A breakthrough on treating PTSD

[LymphocyteLover]

https://www.washingtonpost.com/opinions/2023/07/10/ptsd-treatment-veterans-medicine-mental-health/

All around the conference room in Atlanta last fall, jaws were dropping. Michael Roy, a physician from the Walter Reed National Military Medical Center, had just revealed to the International Society for Traumatic Stress Studies the preliminary results of a study comparing two treatments for post-traumatic stress disorder: Prolonged Exposure (PE) therapy, long regarded as the “gold standard,” and a novel approach called Reconsolidation of Traumatic Memories or RTM.

In such a study, effectiveness is indicated by a complete remission of symptoms, a loss of diagnosis. Roy’s trial was ongoing and still double-blinded, so he could report only the outcomes of the two treatments combined. But the success rate was a stunning 60 percent. Every expert present knew that PE’s known remission rate hovers at 30 to 40 percent, so the 60 percent combined figure could only mean only one thing: The new RTM treatment was tracking dramatically higher.


From the back of the room, PE researchers glowered at Roy: Way too good to be true, dude.

Except it wasn’t. Afterward, the praise from colleagues was effusive, with one top researcher telling RTM’s creator, Frank Bourke, that the presentation was a “home run.” At the same time, a PTSD researcher from the Department of Veterans Affairs approached one of Bourke’s teammates and said coldly, “I don’t think it’s useful to pick fights” — as though RTM’s success had been a provocation.

[Irish_Dem]

1. I'd very much like to read this article but it is behind a paywall.

My first reaction is skepticism about mental health "total cures."
But I would like to find out more about the treatment.

[Sympthsical]

23. If you're reading on a computer

See if your browser has a "reader view". I use Firefox and it does. Turn on reader view and reload the page. Works a treat for most major newspaper paywalls.

[Irish_Dem]

24. Thanks!

[Scrivener7]

2. Oh my effing God.

If his team supported a treatment as apparently effective as RTM, he told Bourke, they would jeopardize their own careers; the Defense Department had already invested more than $1 billion to study more conventional PTSD therapies. The message was clear: Bourke was on his own.

Why must people suck so much?

[LymphocyteLover]

8. Seriously. Maybe they need treatment for their own PTSD?

[Best_man23]

9. No, more along of the lines of someone's "Playing Ball"

Think of the scene from the movie Johnny Dangerously.

I smell special interests are lining pockets of Congress critters who would be upset if this treatment were approved.

[Goonch]

3. RECONsolidation of Traumatic Memories to ResOLve Post Traumatic Stress Disorder

Brief Summary:

"Posttraumatic Stress Disorder (PTSD) is a common cause of morbidity in combat veterans, but current treatments are often inadequate. Reconsolidation of Traumatic Memories (RTM) is a novel treatment that seeks to alter key aspects of the target memory (e.g., color, clarity, speed, distance, perspective) to make it less impactful, and reduce nightmares, flashbacks, and other features of PTSD. The memory is reviewed in the context of an imaginal movie theater, presenting a fast (~45 sec) black and white movie of the trauma memory, with further adjustment as needed so the patient can comfortably watch it. Open and waitlist studies of RTM have reported high response rates and rapid remission, setting the stage for this randomized, controlled, single-blind trial comparing RTM versus prolonged exposure (PE), the PTSD therapy with the strongest current evidence base............."

https://classic.clinicaltrials.gov/ct2/show/NCT03827057

[Scrivener7]

4. And there's this from the OPs article:

PTSD treatment costs for military populations — over $25,000 in annual costs per individual with traditional therapies versus RTM treatment at $1,000 per individual.

[NowISeetheLight]

31. The Cost

Every month I receive two Triwest EOBs for my community care therapist (weekly) and psychiatrst (biweekly). The therapist receives $118 a week and the shrink $185. Roughly $10k a year. Add in the medications and it's probably $14k they cover. Toss in a 5-8 day inpatient stay a year and it's easily $20k+ a year.

[NowISeetheLight]

32. EMDR

I've had a few years of EMDR. It sounds kind of like one aspect of that, where you try to rewrite the ending so it's tolerable.

Then again it sounds a lot like numbing too. Watch the trauma over and over until it doesn't bother you? Problem is it doesn't always work like that. You don't always become "used to it". That's how veteran suicide happens.

The memory is reviewed in the context of an imaginal movie theater, presenting a fast (~45 sec) black and white movie of the trauma memory, with further adjustment as needed so the patient can comfortably watch it.

[Scrivener7]

35. I may be wrong, but it sounds different from that. I will hold my skepticism until I know

more about it and how it works but if it is half as good as they say it is, it might be a game changer.

[pwb]

5. Can it repair marriages, prevent nightmares.

Eliminate thoughts and memories. Does it make certain sounds and smells that trigger PTSD go away? The Veteran Administration guy was right, this is crap IMO.

