The problem, as Karen academic psychiatrist at King's C011ege London discovered, iS that even and an authority on psychological injury in the with the support ofthe most U. K. armed forces, backs innovation but warns sympathetic therapisty such that clinicians shouldnotplace undue faith in feelings areoften t00 much a new PTSD treatment before it is validated to bear. That's why Schwarz by rigorous research. not saymg we don t equips her clients with tOOls need tO treat [PTSD], but the impetus is to do tO give them the strength tO it right, because dOing it wrong can harm peo- confront the raw emotions ple and also dissuades people from going to get they've kept locked deep other treatments. inside for so long. lnspired The battle here is about more than the future of by Native American heal- PTSD therapy. Throughout history, some of the mg arts, mystical traditions biggest breakthroughs in SC1ence have been made and the practices 0f tribal by individuals whose hunche s prompte d them shamans, some Of these tO embrace convention-shattenng ideas—often before the data backed them up. Perhaps the big- resources reqtllre S01 れ e - thing 0f a metaphysical gest hurdle for mavericks in any discipline is that leap. These include vanous intellectual orthodoxies te nd tO perpetuate them- selves. lt's usually much easier t0 obtain funding breathing and visualization exercnses, and alSO work to tinker at the edges of what is already known, with eye positions—based rather than demolish cherished assumptions. Few on the theory that different funding bodie s make grants based on Albert Ein- stein s maxim: "lf at first the idea is not absurd, emotions correlate tO mm- then there is no hope for it. ” ute variations in the direc- tion Ofgaze. At key points The dominant school in psychology today is the process, Schwarz a11 れ S cognitive therapy, a form 0f talk therapy aimed tO help clients tap intO their at helping patients feel better by encourag- intuition by posing what she ing them t0 think differently and change their calls her "magical question behavior. Often used in tandem with medica- tO find out what aspect Of tion tO suppress symptoms ofdepression or anx- their trauma history needs iety, cognitive therapies are backed by a wealth to be tackled next: "Don't 0f scientific research. Although nobody claims think. Ask your body, not they work for everyone, they have become SO deeply embedded in a global, multibillion- your brain, and take the first dollar complex of pharmaceutical companies, answer that comes. The unusual aspects Of insurance firms and health departments that CRM do not stop there. Patients can learn to critics are only half-joking when they describe safely dissolve long-buried distress by making them as a quasi-religion. With such entrenched interests at stake, dissidents armed with an a sound—usually a prolonged, high-pitched alternative paradigm are sure tO face resistance, note—in a process known as toning. Par- ticipants can alSO call on imagmary beings in the form of power animals"—therapy-speak calls them 'finternal attachment figures ”—tO "They're really well-meaning accompany them through the darkest tunnels people, but they of their past. These often take the form of big cats, wolves, bears or birds. None Of these enti- me up even WO 「 se : ties are, Of course, real in any ordinary sense, but CRM practitioners believe these and other resources can help patients connect with what they call the core self ”—an mner essence perhaps even mockery—especially 朝 om empir- lmmune tO life S cuts and bruises. —ically minded psychiatrists allergic t0 anything WhiIe Schwarz is fired by the conviction that that sounds remotely like W00- W00. Nevertheless, there are plenty 0f therapists she can help countless people for whom existing ready tO argue that you don't have tO be a crank methods have failed, there is a risk that some specialists may assume talk Of ' power animals" tO question the lmlts 0 ta . T e SC 00 or "toning sounds iS fantasy-prone pseudosci- iS one tributary in a much wider movement Of entific nonsense. Professor Neil Greenberg, an PTSD specialists who believe body-oriented screwed NEWSWEEK 29 APR 比 07 , 2017
