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USF team investigates eye-movement therapy for PTSD

TAMPA — Sent to fight in Afghanistan, Brian Anderson killed a man for the first time in 2009. He helped load two slain buddies into body bags. Ran low on rounds as Taliban fighters attacked. Heard a dying local man scream for Allah.

Only a few years later, the former Green Beret was a suburban husband and father, physically uninjured but struggling with the psychic fallout of war.

Some days he locked himself in the bedroom to avoid his family. He swore he saw his two dead friends on the street. He passed open doorways and felt his chest tighten and his heart race as if he still had to brace for sudden attack.

Now 31, the Pasco County man tried one of the standard talk therapies used for post-traumatic stress disorder, with only initial success. Last June, he heard that University of South Florida researchers were studying a different approach.

Called "accelerated resolution therapy," or ART, it has patients think about their traumatic memories while watching the therapist's hands move back and forth. That part is similar to another eye-movement therapy. ART adds a second part to the session by asking patients to replace their traumatic memories with new, positive mental images.

Anderson isn't sure why, but after just one hourlong session, he felt better. He knows he saw two friends die in Afghanistan, for instance, but the memory seemed far less vivid and raw than it had before the session.

"It was like going through a mental massage," said Anderson, the veterans services officer for Pasco County, who did the therapy but was not part of the USF study.

Anecdotal success, however, is a far cry from a track record. Pioneered by a Connecticut therapist, ART had no body of research before USF decided to take a look at it. And the therapy comes with some unorthodox claims, promised as a fast cure not only for PTSD but disorders as diverse as fibromyalgia and frog phobia.

USF researchers took a risk by picking such a novel treatment for study, but they believe they may be on the ground floor of something big. Researchers have now published two small studies of military veterans with PTSD that show promising results.

In the most recent study, nearly 60 local veterans were randomly assigned to ART or to nontherapeutic career and fitness counseling. The ART group reported a greater decline in their PTSD symptoms than the nontherapy group.

ART may require far fewer sessions than traditional PTSD therapies, and if that proves true it would be a big deal. Dropout rates from conventional treatments, which often run around 10 sessions and require homework, run as high as 50 percent.

"I think it's a game changer," said Diego Hernandez, a Tampa psychologist who's working with USF on the project. "It's potentially a cure for some patients."

• • •

Officially recognized as a mental disorder in 1980, PTSD can affect anyone who has experienced a traumatic event, but many sufferers are veterans.

According to the PTSD Foundation of America, a third of combat veterans have symptoms such as flashbacks, a desire to avoid other people, irritability, blackouts and sleeplessness. Less than 40 percent of them are thought to seek help.

Research has shown two types of counseling — cognitive processing and prolonged exposure — to be the most effective treatments. Both are offered by Veterans Affairs.

The therapies work in different ways, but both seek to change how patients think and feel about their traumatic events. Medications such as antidepressants and sleeping aids are often used with counseling.

Eye movement desensitization and reprocessing, or EMDR, is a third approach, developed in the late 1980s and now approved by the Department of Veterans Affairs. It requires a patient to focus on a therapist's finger moving back and forth while recalling the traumatic memory. The idea here, too, is to make the memory less potent.

No one can say for certain what the eye movement does. Some theorize it provokes a state of relaxation that mimics deep sleep, allowing patients to finally process traumatic memories the way they do nontraumatic memories.

Skeptics say it's the talking portion of the therapy — not the eye movement — that is effective.

• • •

USF epidemiologist Kevin Kip, who works in the USF College of Nursing, wanted to explore less conventional PTSD therapies, ones not yet endorsed by the Department of Defense and the VA. He learned of ART when his mother mailed him a Connecticut newspaper article about West Hartford therapist Laney Rosenzweig and her new treatment.

Rosenzweig trained in EMDR but said she was dissatisfied with the free-form nature of it. She began experimenting in her sessions, eventually devising a "recipe" with a special number of eye movements and adding what she calls "image replacement" to the session. She said the traumatic memory isn't erased but becomes difficult to see in the mind's eye.

"Keep the knowledge, lose the pain," said Rosenzweig, who privately administered Anderson's single ART treatment on a visit to USF.

Replacing old memories with new images, if proved to work, would mark a significant departure from therapies that aim to help patients better tolerate old memories.

Rosenzweig said she has had success with her own clients over the past seven years. "Everybody says it's too good to be true," she said. "Well, I have plenty of people to testify that it works."

• • •

Still, her evidence is only anecdotal. The USF researchers are subjecting the technique to more rigor, but they have not undertaken the "gold standard'' of medical research — a trial that would compare ART with other standard therapies among randomly chosen subjects.

Scott Lilienfeld, a psychology professor at Emory University, said such studies of psychotherapy are more difficult than drug trials since there's no such thing as a "placebo" in therapy. But rigorous tests have been done on other PTSD treatments, and he said ART supporters are premature in their cheerleading. "The claims seem to be running well ahead of the research," he said.

Paula Schnurr, director of the VA's National Center for PTSD in White River Junction, Vt., had not heard of ART until a reporter asked about it. She said the USF studies look "promising" though she added far more intensive studies are required before it could be offered through the VA.

She emphasized that existing treatments can be effective for many patients, though she acknowledged the appeal of a faster-acting therapy. "That may be something patients strongly prefer," she said.

USF has additional plans for studies on ART, including a privately funded one that is starting to enroll 200 military veterans with PTSD. USF epidemiologist Kip hopes more institutions will take hard looks at ART.

"We're the only group worldwide studying this right now," he said. "We don't want it to be that way."

Times researcher John Martin contributed to this story. Jodie Tillman can be reached at [email protected] or (813) 226-3374.

Learn more

Want more detailed information about PTSD? Check out the National Center for PTSD's website: ptsd.va.gov/apps/AboutFace/.

USF team investigates eye-movement therapy for PTSD 02/02/14 [Last modified: Tuesday, February 4, 2014 12:55pm]
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