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Integrating choice points into mindfulness training for the dissociative subtype of PTSD: A case report

My Ngoc To, Zev Schuman-Olivier

Psychiatry Research Case Reports March 8, 2024 DOI: 10.1016/j.psycr.2024.100218 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case study Randomized Case report Peer reviewed
Sample size 1
Population Individual with dissociative subtype of PTSD (PTSD-D)
Intervention mindfulness-based intervention
Duration 8-week intervention
Topics Meditation PTSD
Keywords Clinical psychology Psychological intervention Psychotherapist Dissociative disorders Dissociation chemistry Randomized controlled trial Sense of agency
Citations 2
Key findings A patient with PTSD-D had a positive experience with an 8-week mindfulness-based intervention and improved self-regulation, possibly due to integration of choice points and structural safety.

Abstract

Approximately 15-30 % of individuals diagnosed with PTSD experience high levels of dissociation, a condition categorized in the DSM-V as a dissociative subtype of PTSD (PTSD-D). Despite the rising number of studies supporting mindfulness-based interventions (MBIs) for the treatment of PTSD, literature on mindfulness and dissociation remains scarce and discording. While best practices for offering mindfulness for dissociative patients remain unclear, integrating choice points into MBIs may be aligned with trauma-informed principles and effective in countering loss of self-agency associated with trauma. In this article, we present a case study from a larger randomized controlled trial of an individual with PTSD-D who successfully completed an 8-week MBI while displaying active dissociation symptoms throughout the group. Follow-up interviews with stakeholders in the patient's care as well as pre-and post-intervention assessments indicate that the patient had a positive experience with the mindfulness training and improved self-regulation. Analysis of the case study suggests that the mindfulness training may have been safe and effective for this patient due to the integration of choice points throughout the mindfulness training and promotion of structural safety. We expand on this by further discussing six influencing factors that contributed to the outcome of the case study and can serve as a reference for clinicians, researchers, and instructors who wish to offer MBIs safely to patients with PTSD-D.

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

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