Resolution of Dissociated Ego States Relieves Flashback-Related Symptoms in Combat-Related PTSD: A Brief Mindfulness Based Intervention.
Genine P. Smith, Glenn Hartelius
Military psychology : the official journal of the Division of Military Psychology, American Psychological Association 2020 DOI: 10.1080/08995605.2019.1654292 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Vietnam veteran with chronic PTSD |
| Duration | 21-month follow-up |
| Topics | Meditation PTSD |
| Keywords | Military PTSD Brief therapy Dissociation Flashbacks |
| Citations | 5 |
| Key findings | A mindfulness-based intervention targeting dissociated ego states produced rapid and durable resolution of chronic PTSD symptoms in a Vietnam veteran, without requiring exposure to trauma memories. |
Abstract
A novel understanding and therapeutic approach to the treatment of PTSD-related flashback triggers are described. Triggered responses are conceptualized as the result of latent dissociative structures of neural organization and psychodynamic functioning activated by current events. The dissociative structure - here described as a dissociated ego state (DES) - reflects a fracturing of executive functioning resulting in a delimited aspect of self that is not under cognitive control or subject to cognitive inhibition by the self of daily experience, and is the psychological construct behind intrusive PTSD symptoms. Use of a mindful attentional state permits regulated access to the DES (therapeutic engagement without risk of emotional dysregulation) so that dissociated cognitive resources can be recovered and the dissociated structure deactivated. This may relieve maladaptive responses and behaviors associated with the DES in a profound and durable way, without the need for exposure to or recovery of traumatic memories. Based on this understanding, a 9-step intervention is introduced with a case example of a Vietnam veteran suffering PTSD symptoms for 49 years with significant gains maintained at 21 months follow up. These findings demonstrate rapid and durable resolution of chronic PTSD symptoms through a mindfulness-based approach that focused on deactivation of dissociated ego states, in contrast to targeting trauma memories. If proven efficacious, this novel approach may result in reduced treatment costs and improved outcomes for veterans suffering with PTSD.
Comparable studies
Other case reports and case series on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Combining Cognitive-Behavioral Conjoint Therapy for PTSD with 3,4-Methylenedioxymethamphetamine (MDMA): A Case Example. One couple with PTSD and a severe trauma history, participating in a pilot trial... | 2019 | Case study | n = 2 |
| Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD | 2022 | Retrospective case series | n = 35 |
| Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder Patients with treatment-resistant depression and comorbid PTSD | 2023 | Case series | n = 5 |
| Treatment of nightmares in the context of posttraumatic stress disorder A client with chronic, severe posttraumatic stress disorder (PTSD) | 2010 | Case study | n = 1 |
| 5-MeO-DMT for post-traumatic stress disorder: a real-world longitudinal case study 23-year-old female with chronic refractory PTSD | 2023 | Case study | n = 1 |
Citations in the library
Cites 16
- Mindfulness and acceptance: expanding the cognitive-behavioral tradition Choice Reviews Online July 1, 2005
- A PILOT STUDY OF GROUP MINDFULNESS-BASED COGNITIVE THERAPY (MBCT) FOR COMBAT VETERANS WITH POSTTRAUMATIC STRESS DISORDER (PTSD) Depression and Anxiety April 17, 2013
- Dissociative identity disorder: An empirical overview Australian & New Zealand Journal of Psychiatry May 1, 2014
- Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience research European Journal of Psychotraumatology May 19, 2015
- A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder Frontiers in Psychiatry August 25, 2017
and 11 more in the library