An Evidence-Based Program to Effectively Treat Posttraumatic Stress Disorder June 17, 2008 Gunter Chasse, Oberstleutnant a.D. Alarik Arenander, PhD

PTBS  Re-experiencing phenomena  Hyperarousal  Avoidance behavior

3 PTBS  “Overwhelmed”  Prefrontal shutdown Brewin, Prog Brain Res, 2008

4 BRAIN DYSFUNCTION  Hypoactivation of mPFC  Hyperactivation of amygdala  Hyperactivation of hippocampus? Brewin, Prog Brain Res, 2008

Liberzon & Sripada, Prog Brain Res, 2008 Key Components of PTBS NegativeCorrelation

6 PTBS  Persistence of symptoms  Adaptation & plasticity  Complex pathways  Case uniqueness

7  18.5%: PTSD or depression (300k)  19.5 %: TBI (330k)  50% seek help  50% get minimal care  Evidence-based treatment lacking  High economic & human loss Rand Center for Military Health Policy, MG-720-CCF, 2008 Invisible Wounds American Veterans

Prefrontal Cortex Executive Control Center

The brain is plastic

Coherence uniquely supports rehabilitation

DoingDoing BeingBeing TMTM

Post-Vietnam Rehabilitation  Random assignment  TM vs psychotherapy  18 Ss, voluntary  Demographics, 33 yrs  9 dependent variables  3 month treatment Brooks & Scarano, J Couns Develop, 1985

Measures  PTSD symptoms  Anxiety  Depression  S/A  Insomnia  Employment  Family life Brooks & Scarano, J Couns Develop, 1985

Post-Vietnam Rehabilitation  Psychotherapy: no change  TM: 8 variables improved  TM: 7/10 no longer needed services of VAMC Brooks & Scarano, J Couns Develop, 1985

Personal Experience Brooks & Scarano, J Couns Develop, 1985 “I feel after I meditate that I no longer have the same intensity of tension, rage, and guilt inside — it’s as if a huge burden has been lifted.” — Vietnam Vet

Brainwave Coherence TM

NeuromuscularFlexibilityNeuromuscularFlexibility Self-AwarenessSelf-Awareness LearningAbilityLearningAbility DecreasedAnxietyDecreasedAnxiety Self-DevelopmentSelf-Development InnerOrientationInnerOrientation MoralReasoningMoralReasoning ConceptLearningConceptLearning EmotionalStabilityEmotionalStability DecreasedNeuroticismDecreasedNeuroticism IntelligenceIntelligence ComputationalEfficiencyComputationalEfficiency CreativityCreativity BrainwaveCoherenceBrainwaveCoherence

TMPMRSBF RABF RABF SM + relaxation * ** Blood Pressure Change Scores Rainforth M, Schneider R, Nidich S, et al: Current Hypertension Reports [9] , 2007 A Meta-analysis of Stress Reduction Programs: High Blood Pressure * p =.0002 * p =.0002 ** p =.02

Summary Upgrading Brain Integration to Improve Rehabilitation

TM Improves Rehabilitation  PTSD  Corrections  Substance abuse  Traumatic brain injury

Brain Integration Coherence Experience Improved Rehab Brain Plasticity

 Evidence-based  Easy to implement, learn  Produces desired results  Changes rapid & holistic  High Compliance  Cost-effective  Complementary  Culture neutral Why use?

Contact Alarik Arenander, PhD Gunter Chasse, Oberstleutnant a.D