CHAPTER 1: LESSONS FROM VIETNAM VETERANS
1.A. Kardiner, The Traumatic Neuroses of War (New York: P. Hoeber, 1941). Later I discovered that numerous textbooks on war trauma were published around both the First and Second World Wars, but as Abram Kardiner wrote in 1947: “The subject of neurotic disturbances consequent upon war has, in the past 25 years, been submitted to a good deal of capriciousness in public interest and psychiatric whims. The public does not sustain its interest, which was very great after World War I, and neither does psychiatry. Hence these conditions are not subject to continuous study.”
2.Op cit, p. 7.
3.B. A. van der Kolk, “Adolescent Vulnerability to Post Traumatic Stress Disorder,” Psychiatry 48 (1985): 365–70.
4.S. A. Haley, “When the Patient Reports Atrocities: Specific Treatment Considerations of the Vietnam Veteran,” Archives of General Psychiatry 30 (1974): 191–96.
5.E. Hartmann, B. A. van der Kolk, and M. Olfield, “A Preliminary Study of the Personality of the Nightmare Sufferer,” American Journal of Psychiatry 138 (1981): 794–97; B. A. van der Kolk, et al., “Nightmares and Trauma: Life-long and Traumatic Nightmares in Veterans,” American Journal of Psychiatry 141 (1984): 187–90.
6.B. A. van der Kolk and C. Ducey, “The Psychological Processing of Traumatic Experience: Rorschach Patterns in PTSD,” Journal of Traumatic Stress 2 (1989): 259–74.
7.Unlike normal memories, traumatic memories are more like fragments of sensations, emotions, reactions, and images, that keep getting reexperienced in the present. The studies of Holocaust memories at Yale by Dori Laub and Nanette C. Auerhahn, as well as Lawrence L. Langer’s book Holocaust Testimonies: The Ruins of Memory, and, most of all, Pierre Janet’s 1889, 1893, and 1905 descriptions of the nature of traumatic memories helped us organize what we saw. That work will be discussed in the memory chapter.
8.D. J. Henderson, “Incest,” in Comprehensive Textbook of Psychiatry, eds. A. M. Freedman and H. I. Kaplan, 2nd ed. (Baltimore: Williams & Wilkins, 1974), 1536.
9.Ibid.
10.K. H. Seal, et al., “Bringing the War Back Home: Mental Health Disorders Among 103,788 U.S. Veterans Returning from Iraq and Afghanistan Seen at Department of Veterans Affairs Facilities,” Archives of Internal Medicine 167, no. 5 (2007): 476–82; C. W. Hoge, J. L. Auchterlonie, and C. S. Milliken, “Mental Health Problems, Use of Mental Health Services, and Attrition from Military Service After Returning from Deployment to Iraq or Afghanistan,” Journal of the American Medical Association 295, no. 9 (2006): 1023–32.
11.D. G. Kilpatrick and B. E. Saunders, Prevalence and Consequences of Child Victimization: Results from the National Survey of Adolescents: Final Report (Charleston, SC: National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina 1997).
12.U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Child Maltreatment 2007, 2009. See also U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, Child Maltreatment 2010, 2011.
CHAPTER 2: REVOLUTIONS IN UNDERSTANDING MIND AND BRAIN
1.G. Ross Baker, et al., “The Canadian Adverse Events Study: The Incidence of Adverse Events among Hospital Patients in Canada,” Canadian Medical Association Journal 170, no. 11 (2004): 1678–86; A. C. McFarlane, et al., “Posttraumatic Stress Disorder in a General Psychiatric Inpatient Population,” Journal of Traumatic Stress 14, no. 4 (2001): 633–45; Kim T. Mueser, et al., “Trauma and Posttraumatic Stress Disorder in Severe Mental Illness,” Journal of Consulting and Clinical Psychology 66, no. 3 (1998): 493; National Trauma Consortium, www.nationaltraumaconsortium.org.