Scotland, where CRM is used at rape cr1SIS centers remove symptoms 0f PTSD, they say, but also and a private in-patient trauma clinic. The therapy help patients live their lives with greater seren- has also been embraced by several psychiatrists ity than they would have imagined possible with Britain s state-run National Health Service, before they were poleaxed by their trauma. including Dr. Alastair Hull, one 0f the nation's top ln standard therapy, practitioners will encour- PTSD specialists, who leads NHS psychotherapy age survlvors tO come tO terms With an awful services for almost 400 , 000 people and runs a event by talking about it in great detail, and per- clinic devoted tO treatlng traumatic stress. haps even record their account SO they can later Ever since Sigmund Freud pioneered the listen tO it over and over tO extmguish their fear. "talking cure" in the late 19th century, psychol- Schwarz s work could not be more different. ln ogists have been trumpeting new ways to make a CRM session, there's no need to talk about people feel happier—or at least less miserable— what happened. Rather than delving int0 the and usually delivered more hype than hope. stories her clients tell about the past, Schwarz lndeed, a widely cited 2001 study found that it encourages them tO focus on the physical sen- is the warmth and empathy of the therapists— sations arising in their bOdies as they silently and not the type of therapy they use—that may recall their worst memones.• chest-crushing be the most important factor in treatment. And sadness, a hOt flash Of anger, stomach cramps, there's another reason tO be cautious about palpitations or feeling like one's heart is frozen CRM: lt has not yet passed any formal clinical in ice. Only by facing such feelings fully—ifonly trials. Nevertheless, CRM's proponents make for a moment—can the survivors finally let go of bold claims. The model can not only completely their buried anger, terror or shame. N E W S W E E K 28 A p R 比 07. 2 017
AT THE TURN Of the millennium, a young wom an move d tO a c abin on the Mull Of Kintyre, a headland in southwest Scotland renowned for the bleak beauty of its cliffs and the treacherous swirl of the currents below. There she took in tWO horses, and for a time the silent companion- ship ofthose geldings offered more in the way of healing than the countless prescriptions she'd been given by psychiatrists, or the well-meaning attempts by therapists tO excavate the most pain- ful parts of her past. Then, in early 2013 , she did something she had promised herself she would never d0 again: She bought a bottle ofvodka. The woman, who asked to be identified only as Karen, cannot recall the precise trigger that made her reach for a drink after 12 years of sobriety. But she does remember stumbling into the hospital in Lochgilphead, the nearest town. lntoxicate d and ne ar- delirious, she fe are d the suicidal impulses that had racked her since she was a teenager might prove t00 strong tO resist. Dr. Gordon BarcIay was making his rounds that day. A consultant in general adult psychiatry with a passion for Goethe, he was a more attentive lis- tener than the street drinkers who had served as Kare n's confidantes durmg past relap se s. From her hospital bed, she t01d him about the sexual abuse in her earlyyears, and how she'd learned to dull its searing legacy W1th alcohol. But the terror she felt while lying awake in bed as a young child, afraid t0 close her eyes, still lived inside her. lt was a story she had t01d t00 many psychiatrists and psychologists, but the endless retelling had never changed the way she 他 lt. lt was as if she was always waiting for the abuse tO begin again ・ ln that way, she was still 5 years old. "Everything was tinged with fear, ” says Karen, now in her mid-40s. "I was always driven by the past. Barclay soon realized Karen had post-traumatlc stress disorder (PTSD), a condition caused by exposure tO a horrific or life-threatening event that can lead tO a wide spectrum Of devastating symptoms, 仕 om bouts 0f overpowenng anxiety tO mind-saturating de sp alr, emotional numbness, night terrors and uncontrollable rage. Sufferers can expenence flashbacks tO a tlme when they thought they were about t0 die: high-definition replays ⅲ their minds, complete with smell, tex- ture and sound. Symptoms like these can persist for years, even decades, and leave people feeling so damage d that they can't help but push away even those they love the most. As Karen had discovered, PTSD can be mad- de ningly dffcult t0 tre at. She still remembers the panic in the eyes Of one SOCial worker When his attempts