Postttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are the “signature wounds” of the wars in Iraq and Afghanistan. They are invisible.
Warriors who have had limbs blown off or sustained other bodily injuries (over 40,000 U.S. military personnel have been injured in these wars to date) are obviously physically impaired. The wounds of those with PTSD and TBI don’t show on the outside, yet these wounds are just as real.
The wounds of PTSD and TBI also have a characteristic that makes them quite different from other mental health problems like anxiety and depression. Depression and anxiety have a “course.”
This means that symptoms get worse, and then get better again. An episode of depression lasts about six months, unless a depressed patient is put on an antidepressant prescription drug, which often leads to relapses, as well as long-term dependence, according to studies summarized in the best-selling book Anatomy of an Epidemic (Whitaker, 2010, p. 169).
This book is so important that it should be required reading for anyone contemplating taking psychotropic drugs, or prescribing them. Studies show that an unmedicated patient with nonclinical anxiety or depression can expect to get better after a certain period of time.
Traumatic stress, however, is not the same as anxiety and depression. Symptoms often don’t show up immediately. In veterans returning home from Iraq and Afghanistan, for instance, symptoms of PTSD usually show up months or even years after the events that gave rise to the diagnosis.
An Iraq veteran who tells part of his story on the EFT introductory video on EFT Universe thought he was fine after he returned home after a tour of duty in the “Triangle of Death” in Iraq in 2004. It was several months later when a family friend remarked that he wasn’t the same person who went off to war, and he realized that he was suffering from traumatic stress, the onset of which had been delayed by a period of many months.
Even more deceptive than the delayed onset of the disease, symptoms can become worse over time. A U.S. Marines general showed me photographs of three young warriors whose MRAP had been blown up by an IED or Improvised Explosive Device in Iraq.
The force of the explosion was so intense that the MRAP, which weighs 16 tons, was tossed in the air and landed upside down on its roof. Yet the vehicles are so well armored that the MRAP’s three-man crew walked out intact. In the photo, the three are grinning as they lean against the overturned hulk and light cigarettes immediately after the incident.
He showed me a second photo of one of the men taken two years later at Walter Reed Military Medical Center. In this photo, there are no grins. The man is disabled, and his body has bloated up by over 100 pounds. He has symptoms of TBI, diabetes, and other evidence of biological dysregulation. These longer-term injuries often don’t show up until well after the event, and often get worse over time.
We get frequent calls in the office of the Veterans Stress Project (www.StressProject.org) from wives or daughters of veterans. The commonality of their stories is striking, variations on the theme of, “It’s been 40 years since Vietnam, and my husband/father is getting worse. Can you help?” Why does PTSD get worse over time, when other psychological problems usually get better, at least if the patient does not get medication?
The answer lies in the phenomenon of neuroplasticity.
The ability of neural networks to repair themselves became dramatically evident in research published in the 1990s. Stroke victims, for instance, who have lost access to parts of their brains, may be able to regain all or part of their lost functionality.
Their neural networks rewire around the parts of the brain damaged in the stroke, sometimes restoring full function.
The work of physician Eric Kandel, MD, showed that within one hour of repeat stimulation, the number of synaptic connections in a neural bundle can double (Kandel, 1998). Neural pathways that are being used repeatedly add capacity, like electricians adding wiring to the circuits in a building that the occupants use most frequently.
If we practice an action repeatedly, for instance, our tennis serve, we add capacity to the neural bundles that carry the information required to complete this action. If we think the same kind of thought, perhaps “I hate my job,” repeatedly, we also add capacity to the synaptic connections responsible for carrying that information through our brains.
Our wise bodies notice which information-processing channels we are using most, and increase their capacity. While this phenomenon had been noted in earlier research, the sheer scope of the rewiring operation “a doubling of capacity in just one hour” was astonishing. Kandel’s work resulted in a well-deserved Nobel Prize for medicine in 2000.
Intrigued by the speed at which the body lays down new lanes in the information superhighways of the brain, the next research question presented itself naturally to Dr. Kandel.
If our bodies are assembling arrays of molecules to bulk up oft-used neural bundles, what happens to bundles we aren’t using? He found that unused neural pathways atrophy. Just as efficiently as it wires in new connections along frequently used channels, our bodies disassemble stretches of neural networks that aren’t being used.