2.E. Bleuler, Dementia Praecox or the Group of Schizophrenias, trans. J. Zinkin (Washington, DC: International Universities Press, 1950), p. 227.
3.L. Grinspoon, J. Ewalt, and R. I. Shader, “Psychotherapy and Pharmacotherapy in Chronic Schizophrenia,” American Journal of Psychiatry 124, no. 12 (1968): 1645–52. See also L. Grinspoon, J. Ewalt, and R. I. Shader, Schizophrenia: Psychotherapy and Pharmacotherapy (Baltimore: Williams and Wilkins, 1972).
4.T. R. Insel, “Neuroscience: Shining Light on Depression,” Science 317, no. 5839 (2007): 757–58. See also C. M. France, P. H. Lysaker, and R. P. Robinson, “The ‘Chemical Imbalance’ Explanation for Depression: Origins, Lay Endorsement, and Clinical Implications,” Professional Psychology: Research and Practice 38 (2007): 411–20.
5.B. J. Deacon, and J. J. Lickel, “On the Brain Disease Model of Mental Disorders,” Behavior Therapist 32, no. 6 (2009).
6.J. O. Cole, et al., “Drug Trials in Persistent Dyskinesia (Clozapine),” in Tardive Dyskinesia, Research and Treatment, ed. R. C. Smith, J. M. Davis, and W. E. Fahn (New York: Plenum, 1979).
7.E. F. Torrey, Out of the Shadows: Confronting America’s Mental Illness Crisis (New York: John Wiley & Sons, 1997). However, other factors were equally important, such as President Kennedy’s 1963 Community Mental Health Act, in which the federal government took over paying for mental health care and which rewarded states for treating mentally ill people in the community.
8.American Psychiatric Association, Committee on Nomenclature. Work Group to Revise DSM-III. Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Publishing, 1980).
9.S. F. Maier and M. E. Seligman, “Learned Helplessness: Theory and Evidence,” Journal of Experimental Psychology: General 105, no. 1 (1976): 3. See also M. E. Seligman, S. F. Maier, and J. H. Geer, “Alleviation of Learned Helplessness in the Dog,” Journal of Abnormal Psychology 73, no. 3 (1968): 256; and R. L. Jackson, J. H. Alexander, and S. F. Maier, “Learned Helplessness, Inactivity, and Associative Deficits: Effects of Inescapable Shock on Response Choice Escape Learning,” Journal of Experimental Psychology: Animal Behavior Processes 6, no. 1 (1980): 1.
10.G. A. Bradshaw and A. N. Schore, “How Elephants Are Opening Doors: Developmental Neuroethology, Attachment and Social Context,” Ethology 113 (2007): 426–36.
11.D. Mitchell, S. Koleszar, and R. A. Scopatz, “Arousal and T-Maze Choice Behavior in Mice: A Convergent Paradigm for Neophobia Constructs and Optimal Arousal Theory,” Learning and Motivation 15 (1984): 287–301. See also D. Mitchell, E. W. Osborne, and M. W. O’Boyle, “Habituation Under Stress: Shocked Mice Show Nonassociative Learning in a T-maze,” Behavioral and Neural Biology 43 (1985): 212–17.
12.B. A. van der Kolk, et al., “Inescapable Shock, Neurotransmitters and Addiction to Trauma: Towards a Psychobiology of Post Traumatic Stress,” Biological Psychiatry 20 (1985): 414–25.
13.C. Hedges, War Is a Force That Gives Us Meaning (New York: Random House Digital, 2003).
14.B. A. van der Kolk, “The Compulsion to Repeat Trauma: Revictimization, Attachment and Masochism,” Psychiatric Clinics of North America 12 (1989): 389–411.
15.R. L. Solomon, “The Opponent-Process Theory of Acquired Motivation: The Costs of Pleasure and the Benefits of Pain,” American Psychologist 35 (1980): 691–712.
16.H. K. Beecher, “Pain in Men Wounded in Battle,” Annals of Surgery 123, no. 1 (January 1946): 96–105.