t0 get her t0 open up brought on the 血Ⅱ force of her terror. "lt didn't matter where I went—nowhere seemed tO be able tO Offer any help," she says. "The only way I knew how to deal with it was alcohol and also pre scnption drugs. Though Karen drew on her expenences tO forge a career ⅲ addiction support, she lived her life on a precipice. The abuse she had suffered did not just live on ⅲ her mind: lt seemed tO inhabit the very muscles, fibers and tissue 0f her body. This ViS ceral volcano was beyond he r COIISCIOLIS con- trol: lt manifested in panic attacks that felt like a giant screw turning in her gut, bouts ofnausea or the times when a lover s touch would cause her tO freeze like a startled deer. No matter how hard she tried to convince herself she was better, her body refused to believe she was safe. "I felt cowardly. I felt shut down," she says. "The fear in the body attached itselfto eve1Ything in life. Contrary to all she'd been told, the answer wasn t more talk. lt was less. Karen was trapped in her head, and with Barclay's help, she saw that the way to fix her mind was tO listen tO her body. "I would hate to knock talking therapy, but it can encase you more in the trauma—you almost become stuck in it, ” she says. They're really well-meaning people, but they screwed 1 れ e up even worse. Karen re ached thiS conclusion—one at stark odds with much of the therapy conventionally used for trauma—after Barclay introduced her to a new and relatively obscure method for treat- ing PTSD. The Comprehensive Resource Model (CRM) was developed overthe past decade by Lisa Schwarz, a licensed psychologist in Pennsylvania wh0 has practiced for 30 years. Fusing elements 0f psychology, spirituality, neurobiology and sha- manic power animals," Schwarz has taught the technique tO more than 1 , 500 therapists around the world, including more than 350 people in NEWSWEEK 26 APRlL07, 2017
Scottish consultant psychiatrist Dr. Frank Cor- re qmres much hard-to - obtain funding. Undaunted, Schwarz is determined to build rigan, tO the Lawson Health Research lnstitute, her movement from the grassroots and spends located in a hospital on the edge of the city much Of the year on the road conducting work- center. Lanius, intrigued by Schwarz s work, shops globally, from lreland and Greece t0 the had offered a dream opportunity for anyone pioneering a new form 0f therapy: a day's run U. S. and AustraIia. She and her comrades are with a powerful functional MRI machine. These alSO pursumg another avenue tO convmce the medical establishment they're not Just New Age types Of scanners measure fluctuatlons in b100d kooks: They're banking that neuroscience will flow and oxygenation t0 show what happens show there's more to CRM than mag1C ・ inside the skull when people perform certain tasks or revisit memories—making them ideal for investigating a new therapy. Lanius has used such images tO shOW that ON A BITTERLY cold day in February 0f 2016 , traumatic experiences can cause lasting physi- Schwarz landed at the airport in London, cal changes in the brain. ln particular, she has Ontano, a city 0f366 , 000 people nestled in the shown hOW trauma appears t&dlsruptt e neu- alpathways th at unde rp in ourabilityto relate agricultural plains Of southern Canada:As hen t0 others, which may help explain why so many taxi sped through slushy streets, Schwarz felt survlvors report feeling cut 0 代 from their loved the anticipation that only comes when years ones. One former soldier tOld N ルルた that Of work suddenl seem a ste closer to frui- when he had returned from Northern lreland in tion. Professor Ruth Lanius, one of the world's the early 1970S , his wife and children seemed leading neuroscientists investigating PTSD, tO him tO be as lifeless as mannequins in a shop had invited Schwarz and a close collaborator, THE DEEPESTWOUND NEWSWEEK 33 APRlL07, 2017
