A single 5-6 hours manualized abreactive ego state therapy session has recently been subjected to two placebo-controlled investigations meeting evidence-based criteria. Ego state therapy was found to be a highly effective and durable treatment for posttraumatic stress disorder. Apparently, ego state therapy works because it is emotion focused, activates sub-cortical structures, and because the supportive, interpretive therapist reconstructs the patient's personality to be resilient and adaptive. In this article the author reviews the treatment procedures and presents the findings of both studies.
Barabasz, Arreed; Barabasz, Marianne; Christensen, Ciara; French, Brian; Watkins, John G
Using abreactive Ego State Therapy (EST), 36 patients meeting DSM-IV-TR and PTSD checklist (PCL) criteria were exposed to either 5-6 hours of manualized treatment or placebo in a single session. EST emphasizes repeated hypnotically activated abreactive "reliving" of the trauma experience combined with therapists' ego strength. Both the placebo and EST treatment groups showed significant reductions in PTSD checklist scores immediately posttreatment (placebo: mean 17.34 points; EST: mean 53.11 points) but only the EST patients maintained significant treatment effect at 4-week and 16- to 18-week follow-ups. Abreactive EST appears to be an effective and durable treatment for PTSD inclusive of combat stress injury and acute stress disorder.
Christensen, Ciara; Barabasz, Arreed; Barabasz, Marianne
Using manualized abreactive Ego State Therapy (EST), 30 subjects meeting DSM-IV-TR and Clinician-Administered PTSD Scale (CAPS) criteria were exposed to either 5-6 hours of treatment or the Ochberg Counting Method (placebo) in a single session. EST emphasized repeated hypnotically activated abreactive "reliving" of the trauma and ego strengthening by the cotherapists. Posttreatment 1-month and 3-month follow-ups showed EST to be an effective treatment for PTSD. Using the Davidson Trauma Scale, Beck Depression II, and Beck Anxiety Scales, EST subjects showed significant positive effects from pretreatment levels at all posttreatment measurement periods in contrast to the placebo treatment. Most of the EST subjects responded and showed further improvement over time.
Marugan de Miguelsanz, Montserrat; Carbonero Martín, Miguel Ángel; León, Benito; Galán, Manue
In this paper the relation between high intellectual capabilities and information retrieval strategies are studied. The variables are: sex, age, educational level and creativity. Strategies were measured with the ACRA Scales (Román and Gallego, 1994, 2004). General intelligence was measured with the "g" Factor Test (Cattell and Cattell, 1990) and the Progressive Matrices Test (Raven, 1996). Creativity was analyzed using the TAEC Abreaction Test (de la Torre, 1991). Primary School and Compulso...
Rotaru, Tudor-Ștefan; Rusu, Andrei
A systematic review and meta-analysis of the efficacy of hypnotherapy in the treatment of PTSD used literature searches to obtain 47 articles. However, only 6 were experiments testing the efficacy of hypnosis-based treatments. A fixed-effects meta-analysis was applied to postintervention assessment results and 4-week follow-ups. A large effect in favor of hypnosis-based (especially manualized abreactive hypnosis) treatment was found for the studies that reported the posttest results (d = 1.17). The temporal stability of the effect remains strong, as reflected by the 4-week follow-up assessments (d = 1.58) and also by long-term evaluations (e.g., 12 months). Hypnosis appears to be effective in alleviating PTSD symptoms.
Barabasz, Arreed F; Barabasz, Marianne; Watkins, John G
Ego state therapy (EST) evolved from a psychodynamic understanding of personality as a product of an individual's ego states to a conceptualization of how ego-energized and object-energized elements are bound together to cope with a traumatic event. Neurobiological studies now substantiate Watkins's war neuroses conceptualizations. Because of their severity, trauma memories are encoded in the subcortical-subconscious brain regions that are accessed by the single-session manualized EST procedure but not by the popular cognitive-behavioral management therapies. The imprint of the trauma is not accessible or resolvable by such top-down verbal understanding or reframing; EST is a bottom-up therapy. Abreactive hypnosis facilitates ego state expression at physiologically and psychologically intense levels sufficient to activate subcortical processes to release affect in the presence of the therapist, who adds ego strength to the patient. This is followed by interpretation and reintegration. The result is a reconstructed personality that is adaptive and resilient.