[WhiskeyGrinder]

7. .

Eliminate thoughts and memories. Does it make certain sounds and smells that trigger PTSD go away?

Eliminating a diagnosis means the symptoms that lead to the diagnosis are gone. So a person who goes through this therapy has a really good chance of having certain sounds and smells not be a trigger anymore, and not have nightmares anymore.

[Kid Berwyn]

6. Why, scientists can be as petty as anyone.

One big reason: Money. Another: Professional Jealousy.

Most importantly: Hope the research yields real relief and treatment for those suffering PTSD.

[mitch96]

10. Truth goes thru three stages

First, it is ridiculed.
Second, it is violently opposed.
Third, it is accepted as being self-evident.”
Humans hate change...
m

[erronis]

25. This happens at the macro scale (university/government) and micro (family/friends)

Strange how we all seem to go through these phases. Well, many do - some very wise people may not.

[erronis]

11. This opinion piece was written by Garry Trudeau (Doonesbury). Here's the archived version.

https://archive.is/20230710131240/https://www.washingtonpost.com/opinions/2023/07/10/ptsd-treatment-veterans-medicine-mental-health/

[niyad]

12. Please post this as its own OP.

Right now, I want to scream in rage and horror and anger. Having spent nearly all of my life dealing with PTSD (first my father, then the Vietnam vets), having seen the devastation to those suffering, and to their loved ones, and to society. . to learn that there appears to be an effective treatment, and the DoD/VA are dragging their feet????? For MONEY??? For job security?????

I have to stop now, because if I continue, the suits will not be happy.

[Hekate]

26. Many, many thanks

[2naSalit]

13. And those of us who...

Are not vets and have multiple incident issues, what about that?

I wonder if this can help other PSTD sufferers who have lifetime PTSD.

[Bayard]

18. This

I know I'm not nearly on the same level as combat vets, but I have been diagnosed with PTSD from my nightmare experience living in Calif. Flashbacks can be a real problem.

[Hekate]

27. I'm sure it can

[diva77]

29. Here is link to the developer's website - you can find an RTM counselor-might be worth looking into

https://www.thertmprotocol.com/

Bourke treated people who were traumatized by 9/11

From his homepage:

A WELCOME FROM RTM'S CREATOR-Dr. Frank Bourke

Thank you for your interest in the RTM Protocol™ and its demonstrated efficacy as a long overdue breakthrough treatment for PTSD. I realized how effective this protocol was after 9/11 when I worked with over 850 survivors whose offices were above the 100th floor of Tower Two. Of these individuals, I treated 250 of them for severe PTSD symptoms. I then made it my life’s mission to scientifically prove the clinical effectiveness of the RTM Protocol™ and bring it to the millions in need of hope and healing. The R&R Project is a 501 (c) 3 nonprofit dedicated to furthering and expanding research which is already establishing the RTM Protocol™ as a most promising breakthrough treatment for PTSD. As a clinical treatment requiring no drugs, the RTM Protocol™ has undergone rigorous scientific evaluation in four published studies (with more underway), as consistently removing the nightmares, flashbacks, and the directly related emotional problems of post-traumatic stress in less than five hours (studies can be found HERE). I hope you will join us in this journey, whether as a practitioner signing up for RTM Protocol™ training; a client seeking treatment; a researcher interested in collaborating with other scientists; an advocate for spreading the word; or a donor contributing funds to make this all possible. Thank you.

[2naSalit]

30. Thanks.

[hunter]

34. My last psychiatrist wanted to prescribe some powerful meds for my PTSD and other issues.

Knowing myself, from much experience, I was pretty sure I knew how that would turn out. I'd begin to find the side effects of the meds intolerable, then I'd quit the meds cold turkey and land in the psych ward again. Been there, done that.

Muddling through on less powerful meds with milder side effects is working for me now.

I haven't had a full blown panic attack or woken up yelling from a nightmare for maybe a year now, even though the last month or two have been pretty hellish giving me lots of exposure to the sorts of situations and places that trigger me.

The weirdest thing happened to me a few weeks ago. I suddenly remembered exactly where I'd experienced one of the more hellish times of my life and for some reason decided I should revisit that place. I followed the maze of streets I remembered and there I was. Amazingly, when I stopped my car there I didn't have a panic attack. (My wife and friends have witnessed those sorts of panic attacks, sometimes with vomiting and other unpleasantness...)

Even more amazingly, stopped there, I remembered there was a park nearby where, for the very first time, I kissed a woman I liked.

Who wouldn't want to remember their first kiss?

That first kiss was entirely unrelated to the trauma of the place and had been a memory I'd been seeking but couldn't quite grab hold of for a long, long time.

I suppose the memory was always there but the intensity of the PTSD crap made it disappear like the stars in the daytime sky of an evil sun.