17.B. A. van der Kolk, et al., “Pain Perception and Endogenous Opioids in Post Traumatic Stress Disorder,” Psychopharmacology Bulletin 25 (1989): 117–21. See also R. K. Pitman, et al., “Naloxone Reversible Stress Induced Analgesia in Post Traumatic Stress Disorder,” Archives of General Psychiatry 47 (1990): 541–47; and Solomon, “Opponent-Process Theory of Acquired Motivation.”
18.J. A. Gray and N. McNaughton, “The Neuropsychology of Anxiety: Reprise,” in Nebraska Symposium on Motivation (University of Nebraska Press, 1996), 43, 61–134. See also C. G. DeYoung and J. R. Gray, “Personality Neuroscience: Explaining Individual Differences in Affect, Behavior, and Cognition, in The Cambrid
ge Handbook of Personality Psychology (2009), 323–46.
19.M. J. Raleigh, et al., “Social and Environmental Influences on Blood Serotonin Concentrations in Monkeys,” Archives of General Psychiatry 41 (1984): 505–10.
20.B. A. van der Kolk, et al., “Fluoxetine in Post Traumatic Stress,” Journal of Clinical Psychiatry (1994): 517–22.
21.For the Rorschach aficionados among you, it reversed the C + CF/FC ratio.
22.Grace E. Jackson, Rethinking Psychiatric Drugs: A Guide for Informed Consent (AuthorHouse, 2005); Robert Whitaker, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America (New York: Random House, 2011).
23.We will return to this issue in chapter 15, where we discuss our study comparing Prozac with EMDR, in which EMDR had better long-term results than Prozac in treating depression, at least in adult onset trauma.
24.J. M. Zito, et al., “Psychotropic Practice Patterns for Youth: A 10-Year Perspective,” Archives of Pediatrics and Adolescent Medicine 157 (January 2003): 17–25.
25.http://en.wikipedia.org/wiki/List_of_largest_selling_pharmaceutical_products.
26.Lucette Lagnado, “U.S. Probes Use of Antipsychotic Drugs on Children,” Wall Street Journal, August 11, 2013.
27.Katie Thomas, “J.&J. to Pay $2.2 Billion in Risperdal Settlement,” New York Times, November 4, 2013.
28.M. Olfson, et al., “Trends in Antipsychotic Drug Use by Very Young, Privately Insured Children,” Journal of the American Academy of Child & Adolescent Psychiatry 49, no.1 (2010): 13–23.
29.M. Olfson, et al., “National Trends in the Outpatient Treatment of Children and Adolescents with Antipsychotic Drugs,” Archives of General Psychiatry 63, no. 6 (2006): 679.
30.A. J. Hall, et al., “Patterns of Abuse Among Unintentional Pharmaceutical Overdose Fatalities,” Journal of the American Medical Association 300, no. 22 (2008): 2613–20.
31.During the past decade two editors in chief of the most prestigious professional medical journal in the United States, the New England Journal of Medicine, Dr. Marcia Angell and Dr. Arnold Relman, have resigned from their positions because of the excessive power of the pharmaceutical industry over medical research, hospitals, and doctors. In a letter to the New York Times on December 28, 2004, Angell and Relman pointed out that the previous year one drug company had spent 28 percent of its revenues (more than $6 billion) on marketing and administrative expenses, while spending only half that on research and development; keeping 30 percent in net income was typical for the pharmaceutical industry. They concluded: “The medical profession should break its dependence on the pharmaceutical industry and educate its own.” Unfortunately, this is about as likely as politicians breaking free from the donors that finance their election campaigns.
CHAPTER 3: LOOKING INTO THE BRAIN: THE NEUROSCIENCE REVOLUTION
1.B. Roozendaal, B. S. McEwen, and S. Chattarji, “Stress, Memory and the Amygdala,” Nature Reviews Neuroscience 10, no. 6 (2009): 423–33.
2.R. Joseph, The Right Brain and the Unconscious (New York: Plenum Press, 1995).
