THE RECONSOLIDATION OF TRAUMATIC MEMORIES (RTM) PROTOCOL FOR PTSD: A TREATMENT THAT WORKS

Abstract

"PTSD treatments occupy five systemic levels—chemical, biological, neurophysiological, phenomenal, and cognitive. Pharmacological treatments bridge the chemical and biological levels. They are often imprecise in effect, and drugs imply brokenness. Direct neurophysiological manipulations include Stellate ganglion block, deep brain stimulation, transcranial magnetic stimulation, etc. These are new, often invasive, and sparsely attested. EMDR and RTM employ imaginal manipulation of internal images. Cognitive manipulations work with conscious responses. Cognitive interventions may expose patients to cultural issues, especially when performed in a group context. These include hyper-masculinized expectations, military culture, shame as self-blame, etc. EMDR, cognitive, and pharmacological approaches have shown equivalent efficacy. RTM modifies the imaginal structure of trauma memories, reimagining them as nonthreatening, past events. RTM may be employed without disclosure of trauma content. We hypothesize that changes to imaginal images directly and lastingly impact neurology via the reconsolidation updating mechanism. Four published RCTs of RTM will be presented with information about a fifth unpublished study of trainee results. All studies found effect sizes exceeding 0.08 SMDs with high patient satisfaction."