The trouble with the PTSD crap is that stuff that happened forty years ago sometimes seems like yesterday to me and won't go away. As a computer guy I'd say the time signatures on the memory files are corrupted. Which may have something to do with the therapy described in this thread.

[Curtis]

14. Interesting. I have severe PTSD

It's from law enforcement. Long story, but it led to major issues with family and relationships (beginning in 2008 from an incident. Therapy has been a joke due to restraints on what I was allowed to talk about openly (worked undercover). Horrid night terrors and so many other issues.

But, I got married to a fantastic woman in 2014 (started dating in 2012) and began openly talking with her about my problem. Because it was impacting this relationshi, and I decided she was more important to me than keeping to NDAs. I started slowly and eventually got where I could tall about the major event that finally ruined me. I have gone from 4 or 5 night terrors a week to one or two a year in the last couple years.

I guess I did this type of therapy on my own and discovered it out of luck and determination to keep my wife in my life. I am by no means healed as I have issues still, but I am a different person from the way I've approached it the last few years. I've even begun seeing a therapist from outside the country and had her sign all kinds of agreements that she would never write down or disclose anything we discuss. I trust her completely. We work on issues along with my wife and I am a different person. When I speak about sspe ific issues I cry and breakdown, but I have gotten where I can actually talk about it.

Anyway, it's just my personal experience that I can attest that talking with trusting individuals helps more than I can say.

[Mosby]

16. Good to hear you're doing better.

Thanks for sharing your experiences.

[Curtis]

36. .

[Ampulae]

20. Heavy, brother

A good read. I'm glad you've found some relief. I could not agree more that "talking with trusting individuals helps." It's been key to my PTSD.

[Curtis]

37. True

I kept it bottled up for too long as per the various NDAs, but I was losing myself and my mind. PTSD is an ugly beast to tame.

[Fiendish Thingy]

15. RTM appears to be a derivative of EMDR

There are claims it has been around since the 70’s, but I worked in the mental health field from 1980 onwards, and this is the first I’ve ever heard of it, whereas EMDR became the prominent treatment for PTSD starting in the late 80’s.

[TheRickles]

17. Actually, the VA has become quite open to non-medication "alternative" therapies.

They have a newly-created Whole Health System which embraces treatments like acupuncture and meditation, and has approved several integrative therapies for PTSD, including EMDR (eye movement desensitization) and EFT (tapping). So it's not quite so black-and-white anymore. Dr. Ben Kligler is leading this initiative; lots online - here's an overview: https://www.va.gov/WHOLEHEALTH/professional-resources/IHCC.asp

[NowISeetheLight]

33. Both

My PTSD is service connected but not combat related. Ive tried both EMDR and tapping. They help a little. I'd like to try ketamine as I have major depression, but the VAMC here doesn't offer it. I've tried to check on community care for Ketamine but the VA has basically axed it and wants to use Spravato nasal spray instead. They cut off vets in San Diego and had some suicides as a result. Doctors begged the VA not to cut them off, they did it anyway.

https://inewsource.org/2020/06/04/san-diego-veterans-suicide-ketamine/

I know a couple vets from a PTSD Facebook group I belong to that had Stellate Ganglion Block. They said it really helped and lasted a while. I know the VA in Long Beach offers it. The VA is expanding its use. It was featured on 60 minutes in 2019.

https://lbpost.com/news/ptsd-va-hospital-cbs-60-minutes/

https://www.va.gov/healthpartnerships/updates/cci/11192020.asp

[Phoenix61]

19. CPT ( Cognitive Processing Therapy)

Studies show effective’s rates from 30% to 97%. I’m not a fan of PE for treating PTSD. It’s great for treating phobias. I had the wonderful opportunity to take the training for CPT from the woman who literally wrote the book for the VA for treating PTSD with CPT. I used it to treat adult survivors of childhood abuse and the results were nothing short of amazing.

[FakeNoose]

21. Good explanation of RTM from the OP link

This is for the tl/dr folks ...

In contrast, RTM requires only three to four sessions, totaling about five hours, and involves no drugs or re-traumatization. Therapists can be trained in three days, and treatment can be conducted online. Best of all, the effects last. As one veteran put it, “Who knew that you could retrain your brain in a few hours, without medication, to remove yourself from the traumatic events that have been crushing you and making you wish you would just die?”

How does RTM work? Bourke explains it like this: “The technique is actually a neurological intervention that takes a traumatic memory and restructures it using several exercises like visualizing it as a black-and-white movie. The revised memory updates the original — reconsolidation.”

There's much more info in the article....

This looks like a major breakthrough for victims of PTS.

[LymphocyteLover]

22. it sounds pretty amazing-- I hope it's as good as advertised!

[Hekate]

28. This is a great thread. All I can say is thank you all.