Field, E S
The therapeutic dissociative techniques of "anchoring" and "three-part dissociation," neurolinguistic programming (NLP) treatment paradigms incorporating the idea of division into ego states, are effective in crisis intervention and as a stimulus for catharsis. Using the anchoring technique in the first session, a patient with severe anxiety, manifested by episodes of hyperactivity, was able to superimpose inner resources upon the situations which led to the episodes. Utilizing three-part dissociation, the patient experienced the hyperactive episodes "for the very last time" and terminated them permanently. Hypnotic exploration and ideomotor signaling were used with a patient presenting with uncomfortable feelings associated with intense anger. After the origin of the anger was determined, a three-part dissociation produced an abreaction and catharsis. Interaction at a cognitive level integrated the feelings and knowledge into personal consciousness.
Favazza, A R
Most of the literature on bibliotherapy has been nonscientific, because of the too broad use of the term "bibliotherapy." The author proposes, for the sake of clarification in the literature, that "bibliotherapy" be defined as a program of selected activity involving reading materials which is planned, conducted, and controlled under the guidance of a physician as treatment for psychiatric patients and which uses, if needed, the assistance of a trained librarian. Bibliotherapy, then, falls into three categories: books prescribed for a patient, books selected by a patient, and group discussion of books. Bibliotherapy may be helpful by facilitating abreaction, projection, narcissistic gratification, verbalization, constructive thinking between interviews, and reinforcement of social and cultural patterns. Bibliotherapy is probably indicated in self-motivated neurotic patients who ask for helpful reading materials. Bibliotherapy offers no panacea, but with proper scientific study may help many patients.
Favazza, Armando R.
Most of the literature on bibliotherapy has been nonscientific, because of the too broad use of the term “bibliotherapy.” The author proposes, for the sake of clarification in the literature, that “bibliotherapy” be defined as a program of selected activity involving reading materials which is planned, conducted, and controlled under the guidance of a physician as treatment for psychiatric patients and which uses, if needed, the assistance of a trained librarian. Bibliotherapy, then, falls into three categories: books prescribed for a patient, books selected by a patient, and group discussion of books. Bibliotherapy may be helpful by facilitating abreaction, projection, narcissistic gratification, verbalization, constructive thinking between interviews, and reinforcement of social and cultural patterns. Bibliotherapy is probably indicated in self-motivated neurotic patients who ask for helpful reading materials. Bibliotherapy offers no panacea, but with proper scientific study may help many patients. PMID:5325817
Many of the revolutionary principles introduced by Ferenczi in his clinical practice have now been widely accepted especially in the field of trauma and trauma therapy. Examples of these innovative views include his emphasis on empathy as opposed to technical neutrality and his stress on the real conditions of child caring and family environmental deficits and on the consequences of interpersonal violence and abuse that lead to "identification with the aggressor" by the victim thereby resulting in the internalization of both aggressiveness and guilt (the split guilt of the abuser). The resulting "fragmentation" of the personality, which is now considered dissociation (instead of Freud's "repression"), is at the root of several severe disorders, characterized by distortion of reality, loss of touch with one's body and loss of trust in the other. Therefore "abreaction is not enough". A new, positive relational experience must be re-inscribed at the level of implicit memory.
The mechanism of menstrual rubella formed to be different shapes, characterized by itchy welts and attacked patient recurrently, they frequently came before menstruation and through the menstrual period. The mechanism of menstrual rubella in Chinese theory is heat accumulated in Yangming meridian and fur offended by wind-heat. The treatment for menstrual rubella is periodical treatment according to menstrual cycle. The basic principal is abreacting wind, nourishing Wood and eliminating heat in the premenstrual period, driving wind and removing heat in the menstrual period, nourishing blood and calming wind after menstruation. After the treatment, the chronic urticaria was cured and never attacked the patients before or during menstruation days any more.%经行风疹块,每值临经或行经期间,全身皮肤突起疹块,疹形大小不一,瘙痒异常,甚则融合成片,经净渐退,常反复发作,迁延不愈.若经行风疹为阳明积热于内,风热外侵皮毛；治疗可按月经周期性治疗,经前疏风养血,清热除湿；经期祛风清热；经后主要予以养血熄风治疗为基本治疗原则.
