In general, PTSD treatment involves changing one's perspective towards the traumatic event so that when triggered, the thoughts it recalls are not intrusive and debilitating - making it so the patient doesn't feel shame, fear, loss of control when trigered.
I know PTSD can be traumatic and takes different forms
I suppose my confusion still comes from the fact that stopping intrusive thoughts is measured as good. But what if these intrusive facts are needed (just like therapy) to process things in the long run?
I would understand if someone could ran a (very costly) experiment that said "Taking this over the course of 5 years lowered the amount of outbursts/negative behaviors someone took" but this is just measuring thoughts.
Presumably, if there had been another group that had been in a therapy group after seeing this traumatic film it is highly possible the number of times someone thought about the film (which is what they were measuring) would have gone up - but would that be bad?
If the patient is not sufficiently able to choose due to being mentally unable and the drug is likely to bring them back to lucidity, then it is obvious that bringing them into a lucid state is the logical path, so we should recommend administering the drug.
For my part, I've noticed that people who dwell on these traumas have a hard time. Meanwhile I've suffered numerous things that many of these people claim have led to debilitating mental illness and I operate in a space of mental comfort. So, should I encounter another trauma event, I'll take the forgetting drug.
And presumably you, believing otherwise, should refuse it.
P.S. Here's a thought experiment for you: What if the MMR-2 vaccine instantaneously kills people at the age of 60. It was introduced in 1963 and this year is 2022, so the first recipients are not yet 60. So you simply cannot prove that it does not do this. You have a son. How do you reason whether to risk the possibility of instantaneously killing your son when he hits 60 vs the risk of him contracting any of Measles, Mumps, or Rubella?
If someone successfully processes the trauma in a way that isn’t disruptive, they by definition don’t have PTSD anymore.
What you’re saying is a bit like saying someone who suffers from persistent, terrible constipation, to the point it causes them health issues should ‘just poop’.
If they could on their own, they wouldn’t have the problem!
Perhaps therapy is an intervention where they really can remove that waste from you with minimal invasiveness? And that's the argument here? But I still sorta think there is a measurement error here where taking a drug to not think about something so you can only think of it while with others is delaying the issue, not solving it.
The point remains - saying ‘but can’t you just x’ when the problem is they can’t just x doesn’t really get you anywhere.
If you have a bad day, talking to someone about it usually helps.
Hell, bitching to a coworker about the idiot you just got off the phone with is a pastime for the average office workers.
This drug eliminates the amount of time you think about a past event. This is pitched as good. Is the model that thinking about something is bad but talking about something is good? What if talking about something changes how or when you think about something? As you said with your co-worker example (which I realize is not PTSD levels) I think it could be pretty easily argued that fixating about your current situation is actually contributing to negative mental processes.
I have done therapy for specific issues and it worked for me - but nonetheless still dont see some contradictions between therapy and a pill that makes you think about something less.
Also, the purpose of therapy, such as CBT, is not to fixate on one's current situation, but be able to unlearn feelings of trauma / anxiety from the event. This is done by engaging with a trained professional who can help the patient carefully break down their thoughts and feelings. Reflecting on a traumatic situation with a partner is different from reflecting on a traumatic situation amongst oneself.
I think it's probably better to reflect on and process a _potentially_ traumatic event, than it is to repress or otherwise force yourself to forget it. But either of those is preferable to dwelling on it and spiraling in negativity.
Perhaps this is just a matter of degree. For really bad trauma (mass casualty, etc) it's probably good to have stronger tools available.
I think I get what you're saying; I could, for instance, just drink a lot every day to ignore a variety of ideas, but it's much healthier in the long run to deal with those ideas directly.
Unfortunately, the reason why there are so many palliative coping strategies is that unless a person is in a state where they can examine those uncomfortable thoughts, then it's just creating more harm and the person isn't able to deal with the issue. That in turn often leads to the maladaptive coping that leads people into therapy in the first place.
So a common therapeutic goal getting people to a point where they can first recognize that they are in an upset state, second calm themselves without totally disengaging from the event and, then (if possible) work on whatever thoughts or events led to becoming upset in that manner.
That work is contingent on the first two parts of that; palliative care to help people get into a place where they can do the first two things without engaging in more harmful types of coping strategies (drinking, for instance) seems like a reasonable method.
The drug in the paper, to me, seems more like the coping strategies you talk about but without the other physical harms. Like what if alcohol made you not think about something but actually kept your physical and mental health the same/stable? Would that be desired? Isn't that what this drug is hoping to achieve?
It seems plausible to that thinking (even if involuntary) about any other traumatic memory may result in short term stress but in the long run help you process it and be healthy? Like in my own experience thinking about something a lot on my own is part of therapy - since I really think about how I explain the situation and what really happened - so I guess I'm skeptical that not thinking of something is actually good for mental health in the long run even if in the short run it works.
That's a fair criticism. Doing research on real is tough -- everyone's experience is a little different, and is colored by their personal history -- and it'd be wildly unethical to put test subjects through an in-person experience stressful enough to induce lasting PTSD. Some studies, like the Tetris intervention one I linked elsewhere [1], used real trauma patients; others, like this one, have to rely on stress simulants like a violent film.
I will note, however, that Irréversible [2] -- the film this study used excerpts from -- is exceptionally violent. It's not a run-of-the-mill action film. One of the scenes the study probably used graphically depicts a man being beaten to death with a fire extinguisher.
[1]: https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-...
I guess maybe the core of my confusion comes with the term "intrusive" or "involuntary" memory. To me, in reference to PTSD, this sounds extremely negative. But perhaps you were in a situation where you saw someone die, perhaps even someone you know, should the goal be to only think about these things in therapy or when you sit down to meditate? Is involuntary/intrusive thoughts on these bad so long as it doesnt have major effects on your stability?
Not nearly as traumatic - but when I went through my last break-up I thought about it non-stop for a few weeks. I was able to get through my work and keep up social engagements fine, but otherwise it consumed me. Would it have been better to only think about the situation in therapy sessions and allotted meditation time? Maybe? But I'm not that sure on that I probably needed a few weeks of internal "involuntary" struggle in order to be free of the negative thoughts around it going forward.
I guess for me the answer is that if your brain is thinking about something, even if it seems a bit disorganized, you are still processing it on your own time and the short term benefits of not thinking about it then may not actually be good for your long term. Though perhaps this runs counter to established literature I'm not aware of.
I still have this multiple times, every day, even with 2-3x therapy per week since a year.
This is nothing like "recalling a memory". Also, since I am unable to clearly express what I have witnessed/experienced, talking to "ordinary people" (e.g. most my friends) about it is mostly met with reactions that really don't help at all.
A lot more people should come to this conclusion, reflect on it, and then not post whatever thought helped them come to this realization. Just go read enough to inform an opinion on the matter before sharing it.
There should not be discussion forum on the website if there is a belief that smart people (who have read plenty of books on clinical psychology and neurology) can't ask questions about something they haven't personally worked in.
>We found that participants receiving hydrocortisone showed a faster reduction in daily intrusion frequency. Voluntary memory was assessed once, at the end of the week, but was unaffected by hydrocortisone.
Ultimately I see some contradictions in what the goal of different types of psychiatry/therapy is. Is the end goal to just be as happy and functional as possible? Is it to avoid the worst case scenarios the most while not caring as much about baseline? Or is there a moral/humanistic good to processing the world even if it results in being less happy and more functional in concrete tasks?
I'm really not an expert in any of these things - but it does sometimes bother me that the discourse on this is jointed. I think it comes up in political/cultural talk quite often.