A new psychotherapy that may treat PTSD in one session

Patients who have PTSD may not respond completely to standard treatments. As one text states, "Current therapeutic regimens are effective in a majority of patients, but many individuals continue to have persistent symptoms of PTSD despite conventional treatment. (1,2) Thus, new approaches that can help these patients do better are needed. The recent emergence of accelerated resolution therapy (ART) and psychedelics with psychotherapy are relatively new therapies responsive to this need. (3,4) There is now also another psychotherapeutic approach that may be added to this list. It is based on the suggestion of New York University neuroscientists led by Daniela Schiller in Nature in 1910 that people's fearful memories could be erased. (5) This therapy is called The Cortina Method or TCM, named after Michael Cortina, who developed it. This new approach to patients who have painful memories may be profoundly effective in some cases and is briefer than other interventions. As NBC has reported this and as is presented in this therapy's website, just one visit is often enough to eliminate crippling affect patients may have after trauma even when it has been present for decades. This relief may therefore wholly alter these patients' lives. In light of this success, Cortina's therapy has now been reported in over 400 press and media US outlets. Testimonials of both patients and therapists can be reviewed at MichaelCortina.com (Accessed 5/27/2024). This opinion piece will present an overview of this therapy.The core benefit from TCM likely involves memory reconsolidation.Memories previously stored may be rebuilt each time a memory is recalled, and as a result of this rebuilding, the affect associated with painful memories may be altered. (6,7) TCM, though, does not require patients to recall or recite their past trauma in detail. This benefit is potentially most important because otherwise, patients may not initially seek out or may not later continue other PTSD therapies that could be beneficial, because they may find their reciting past details of their traumas too painful. As of now, this therapy has not shown any downsides, though in the future, follow-up studies may reveal these.Patients responding have had even the most painful emotions and tragic past traumas, yet after just one session experienced relief. These traumas have Included, for example, veterans who have had beloved service members blown up by an explosive device right next to them, patients have had family members killed when with them in a car accident, patients have been gangraped and even tortured. The gains from this therapy, it appears, too, may generalize. Patients after experiencing this therapy have reported relief of anxiety associated with other past traumas they have experienced. These findings have been recorded in video-recordings that show these results from start to finish.Peer-reviewed, double-blind research comparing TCM head-to-head with other, current standard therapies has not though been done. Long term results also have not been obtained. Researchers interested in conducting these studies could, it would seem, readily conduct these studies. With the positive results obtained this far and the absence of reported, harmful side effects, though all this is only anecdotal, Institutional Review Boards likely would be prone to accepting pilot studies that are proposed.Patients coming for treatment as shown in video-recordings by therapists who have treated them often initially feel hopeless due to their anxiety having destroyed the quality of life for years when prior help hasn't succeeded. They have sometimes seen several past therapists without success. Since these dire beginnings and subsequent positive results are documented in numerous video-recordings and reported by now large numbers of patients and therapists, in this piece I will bring basic information regarding TCM to the attention of therapists and others.Personal reports of patients and therapists are presently immediately available on the above TCM website. One patient exclaims there, for instance, "Unbelievable, incredibly life-changing for me! For 40 years I carried the past around as part of my identity, it's not me anymore! Thank you!" Another says, "This session was more helpful than 20 years of therapy. It's a miracle." A therapist calls this therapy "truly life-changing. Another therapist says that this method has "revolutionized how we deliver care for acute and complex trauma.The results are fast, lasting and transforming". Some of the therapists I talked to at the training session I attended were initially, themselves, patients. They had PTSD, learned of TCM, and then sought it out. After they regained their quality of life, some of these therapists, they told me, then, sought out TCM training to be able to offer it to their patients. Some therapists at this same training session I attended were returning for additional training. They sought to hone the skills they had learned only initially, since acquiring TCM skills is as the case with most therapies an asymptotic endeavor.In TCM Cortina has provided a panoply of interventions that he has integrated into a series of step-by-step measures that build upon each other.Counter-intuitively, at least for me, therapists having attended even just one first training session may gain results close