Turri, Maria Grazia
Aristotle's theory of tragic katharsis is the most ancient and debated theory of the effect of the theatrical experience on the audience. It affirms that tragedy effects the katharsis of fear and pity, engaging readers with the controversy whether by katharsis Aristotle meant purification of the emotions (i.e. their perfection within the mind) or purification of the mind from the emotions (i.e. their abreaction from the mind). In this paper I will explore how Freud's theory of transference can suggest a new interpretation of Aristotle's tragic katharsis. Transference allows for the representation and expression of repressed emotions through the re-enactment of past relational dynamics. Although this process is essential to the psychoanalytic method, it is the subsequent analytic endeavour which allows for the "working through" of repressed emotions, bringing into effect the transference cure. I argue that the dynamic between emotional arousal in re-enactment and emotional distancing in analysis offers an effective parallel of the dynamic between katharsis of fear and katharsis of pity in Aristotle's theory. Such interpretation of tragic katharsis suggests that the theatrical effect in audiences may be an opportunity for self-analysis and the 'working through' of unconscious psychic dynamics. Copyright © 2014 Institute of Psychoanalysis.
The notion of catharsis, in relation to tragedy, was introduced by Aristotle in his work Poetics. Over the centuries, Aristotle's innovative and enigmatic reference to this process has been widely commented on and given rise to intense controversy. In 1895, Freud and Breuer reconsidered this notion in their Studies on Hysteria, where they present the so-called cathartic therapeutic method. It is not, however, this aspect of psychoanalytical theory that the author of this article seeks to elucidate: drawing on a detailed study of the references to tragic catharsis in the work of Freud and Lacan, the author proposes to examine their implications for psychoanalytic treatment.With specific reference to Freud's article Psychopathic characters on the stage (1905) and Lacan's commentary on Sophocles' Antigone (1960), the author argues that catharsis is to be understood not so much as a mechanism of discharge linked to abreaction, but rather as the actual analytic process itself during which the Subject is 'unveiled' and thus faced with the enigma of his own desire. Copyright © 2011 Institute of Psychoanalysis.
Modern hypnosis started with the Austrian physician Franz Anton Mesmer (1734-1815), who believed that the phenomenon known as mesmerism, or animal magnetism, or fluidum was related to an invisible substance--a fluid that runs within the subject or between the subject and the therapist, that is, the hypnotist, or the "magnetizer". The term hypnosis was introduced in the 1840s by a Scottish surgeon James Braid (1795-1860), who believed the subject to be in a particular state of sleep--a trance. In the late 19th century, a French neurologist Jean Martin Charcot (1825-1893) thought hypnotism to be a special physiological state, and his contemporary Hyppotite-Marie Bernheim (1840-1919) believed it to be a psychological state of heightened suggestibility. Sigmund Freud, who studied with Charcot, used hypnosis early in his career to help patients recover repressed memories. He noted that patients would relive traumatic events while under hypnosis, a process know as abreaction. Freud later replaced hypnosis with the technique of free associations. Today, hypnosis is used as a form of therapy (hypnotherapy), a method of investigation to recover lost memories, and research tool. According to Caplan & Sadock, F.A. Mesmer is generally thought of as the fons et origo of modern psychotherapy; and from the early techniques of mesmerism, it is said, have evolved the more elaborate and sophisticated therapeutic measures of the analyst and his colleagues. Although Mesmer was certainly dealing with individuals suffering from a variety of neurotic disorders, and though the clinical successes he achieved were the result of psychological processes that his procedures induced in his patients, Mesmer's theoretical formulations, his understanding of the nature of the treatment he developed, and his specific procedures were all totally different from those of the 20th century analyst. He was one of the corne stones in the development of psychoanalysis through hypnosis mainly of hysterical
McKenzie, A G
Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.
Wu, Dongmei; Jiang, Xiaolian; Ho, Kit-Wan; Duan, Lijuan; Zhang, Weiqing
Experiencing a major natural disaster is a stressful event that challenges survival and sense of self. Adolescents are undergoing rapid developmental change in self-concept, and their sense of self is particularly susceptible to such stressful events. Although many studies have investigated adolescent self-concept, few have examined self-concept in relation to experiencing a natural disaster. Following the Great Wenchuan Earthquake in Sichuan Province, China, in 2008, this study aimed to (a) describe disaster experiences; (b) describe social support, coping, and self-support; and (c) identify disaster experiences, social support, and coping factors associated with self-concept of adolescent survivors 3 months after the earthquake. This was a large-scale cross-sectional study. A total of 1,976 adolescents living where the earthquake caused the most severe damage took part. The Tennessee Self-Concept Scale; Coping Styles Scale; and Internality, Powerful Others, and Chance Scales were used to assess self-concept, coping strategy, and locus of control, respectively. Sociodemographic characteristics, earthquake experiences, and social support were also obtained by self-report. Three months after the disaster, adolescent self-concept was generally positive. Locus of control centered on powerful others was the strongest predictor of total self-concept. The negative coping strategy, "abreacting," was a positive predictor of negative self-concept (self-criticism). Close attention to adolescents who use negative coping strategies and who tend to lack a sense of control is needed after major disaster events. Studies that examine long-term relationships between earthquake and other major disaster experiences and self-concept of adolescent survivors are needed.