ofdirt"—practitioners report that the absence Of CliniC for military veterans he runs ln judgment from the animal can help people learn Dundee, Scotland. tO forgive Others and themselves. As Steve's sesslons with Hull pro- For all this innovation, however, history sug- gressed, the former soldier discov- gests there has been no smooth arc from igno- ered hiS power animal"—a sleek, rance tO enlightenment in our understanding velvet-coated Jaguar. HuII asked him of the interplay of mind and body at work in t0 close his eyes and then led him trauma. ln the American Civil War, medics diag- back tO one of his most disturbing nosed spent men with an ailment they termed early memories: being beaten by his "soldier's heart," blaming their psychological alcoholic father. Hull told steve the collapse on cardiac problems. Victorian doctors Jaguar could help the little boy in him diagnosed suruvors Of train crashes With rail- feel that he would not have to face his way spme, assuming their malaise was caused ordeal alone. by damage t0 their spinal columns. while the Recalling that moment, Steve tells creation 0f the PTSD diagnosis by the American N どルル記た , 'l'm standing there as a Psychiatric Association in 1980 spurred a pro- small child, standing underneath this liferation Of research, treatment outcomes are cat, with huge paws on either side of still often poor. Given that history, professor Sir me, almost with my head against its Simon Wessely, president ofthe Royal ColIege of chest. l'm feeling the vibration of Psychiatrists, wonders whether the buzz around this thing breathing. lt was incredi- the neuroscience Of trauma may be premature. bly powerful. We believe we have 1 れ ore 0f a neuroscientific Hull worked with another former understanding 0fPTSD, but l'm slightly dubious soldier WhO learned tO summon an about that, and I think an awful 10t ofit is pretty eagle, which circles overhead, scout- crude," Wessely tells N ルた . "ljust wonder if ing for danger, and a grizzly bear, that's our modern way ofstorytelling. wh0 taught him he can be tender as Despite such reservations, it is hard tO dis- well as tough, but there was some- miss the testimony ofpatients whO say they owe thing extra special about Steve's their sanity t0 CRM. Among them is Steve (not bond with his big cat. One evening, hiS real name), a former special forces SOldier when Steve encountered a group of whose PTSD symptoms had grown so severe aggresslve young men at a servlce that he had come close to taking his own life. station, he says the jaguar steered Steve, who lives in ScotIand, sought help from him out of trouble. Steve recalls the Hull, the NHS trauma specialist, who has since Jaguar's advice: "Listen, it will all co-authored an academic textbook on CRM be fine, walk away. Even if someone with Corrigan and Schwarz. does provoke you, what's the worst Hull has practiced psychiatry for 26 years and thing that can happen? You're a cou- e arne d his medical doctorate studying survl- ple ofminutes late for your coffee. vors of Piper Alpha, a North Sea oil platform that Steve adds: "A power animal' gives you exploded in 1988 , killing 167 people in the world's options. With my history, l'm worried that l'm deadliest offshore 0 ⅱ disaster. Having taught going tO hurt someone and this is not going tO evidence -based the rapies, including E MDR and end well. I don't care—if l'm provoked in that trauma-focused CBT, two of the most widely way, I m going tO react, and l'm not going tO use d trauma treatme nts in Britain, Hull adopted stop until they stay down. Schwarz s approach when he found it worked for Like Steve, Karen needs no convlncing. Armed patients whO did not respond to other methods. with the sense 0f security provided by the Earth He later began using CRM at a mental health breathing, grid and her two power horses, she found the courage tO confront her past without feeling like she was about to die. Under Barclay's patient guidance, she was finally able t0 say goodbye t0 four decades ofwordless pain. Patients are relieved to For me, something shifted," Karen says. di500 e 「 they may be suffering 'There was a degree 0f re-experiencing which l'd never done before. He created a safe space from a very 「 e physicalinjury to allow me to feel. ” buried somewhere in the brain's While a menagerie of animal totems now 86 b 弸 i00 れ eu 00 poised tO pounce, SW1m or wing their way tO N E W S W E E K 36 A p R 比 0 7 , 2 017