to those that Cortina himself achieves. The successes they may achieve, unprecedented in their practices, often surprise even them. This may occur because these interventions may be effective even when they are performed sub-optimally. Even when they use only some, these therapists report, these alone may still achieve for patients the results they have sought. How Cortina came to develop TCM may help explain this. He as a social worker had given patients state-of-the-art therapy but found this to be frustrating because all-too-often it was insufficiently effective. Consequently, he sought out from the medial literature all interventions that showed unequivocal evidence of therapeutic efficacy. He sought to maximize measures possible due to the plasticity of our brains. This therapy may also be effective because in addition it includes suggestion as used and taught early on by the psychiatrist Milton Erickson. He was known for his exceptional success in treating patients with whom other therapists had failed. Therapists I initially came to know of TCM through a colleague who contacted me, raving at how singularly successful she and others had found it to be. She, like me, had studied ART before this and found TCM to be even more rapid and effective. I went, then, myself, to a training session, as I had before to learn ART. I recall, to provide an example of ART for comparison a patient who responded well to ART. She had repeatedly been sexual abuse be an older person as a teen. She in her imagination using ART saw in her mind this abusing person decomposing into the dirt beneath her. This fertilized the soil resulting in its growing beautiful, flowers. She then saw herself giving these flowers to children who receiving them, shrieked with delight.TCM may equal to or even surpass ART in its efficacy as my colleague believed, though, as I repeat, this has not been empirically studied and shown. TCM may most reflect and be seen as built upon the views of Bessel Van Der Kolk as related in his book, The Body Keeps the Score. (11) Passages in this work suggest the principles Cortina has adopted. I will include here a few of these similarities here. Van Der Kolk reports, for example, how one patient feared that his approach was "some new age gimmick." (11, at 296) Some people, likewise, have thought this too when they have first heard from others examples of TCM's most marked successes.As a second example, Van Der Kolk relates the experience of a veteran who had unbearable nightmares. He saw in his dreams, for instance, Vietnamese children who had died. He reports in regard to this patient that trauma during war may not be treatable only with words. Cortina, in sync with this, uses visual, body, and other measures, seeking, too, to effect change by these additional means.Van Der Kolk also cites the United States World Trade center disaster as an example of how profoundly visual images may affect us. We may play sights of such disasters, he says, "over and over" in our minds. (11, at 233) Seeing an event like this, he says, disrupts our brain's networks of communications. Cortina, likewise, again, seeks to restore to patients the healthy brain circuits they had prior to their trauma.Van Der Kolk, finally, summarizes the therapeutic ends he believes therapists should strive for. The sensory feelings of being seen, cradled and supported, he says, can serve as antidotes to static, frozen feelings produced by prior trauma. They then can contradict these frozen feelings, replacing them with sensations rooted in "safety, mastery, delight and connection." (9, at 310) This could be seen Cortina's ultimate mantra just as well. His basic presupposition mirrors also Milton Erickson's, that "people already have the resources they need to effect change." (12) Therapists, as others, may quite rightly question whether patients who have experienced life-shattering trauma can again ever escape life-deadening PTSD symptoms. They reasonably may doubt whether any therapy exists that can provide them relief. They may after experiencing TCM be without, however, their previously even unbearable anxiety.TCM may restore meaningful life to patients who previously have given up hope and concluded that for them at least, getting better will never be possible.As one authority says this, "New advances in the neurobiology of fear memory promise novel approaches to PTSD treatment, including the erasure of traumatic memories." (13) Still, of course, experts most appropriately urge caution. They say, for example, "Caution is required when inferring reconsolidation from behavioral results and when using reconsolidation theory to predict and account for such data." (14)(15)(16)(17) Therapists seeking TCM training can pursue this through the above TCM website. Those wanting simply to become acquainted with this therapy may find that by just viewing this website, this will provide for them the information they want. These patients' and therapists' testimonials particularly illustrate the profundity of the changes our brains' plasticity may make possible. For me, my merely becoming aware of even just these relatively few patients' success has informed me of how much change after only brief therapy is possible. Patients' lives can be destroyed by trauma. Yet, they may have the potential, even then, to get better. I would not have, prior to coming to know of TCM have as fully imagined this.