3.The movie The Assault (based on the novel of the same name by Harry Mulisch), which won the Oscar for Best Foreign Language Film in 1986, is a good illustration of the power of deep early emotional impressions in determining powerful passions in adults.
4.This is the essence of cognitive behavioral therapy. See Foa, Friedman, and Keane, 2000 Treatment Guidelines for PTSD.
CHAPTER 4: RUNNING FOR YOUR LIFE: THE ANATOMY OF SURVIVAL
1.R. Sperry, “Changing Priorities,” Annual Review of Neuroscience 4 (1981): 1–15.
2.A. A. Lima, et al., “The Impact of Tonic Immobility Reaction on the Prognosis of Posttraumatic Stress Disorder,” Journal of Psychiatric Research 44, no. 4 (March 2010): 224–28.
3.P. Janet, L’automatisme psychologique (Paris: Félix Alcan, 1889).
4.R. R. Llinás, I of the Vortex: From Neurons to Self (Cambridge, MA: MIT Press, 2002). See also R. Carter and C. D. Frith, Mapping the Mind (Berkeley: University of California Press, 1998); R. Carter, The Human Brain Book (Penguin, 2009); and J. J. Ratey, A User’s Guide to the Brain (New York: Pantheon Books, 2001), 179.
5.B. D. Perry, et al., “Childhood Trauma, the Neurobiology of Adaptation, and Use Dependent Development of the Brain: How States Become Traits,” Infant Mental Health Journal 16, no. 4 (1995): 271–91.
6.I am indebted to my late friend David Servan-Schreiber, who first made this distinction in his book The Instinct to Heal.
7.E. Goldberg, The Executive Brain: Frontal Lobes and the Civilized Mind (London, Oxford University Press, 2001).
8.G. Rizzolatti and L. Craighero “The Mirror-Neuron System,” Annual Review of Neuroscience 27 (2004): 169–92. See also M. Iacoboni, et al., “Cortical Mechanisms of Human Imitation,” Science 286, no. 5449 (1999): 2526–28; C. Keysers and V. Gazzola, “Social Neuroscience: Mirror Neurons Recorded in Humans,” Current Biology 20, no. 8 (2010): R353–54; J. Decety and P. L. Jackson, “The Functional Architecture of Human Empathy,” Behavioral and Cognitive Neuroscience Reviews 3 (2004): 71–100; M. B. Schippers, et al., “Mapping the Information Flow from One Brain to Another During Gestural Communication,” Proceedings of the National Academy of Sciences of the United States of America 107, no. 20 (2010): 9388–93; and A. N. Meltzoff and J. Decety, “What Imitation Tells Us About Social Cognition: A Rapprochement Between Developmental Psychology and Cognitive Neuroscience,” Philosophical Transactions of the Royal Society, London 358 (2003): 491–500.
9.D. Goleman, Emotional Intelligence (New York: Random House, 2006). See also V. S. Ramachandran, “Mirror Neurons and Imitation Learning as the Driving Force Behind ‘the Great Leap Forward’ in Human Evolution,” Edge (May 31, 2000), http://edge.org/conversation/mirror-neurons-and-imitation-learning-as-the-driving-force-behind-the-great-leap-forward-in-human-evolution (retrieved April 13, 2013).
10.G. M. Edelman, and J. A. Gally, “Reentry: A Key Mechanism for Integration of Brain Function,” Frontiers in Integrative Neuroscience 7 (2013).
11.J. LeDoux, “Rethinking the Emotional Brain,” Neuron 73, no. 4 (2012): 653–76. See also J. S. Feinstein, et al., “The Human Amygdala and the Induction and Experience of Fear,” Current Biology 21, no. 1 (2011): 34–38.
