CURRICULUM SUMMARIES

INTERVIEW #1: Hugh Johnston, MD "Differential Diagnosis

PTSD is one of the very few psychiatric disorders that come under attack in almost every way: every assumption and theoretical underpinning is up for grabs. The criteria for a PTSD-inducing stressor has become so broad that virtually any event can now qualify as long as someone perceived it as traumatic. 

In this interview, we look at some of these diagnostic issues, as described in the DSM IV TR, especially the difference between acute stress disorder and posttraumatic stress disorder.

Here, Dr. Johnston uses the Diagnostic and Statistical Manual to clarify diagnostic issues.

INTERVIEW #2: GERALD ROSEN, Ph.D. “MALINGERING”

In 1994, the newer edition of the Diagnostic and Statistical Manual issued a warning about the diagnosing of PTSD: “Malingering should be ruled out in those situations in which financial remuneration, benefit eligibility and forensic determinations play a role."

Malingering is a medical and psychological term that refers to an individual fabricating or exaggerating the symptoms of mental or physical disorders for a variety of motives, including getting financial compensation (often tied to fraud), avoiding work, obtaining drugs, getting lighter criminal sentences, trying to get out of going to school, or simply to attract attention to sympathy.

At the present time, there are no clear methodologies that allow researchers researchers and clinicians to fulfill the guidelilne of the DSM IV to do that "ruling out" of malingering. The shame of this is that malingering in PTSD casts doubt on everyone who is actually suffering.

In this interview, we look at the impact of malingering and how to assess it.

INTERVIEW #3: JAMES HERBERT, Ph.D. “THE CULTURE OF PTSD.

The understanding and treatment of posttraumatic stress has changed over the years, especially as between the 2 world wars, the Vietnam conflict, and the conflicts in Iraq and Afghanastan. Dr Herbert reviews and explains these views.

INTERVIEW #4: ANTHONY D’AGOSTINO, MD: THE BRAIN, TRAUMA, and MEDICATION”

Posttraumatic stress disorder is characterized by symptoms that reflect some form of persistent reexperiencing of the original traumatic event. Possible symptoms of this reexperiencing include recurrent and intrusive distressing recollections of the event, recurrent distressing dreams of the event, and physiological reactivity upon exposure to internal or external cues that resemble an aspect of the traumatic event. Research has repeatedly shown that many individuals with PTSD produce significantly larger psychophysiologic responses upon exposure to trauma-related cues, compared to individuals without the disorder.

Trauma has been found to make the brain’s emotional processing centers — particularly the amygdala -- the parts of the brain that judge emotional intensity and make emotional memories — more sensitive in cases of PTSD.

In this interview, a practicing psychiatrist discusses the uses neurological findings and medication to treat adults and children with PTSD.

INTERVIEW #5: STEVEN TAYLOR, Ph.D: “COGNITIVE BEHAVIORAL TREATMENT”

Trauma outcome studies have consistently found the most effective PTSD treatments to be cognitive and exposure-based therapies that focus on emotional processing of the trauma material.

According to our next speaker, Dr. Steven Taylor, a number of cognitive and behaviors features distinguish people with PTSD. These include a complex array of cognitive abnormalities and behavioral problems. PTSD is associated with negative beliefs about oneself and the world. Behavioral factors and PTSD can mutually influence one another: PTSD symptoms can impair interpersonal functioning and aversive post trauma social environ-ments, such as low social support can exacerbate PTSD. 

In this interview, Dr Taylor discusses how and why CBT works.

INTERVIEW #6: BABETTE ROTHSCHILD, LCSW: “THE BODY REMEMBERS” 

The goal of Babette Rothschild is “to inspire psychotherapists working with traumatized individuals to learn as much as possible about theory, tools and treatment so that they can be well-equipped in working with the unpredictability of trauma and the diverse needs of clients.” In her books and in this interview, she encourages therapists to learn to trust and use their own common sense, often in lieu of what they have been taught, stating that “When therapy methods are applied uniformly like a recipe, their potential for harm increases, no matter how good they are.”

INTERVIEW #7: MARTHA BRAGIN, Ph.D: “ENGAGING SURVIVORS OF EXTREME VIOLENCE”

Engaging them in treatment requires the therapist’s being able to have and convey the capacity to understand and tolerate the awareness of terrible, unacceptable events in the world as well as terrible, unacceptable feelings in themselves. 

Melanie Klein, a post-Freudian psychoanalyst, provides a springboard for understanding and connecting to these survivors, who feel isolated by their experiences. 

Dr. Martha Bragin has spent her professional career working with survivors of extreme violence. She discusses her work in this interview.

INTERVIEW #8: FROMA WALSH, Ph.D.: “RESILIENCE”

Dr. Froma Walsh has developed core principles and values of a family and community resilience-oriented approach to recovery from traumatic loss when catastrophic events occur. In contrast to individually based, symptom-focused approaches to trauma recovery, this multi-systemic practice approach contextualizes the distress in the traumatic experience and taps strengths and resources in relational networks to foster healing and posttraumatic growth.

She discusses her work in this interview.

INTERVIEW #9: BILL O’HANLON, LMFT: POSTTRAUMATIC GROWTH”

Bill O’Hanlon presents alternative perspectives on the development of trauma-related disorders as well as powerful new methods for their successful resolution. His approach incorporates a treatment philosophy and methodology hope for the future. Clients are left with a feeling of freedom and a sense of renewed possibilities sometimes missing from more traditional approaches.