scan her b0dy for even the smallest points where she could still feel a sense ofbeing centered and present. He then asked her tO imagme JOlning these dOts with bars Of energy tO create a grid of light" crisscrossing her body—a CRM tech- nique tO stop her dissociating. patients say that this imagmary structure—the grid—serves as a kind of"emotional scaffolding" that keeps them stable as painful memones surface. ln later sesslons, Barclay invlted Karen tO choose a power animal" tO help her confront more of the abuse she'd suffered ⅲ childhood. Rather than conjure an lmagmary animal, as clients often do, Karen drafted ⅲ her adopted horses, imagining that they were close tO her the whole time, watching W1th loving, protective eye s. Barclaywent on t0 teach her another grounding exercise, known as 'CRM Earth breathing," ln which Karen imagined she was filtering energy up from the Earth's core, drawing it t0 the base 0fher spine through the sole 0f one f00t then expelling it out the Other. ln another breathing exercise, she released anger by seeing herself "fire breathing smoke and flames like a dragon. And she learne d t0 bathe herselfin kindness by visualizing the act of inhaling and exhaling through her he art. Some psychiatrists will lump such techniques intO the same waste bin as tarot cards and crystal he aling, and advise patle nts tO instead try one Of the standard therapies widely endorsed by gov- ernment health regulators. Many practitioners use trauma-focused cognitive behavioral ther- apy, a form oftalk therapy adapted t0 treat PTSD. Though CBT therapists may also use breathing and relaxation tOOls, the core Ofthe process rests on leading trauma survivors through an "expo- sure exercise tO revisit their most distressing memone s SO they gradually become e asier tO bear. At the same time, the therapists will talk through what happened with the clients t0 help them arrlve at a less threatening mterpretation SO the past loses its grip over the present. Stud- ies show the approach can help people who have suffered a one-offevent such as a car crash or Ⅵ 0- lent assault. However, there is far less evidence tO suggest it helps people W1th the most complex pre- "l'm worried that l'm going 50me0 れ e and this is れ 0t going t0 end w 可 to hurt NEWSWEEK 32 APR 比 07. sentations: those whO, like Karen, have suffered multiple traumas over many years. Here is the problem with cognitive thera- P1es, according tO the CRM innovators: Talking engages primarily with the prefrontal cortex¯ the walnut-contoured upper layer 0f the brain that processes language and abstract thought. This "top-down' approach might help some- b0dy t0 cope better with their symptoms but t0 truly resolve decades-old fear, anger or shame, the therapist needs tO find a way tO influence the pnmitlve, mstinct-driven parts Ofthe brain near the top 0fthe spine. words alone are unlikely t0 have much impact on these deeper, preverbal regions. The best way tO rewire this emotional brain" is tO help clients work from the "bottom up by putting their physical sensations at the center Of the process. For clients like Karen, whose lives are organized around escapmg these feelings, the first task is tO regaln a sense of self-mastery over their own body. "ln order to confront the deepest layers of anxiety, fear and survival terror, you have tO go beyond just telling stories about the past, says Domna Ven- touratou, a Greek psychotherapist and founder of the lnstitute for Trauma Treatment in Ath- ens, WhO trained under Schwarz. "You have tO find ways to safely unearth 01d emotions stored deep in the body. ln CRM the emphasis is on making sure these emotions can be dissolved safely. Prac- titioners claim the breathing exerclses, visual- izatlons and Other t001S can help cleanse toxic emotions from the emotional brain ” while actlvating neural pathways associated with being cared for and nurtured. Girded with their power animals," and Other resources, survivors can finally release feelings that would have otherwise been t00 overwhelming tO face. TO resolve trauma you have t0 go back and re-experience it, rather than just understand says Barclay. ℃ RM provides the t001s t0 d0 that in a way that conventional talking therapies, and indeed many trauma-focused therapies, Often don't. That's why it leads t0 breakthroughs. " For all the enthusiasm, however, the obstacles to CRM and other body-focused therapies becom- ing more W1dely available are formidable. Govern- ment regulators te nd tO approve only tre atments that have been subJected to large and expensive clinical trials—whether they be new therapie s or drugs. Although several insurers will cover CRM sesslons in the U. K. , this is not yet the case in the much larger U. S. health market. Schwarz and her collaborators in S cotland plan to launch a joint U. S. - し K. treatment outcome study in the fall, but accumulating persuasive data can take years and 2 017