12.The medial prefrontal cortex is the middle part of the brain (neuroscientists call them “the midline structures”). This area of the brain comprises a conglomerate of related structures: the orbito-prefrontal cortex, the inferior and dorsal medial prefrontal cortex, and a large structure called the anterior cingulate, all of which are involved in monitoring the internal state of the organism and selecting the appropriate response. See, e.g., D. Diorio, V. Viau, and M. J. Meaney, “The Role of the Medial Prefrontal Cortex (Cingulate Gyrus) in the Regulation of Hypothalamic-Pituitary-Adrenal Responses to Stress,” Journal of Neuroscience 13, no. 9 (September 1993): 3839–47; J. P. Mitchell, M. R. Banaji, and C. N. Macrae, “The Link Between Social Cognition and Self-Referential Thought in the Medial Prefrontal Cortex,” Journal of Cognitive Neuroscience 17, no. 8. (2005): 1306–15; A. D’Argembeau, et al., “Valuing One’s Self: Medial Prefrontal Involvement in Epistemic and Emotive Investments in Self-Views,” Cerebral Cortex 22 (March 2012): 659–67; M. A. Morgan, L. M. Romanski, J. E. LeDoux, “Extinction of Emotional Learning: Contribution of Medial Prefrontal Cortex,” Neuroscience Letters 163 (1993):109–13; L. M. Shin, S. L. Rauch, and R. K. Pitman, “Amygdala, Medial Prefrontal Cortex, and Hippocampal Function in PTSD,” Annals of the New York Academy of Sciences 1071, no. 1 (2006): 67–79; L. M. Williams, et al., “Trauma Modulates Amygdala and Medial Prefrontal Responses to Consciously Attended Fear,” Neuroimage, 29, no. 2 (2006): 347–57; M. Koenig and J. Grafman, “Posttraumatic Stress Disorder: The Role of Medial Prefrontal Cortex and Amygdala,” Neuroscientist 15, no. 5 (2009): 540–48; and M. R. Mi
lad, I. Vidal-Gonzalez, and G. J. Quirk, “Electrical Stimulation of Medial Prefrontal Cortex Reduces Conditioned Fear in a Temporally Specific Manner,” Behavioral Neuroscience 118, no. 2 (2004): 389.
13.B. A. van der Kolk, “Clinical Implications of Neuroscience Research in PTSD,” Annals of the New York Academy of Sciences 1071 (2006): 277–93.
14.P. D. MacLean, The Triune Brain in Evolution: Role in Paleocerebral Functions (New York, Springer, 1990).
15.Ute Lawrence, The Power of Trauma: Conquering Post Traumatic Stress Disorder, iUniverse, 2009.
16.Rita Carter and Christopher D. Frith, Mapping the Mind (Berkeley: University of California Press, 1998). See also A. Bechara, et al., “Insensitivity to Future Consequences Following Damage to Human Prefrontal Cortex,” Cognition 50, no. 1 (1994): 7–15; A. Pascual-Leone, et al., “The Role of the Dorsolateral Prefrontal Cortex in Implicit Procedural Learning,” Experimental Brain Research 107, no. 3 (1996): 479–85; and S. C. Rao, G. Rainer, and E. K. Miller, “Integration of What and Where in the Primate Prefrontal Cortex,” Science 276, no. 5313 (1997): 821–24.
17.H. S. Duggal, “New-Onset PTSD After Thalamic Infarct,” American Journal of Psychiatry 159, no. 12 (2002): 2113-a. See also R. A. Lanius, et al., “Neural Correlates of Traumatic Memories in Posttraumatic Stress Disorder: A Functional MRI Investigation,” American Journal of Psychiatry 158, no. 11 (2001): 1920–22; and I. Liberzon, et al., “Alteration of Corticothalamic Perfusion Ratios During a PTSD Flashback,” Depression and Anxiety 4, no. 3 (1996): 146–50.
18.R. Noyes Jr. and R. Kletti, “Depersonalization in Response to Life-Threatening Danger,” Comprehensive Psychiatry 18, no. 4 (1977): 375–84. See also M. Sierra, and G. E. Berrios, “Depersonalization: Neurobiological Perspectives,” Biological Psychiatry 44, no. 9 (1998): 898–908.
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