In the parsimonious economy of the brain, nothing is wasted. Roads that aren’t being used are torn apart, freeing those molecules for the construction of new capacity in frequently used highways.
The speed of demolition was as surprising as that of construction. Kandel found that, within two weeks, unused neural bundles start to be disassembled.
The implications of this are profound. Imagine that you have the option of thinking positively or negatively about your job. You can tell yourself positive stories or negative ones, and either of them can affect the structure of your brain.
Years ago I ran a large book publishing company. When I started my job as CEO, industry surveys ranked us in the bottom tier for customer service. I resolved to change that, and restructured the customer service department, which eventually employed seven people. Some of those people would tell their supervisor a very positive story about their jobs.
They would be enthusiastic at the opportunities they perceived, and appreciative of the money they earned. Other individuals, working in the adjoining cubicle, told the opposite story. They saw nothing but limitation and poor pay.
Same job, same pay, but a diametrically opposite view of the job. Those with a negative perception usually didn’t last long, and after hiring positive new people, our company was eventually ranked number one for customer service in the publishing industry.
If you think a negative thought repeatedly, you literally rewire your brain. Same with a positive thought. Henry Ford was no neuroscientist, but his famous maxim foreshadows the work of pioneers like Kandel: “Whether you think you can, or think you can’t, you’re right.”
Chiropractor Joe Dispenza, in his book Breaking the Habit of Being Yourself, stresses that we have to build the neural wiring to perceive a positive reality, in the absence of material evidence of that reality, in order to be able to perceive that reality when it shows up (Dispenza, 2012).
If we haven’t built the neural capacity to perceive it, we don’t see our desired reality even when it’s right before our eyes. The old maxim “seeing is believing” has the process backward. Believing creates the neural capacity for seeing.
Neural plasticity works for us or against us. When a stroke victim regains full function by rewiring around the areas of the brain damaged by the stroke, or when a positive thinker rewires her brain to perceive a positive outcome, we use neural plasticity to our advantage. That’s the light side of the phenomenon.
There’s a dark side to neural plasticity. When the negative thinker repeats those thoughts hundreds of times, for thousands of days, that person reinforces corresponding pathways in the brain.
The plight of the PTSD sufferer is even worse.
He or she isn’t choosing to think negative or disturbing thoughts. They recur spontaneously. There are 17 symptoms of PTSD described in the DSM-IV, or Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, of the American Psychiatric Association.
Among those are intrusive thoughts, flashbacks, and nightmares. Nightmares are fear-laden dreams that interrupt our sleep. Flashbacks are scenes from the past that we experience as though they were in the present. Intrusive thoughts aren’t thoughts we choose to think, the way the negative thinker broods on what’s wrong.
Like flashbacks or nightmares, they’re involuntary. We are going about our business when suddenly our mind is ambushed by an uninvited thought.
The problem with PTSD is that these three symptoms indicate that the brain is being rewired with the negative memories of trauma. After experiencing a horrible event, the brain’s neural pathways are hijacked by those memories.
They intrude on sleep as nightmares, into daily life as flashbacks, and into normal thought processes as intrusions. They are invasions that rob the sufferer of a normal experience, and of inner peace. Brain researcher Joseph LeDoux calls this the “hostile takeover of consciousness by [negative] emotion” (LeDoux, 2002).
The dark side of the problem is that, disturbing though these symptoms are, they aren’t static. Over time, the neural bundles that carry the information related to the trauma grow in capacity.
What began as a small neural bundle becomes a big neural bundle. Other neural pathways wither to support the growth of these trauma-laden information superhighways. The brain reshapes itself around the invisible wound.
Recent research shows that the parts of the brain responsible for memory and learning, for integrating new ideas and keeping our lives fresh and vibrant, start to stagnate in people suffering from PTSD. Those parts of the brain actually shrink in size.
As neural resources flow into reinforcing the stress response inherent in nightmares, flashbacks, and intrusive thoughts, other parts of the brain are cannibalized to support the trauma. Even the prefrontal cortex, the part of the brain tasked with making logical executive decisions, shrinks in PTSD patients.
The cumulative result of decades of brain reshaping shows up in the calls we receive at the Stress Project office with plaintive observations that Dad is getting worse 40 years after Vietnam. The reason for this is that his brain has become expert at conducting the signals of trauma, while executive and learning functions wither.
