings are CBT devotees, who complain that this study is across various mental disorders, rather than focusing on just one.  Fair enough, but the analytic schools had to start somewhere (and admittedly should have done so sooner), and ’somewhere’ is proving to be a promising start.

Talk Therapy: Off the Couch and Into the Lab

A few other articles of interest came up this week, but I think I’ve drivelled on enough.  Enjoy.  *coughs*

C is off tomorrow :-(   So I shall report on last week’s session then, hopefully.

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