Terr, Lenore C
Methods of conducting psychotherapy in the most severe forms of childhood posttraumatic stress disorder (PTSD), especially in those traumas discovered very early in life, are rarely reported. This paper presents such a report and in the process emphasizes three elements of treatment: abreaction (full emotional expression of the traumatic experience), context (understanding and gaining perspective on the experience), and correction (finding ways personally or through society to prevent or repair such experiences). With traumatized children, all three elements may be inserted into their therapeutic play, art, and/or talk. An overarching mood of light humor helps the transference stay positive and the child interested. The case of "Cammie," an infant who was bitten, shaken, and sexually abused, and whose 25-day-old sister was discovered at home, murdered, is the subject of this report. This little girl, upon removal at 13 months of age from her home of origin, growled, bit, sniffed sexual organs, rarely spoke, and behaved like the "feral children" described in the classic psychiatric literature. Two respected professionals diagnosed her as mentally retarded. A year in an outstanding foster home did little to improve her. At 29 months of age she was brought to the author, who saw enough imagination and pithy language to believe the child to be intelligent but severely traumatized. The author had begun to conceptualize three principles of PTSD treatment after a study of normal schoolchildren's reactions to the 1986 Challenger disaster. These three principles were used with varying emphases at different phases throughout the "wild child's" 12-year course of once-monthly therapy. Improvement beyond anyone's expectations ensued.
Quantitative Correlation of in Vivo Properties with in Vitro Assay Results: The in Vitro Binding of a Biotin–DNA Analogue Modifier with Streptavidin Predicts the in Vivo Avidin-Induced Clearability of the Analogue-Modified Antibody
Dou, Shuping; Virostko, John; Greiner, Dale L.; Powers, Alvin C.; Liu, Guozheng
Quantitative prediction of in vivo behavior using an in vitro assay would dramatically accelerate pharmaceutical development. However, studies quantitatively correlating in vivo properties with in vitro assay results are rare because of the difficulty in quantitatively understanding the in vivo behavior of an agent. We now demonstrate such a correlation as a case study based on our quantitative understanding of the in vivo chemistry. In an ongoing pretargeting project, we designed a trifunctional antibody (Ab) that concomitantly carried a biotin and a DNA analogue (hereafter termed MORF). The biotin and the MORF were fused into one structure prior to conjugation to the Ab for the concomitant attachment. Because it was known that avidin-bound Ab molecules leave the circulation rapidly, this design would theoretically allow complete clearance by avidin. The clearability of the trifunctional Ab was determined by calculating the blood MORF concentration ratio of avidin-treated Ab to non-avidin-treated Ab using mice injected with these compounds. In theory, any compromised clearability should be due to the presence of impurities. In vitro, we measured the biotinylated percentage of the Ab-reacting (MORF-biotin)⊃-NH2 modifier, by addition of streptavidin to the radiolabeled (MORF-biotin)⊃-NH2 samples and subsequent high-performance liquid chromatography (HPLC) analysis. On the basis of our previous quantitative understanding, we predicted that the clearability of the Ab would be equal to the biotinylation percentage measured via HPLC. We validated this prediction within a 3% difference. In addition to the high avidin-induced clearability of the trifunctional Ab (up to ~95%) achieved by the design, we were able to predict the required quality of the (MORF-biotin)⊃-NH2 modifier for any given in vivo clearability. This approach may greatly reduce the steps and time currently required in pharmaceutical development in the process of synthesis, chemical analysis, in
Quantitative Correlation of in Vivo Properties with in Vitro Assay Results: The in Vitro Binding of a Biotin-DNA Analogue Modifier with Streptavidin Predicts the in Vivo Avidin-Induced Clearability of the Analogue-Modified Antibody.