Here’s where energy psychology can help both those suffering from PTSD and their family members. Research shows that 86 percent of veterans with high levels of clinical PTSD including nightmares, flashbacks, and intrusive thoughts normalize after six sessions of EFT (Church, Hawk, Brooks, Toukolehto, Wren, Dinter, & Stein, in press).
A study of young people who were orphaned in the 1994 Rwandan genocide and then learned TFT or Thought Field Therapy in a single session demonstrated that 75 percent of them recovered from clinical PTSD, and remained sub-clinical on follow-up (Sakai & Connolly, 2012).
EFT also helps family members. In a study of 218 veterans and spouses, many of the spouses themselves had PTSD after decades of living with veterans. Virtually all of these spouses normalized after a weeklong EFT retreat; 29 percent of them had clinical PTSD before the retreat.
A follow-up assessment six weeks later found that only 4 percent had clinical PTSD (Church & Brooks, 2012). Other EFT studies also show that once PTSD symptoms have improved, they remain that way over time.
This implies that new synaptic pathways, initiated at the healing retreat, are subsequently being reinforced. Other scientific work in the field of memory reconsolidation shows that there are periods during a therapeutic experience when a window of “lability” opens up, and long-standing behaviors can be disrupted. Once the association between a traumatic memory and the body’s stress response is broken, it stays broken. Neural networks then begin to rewire themselves to carry new and more supportive behaviors and thoughts.
In the study of veterans and spouses, the 218 participants received EFT in groups, rather than as individual therapy. There were five separate groups, and the symptom reductions followed the same trajectory in each group. This study is particularly encouraging because it demonstrates that EFT is effective when delivered to veterans in groups.
With estimates of the number of veterans of the recent Middle East wars who suffer from PTSD exceeding 500,000 (Veterans Health Administration 2012), in addition to those from the Vietnam War, our society desperately needs a way of helping large numbers of people to heal quickly.
Group work is more efficient than individual psychotherapy and offers the prospect of being able to treat this large cohort in a short space of time, before the neural pathways associated with PTSD have been enlarged by years of reinforcement.
Traumatic stress has been with us for as long as we’ve been a species. Yet we now find ourselves with the tools to address it effectively. It is also in our best financial interests to do so. A recent report finds that the lifetime cost of treating a single veteran suffering from PTSD is $1,400,000 (Kanter, 2007).
Besides the costs in human misery, the economic costs to society, if we fail to rapidly integrate energy psychology into primary care, will be intolerable. Multiply $1.4 million per veteran times 500,000 veterans and you get a cost of $700 billion.
That is a huge unnecessary cost in dollars piled on top of all the suffering it represents. As a society, it is essential that we choose differently. Neural plasticity has a dark side, but the good news is that the phenomenon works to our advantage if we treat it early and effectively with energy psychology.
Church, D., & Brooks, A. J. (2012). CAM and Energy Psychology techniques remediate PTSD symptoms in veterans and spouses. Paper presented at the conference of the Association for Comprehensive Energy Psychology, San Diego, CA, June 4. Submitted for publication.
Church, D., Hawk, C., Brooks, A. J., Toukolehto, O., Wren, M., Dinter, I., & Stein, P. (in press). Psychological trauma in veterans using EFT (Emotional Freedom Techniques): A randomized controlled trial. Journal of Nervous and Mental Disease.
Dispenza, J. (2012). Breaking the habit of being yourself: How to lose your mind and create a new one. Carlsbad, CA: Hay House.
Kandel, E. (1998). A new intellectual framework for psychiatry. American Journal of Psychiatry, 155, 457.
Kanter, E. (2007). Shock and awe hits home. Washington, DC: Physicians for Social Responsibility.
LeDoux, J. (2002). Synaptic self: How our brains become who we are. New York: Penguin.
Connolly, S. M., & Sakai, C. E. (2012). Brief trauma symptom intervention with Rwandan genocide survivors using Thought Field Therapy. International Journal of Emergency Mental Health, 13(3), 161-172.
Veterans Health Administration, (2012). Report on VA facility specific Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans coded with potential PTSD. Accessed Oct 30 at http://www.publichealth.va.gov/docs/epidemiology/ptsd-report-fy2012-qtr3.pdf
Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. New York: Crown.