"Keith"
was an infantry soldier for the Ninth Division in the Mekong Delta during
the Vietnam War. During an initial session in April 2008, he reported that he had seen
"many casualties on both sides" and was "still tormented with nightmares
and repeated flashbacks . . . sometimes I think I see Viet Cong soldiers behind bushes and
trees." His severe insomnia, complicated by the nightmares, kept him fatigued and low
functioning (self-rated as a 2 on a scale of 1 to 5) during the day. He had been diagnosed
with PTSD and reported having "had group and individual therapy through the VA with
little results." He was also diagnosed with Parkinson’s disease and was on
multiple medications for Parkinson’s, PTSD, insomnia, and depression, though they
were affording little or no relief for his psychological symptoms.
Just prior to treatment, Keith completed the PCL-M, which is the
military version of the PTSD Checklist (Weathers, Litz, Herman, Huska, & Keane, 1993).
His score was 65. The PTSD range is 50 or above.
Keith received six sessions that combined tapping on acupoints with the
mental activation of traumatic war memories and other psychological stressors. The
treatments averaged about an hour each, with the first five occurring within the initial
week and a follow-up session about two months later. The second session focused on
Keith’s profound sadness and guilt for shooting off another man's arm from close
range while the man was probably trying to surrender. By the end of the tapping protocol,
Keith was able to recall the horror of the situation with no self-reported physiological
reaction. This made it possible for him to fully embrace his sadness about what he had
done, recognize that it was in the context of war and it was possible that the man was not
surrendering, and to ask his own internal representation of the victim for forgiveness.
Following that session, Keith sent an e-mail: "Sleep is improving, no nightmares last
night. My overall energy has been on an upswing. My hands still shake but not as much.
I've been tapping on the shakes and it seems to help. I think what we've worked on is
quite amazing." The third session focused on Keith's anguish and self-blame about the
death of his closest friend. Even though Keith received a bronze star for his efforts to
save his friend, he felt he did not deserve it since his friend did not survive and he
still wept about the loss. Again, by the end of the tapping, Keith was able to access
the memory without physiological distress. Following this session, he reported continued
sleep improvement and feeling "much more at ease." Subsequent sessions focused
on additional combat traumas as well as incidents from his childhood and the general
stress and tension in his life.
From the end of the war until he began treatment, Keith was rarely able
to get more than one to two hours of sleep at a stretch, and he reported averaging about
two nightmares each night. By the end of the fifth session, he was getting seven to eight
hours of sleep each night and was having no nightmares. He reported at the two-month
follow-up session that the improved sleep patterns remained stable and symptoms such as
intrusive memories, startle reactions, and overwhelming obsessive guilt had abated. At the
end of the fifth session, Keith's PCL-M score was down from 65 to 34 (the PTSD cutoff is
50). Three months later the score had stayed stable at 34 and six months later it was 32. |
A
U.S. Coast Guard veteran who had served as the only female in an elite
search and rescue unit had been on medical disability since 1993 for both psychiatric
causes (PTSD) and physical conditions (spinal injury and tendonitis). She had frequently
been in life-threatening situations during non-combat rescue operations and had also
suffered severe sexual assaults while in the military. She scored 76 on the military
version of the standardized PTSD Checklist (scores above 49 exceed the PTSD cutoff)
administered immediately before commencing exposure/acupoint treatments in April of 2008.
Severe sleep disorder was a pervasive underlying symptom. Previous treatment included
years of individual and group counseling at the Veterans Administration, psychiatric
medications, a course of in-patient treatment as a result of high
suicidality/homocidality, PTSD Awareness Training, a program at the University of New
Mexico that focused on reducing nightmares in PTSD patients, and a variety of auxiliary
approaches such as Transcendental Meditation and nutritional counseling. None provided
significant or sustained symptom reduction.
Treatment consisted of four 90-minute telephone sessions using an
exposure/acupoint approach known as EFT ("The Emotional Freedom Techniques")
administered over a 10-day period. One month after the final session, the PTSD Checklist
scores had dropped from 72 to 47, falling below the PTSD cutoff, and the sleep disorder
symptoms had resolved. At that time, the patient provided a written narrative, commenting
that after all her previous treatments: "I still couldn’t fall asleep. I
couldn’t remain asleep without waking up repeatedly during the night. And I was
plagued by repeated traumatic nightmares every night. Sleep was my enemy, and I fought it
every night, waking up exhausted and tired . . . Within two sessions [of EFT], I felt
myself release all the associated trauma, emotions, and obsessions that interfered with my
sleep. Sleep became an easy and gentle activity free from worry and fretting. . . . No
more nightmares." One-year post-treatment, she reported having self-applied the
tapping protocol almost daily and her PTSD Checklist score was down to 32. |