Dou, Shuping; Virostko, John; Greiner, Dale L; Powers, Alvin C; Liu, Guozheng
Quantitative prediction of in vivo behavior using an in vitro assay would dramatically accelerate pharmaceutical development. However, studies quantitatively correlating in vivo properties with in vitro assay results are rare because of the difficulty in quantitatively understanding the in vivo behavior of an agent. We now demonstrate such a correlation as a case study based on our quantitative understanding of the in vivo chemistry. In an ongoing pretargeting project, we designed a trifunctional antibody (Ab) that concomitantly carried a biotin and a DNA analogue (hereafter termed MORF). The biotin and the MORF were fused into one structure prior to conjugation to the Ab for the concomitant attachment. Because it was known that avidin-bound Ab molecules leave the circulation rapidly, this design would theoretically allow complete clearance by avidin. The clearability of the trifunctional Ab was determined by calculating the blood MORF concentration ratio of avidin-treated Ab to non-avidin-treated Ab using mice injected with these compounds. In theory, any compromised clearability should be due to the presence of impurities. In vitro, we measured the biotinylated percentage of the Ab-reacting (MORF-biotin)⊃-NH2 modifier, by addition of streptavidin to the radiolabeled (MORF-biotin)⊃-NH2 samples and subsequent high-performance liquid chromatography (HPLC) analysis. On the basis of our previous quantitative understanding, we predicted that the clearability of the Ab would be equal to the biotinylation percentage measured via HPLC. We validated this prediction within a 3% difference. In addition to the high avidin-induced clearability of the trifunctional Ab (up to ∼95%) achieved by the design, we were able to predict the required quality of the (MORF-biotin)⊃-NH2 modifier for any given in vivo clearability. This approach may greatly reduce the steps and time currently required in pharmaceutical development in the process of synthesis, chemical analysis, in
Terr, Lenore C
A severely traumatized child, acting like a wild animal, was removed from her parents at thirteen months of age when her three-week-old sister was found, bitten and shaken to death. (Her father was later convicted of manslaughter and imprisoned.) The older child was also covered with bite marks. When she was twenty-nine months old, this child, whom I call "Cammie," was brought to me from miles away by herfoster parents for once-monthly psychotherapy. I have treated her, stressing abreaction, context, and correction, once a month ever since. When she was five years old Cammie's foster family adopted her. She is now twenty-two. I call her the "wild child" because of the growly voice, vomiting at will, grabbing at the genitalia of strangers, and cruelties to animals that she exhibited after her rescue. Presently she attends college and is training to be a preschool teacher or an aide to pediatricians. I have taken notes on what Cammie says and does during the twenty years she has come to me. In the spring of 2011, I was asked to speak later that year about infantile memories at the Margaret Mahler Symposium, Columbia University, New York. With the organizing committee's approval, I accompanied Cammie and her adoptive mother to the October 1, 2011, meeting and asked her in front of the psychoanalytic audience to recount her oldest remembrances. She, her mother, and I spoke about the nonverbal manifestations of her memory as well. I had briefly prepared Cammie and her mother for our presentation at the Mahler Symposium, but for the most part, it was spontaneous and unrehearsed. Their comments are quoted in this article. At twenty-two the "wild child" reports no verbal memory from her first year. On the other hand, her behaviors, attitudes, and perceptions over the years have reflected what occurred to her and indicate very active nonverbal memories of the traumatic experiences. Fragments of verbal memory that she recounted in therapy between ages two and three have
Fabricación digital de maquetas para la mejora de la interpretación cartográfica y el fomento de la competencia creativa = Digital manufacturing of 3D DTM models to enhance cartographic interpretation & creative competence
Dámari Melían Díaz
environment. However, in the university context deficiencies have been detected for the interpretation of the relief forms. Land models can help to fill this gap. The emergence of low cost digital manufacturing technologies allows the creation of terrain models and their incorporation for teaching. This article presents the results of two experiences. In the first one, carried out during the 2015-16 academic year with 33 university students, topographic models are made using stacked sections, with the aim of improving the three-dimensional interpretation of the terrain forms. The second part of the experience, performed during the 2016-17 course is carried out with Master's students. This is a preliminary validation, with few students, which seeks to incorporate creative aspects to the realization of land models. To measure the variation of creative competence in students, the Creativity Abreaction Test (TAEC is used, before and after the experience.