3 Comments

1. 

   Mike on March 3, 2014 at 8:22 am

   This was a fantastic show for so many reasons, but the discussion of Dr. Zimbardo’s work the famous Stanford Prison Experiment immediately called to mind NPR’s On The Media show this week. The show is called, Secrecy at the Border, and highlights abuses of unchecked U.S. agents, including a case that caused PTSD in a four-year-old girl.

   It’s a shame the advances in psychological understanding aren’t more universally understood and integrated into our system of government for the good.

   Thanks for the great content, Dr. Dave. I’m a long-time listener.

   Mike

   P.S. NPR’s Security at the Border can be heard at this url:

   https://www.wnyc.org/radio/#/ondemand/353531

2. 

   James Alexander on September 7, 2015 at 2:40 pm

   Dr Dave- following your interview with Zimbardo, I bought ‘The Time Cure’. I have been working with highly traumatised people for many years, and am always open to new approaches to this endemic issue. I must say, it was a very disappointing read- and overall approach. I had hoped that the general cognitive behavioural thrust had produced something of more value by now, but found that The Time Cure is just another means of engaging the pre-frontal cortex, just like standard CBT. Trauma is not a thinking issue- it is deeply embedded in the ’emotional brain’, as described by standout clinicians and authors like Bessel van Der Kolk (;The Body Keeps the Score’), and Bruce Ecker et al (‘Unlocking the Emotional Brain’). Contemporary neuroscience is very clearly demonstrating that brainstem and limbic areas are fundamental to trauma, leaving the neocortex of only peripheral relevance. This seems to be completely lost on Zimbardo et al. How can they write an entire book on trauma and not even mention this reality? Instead, their approach presents yet more variations of the ‘change your thinking- change your feelings ‘ paradigm, which has been to a large extent left behind by contemporary approaches and research (as being both inaccurate and inadequate). In addition to this glaring oversigtht, the authors present only CBT and exposure therapy as the standard treatments for PTSD- again, in this era, how are they able to write a book about the treatment of trauma, and include discussion of other psychological therapies, and omit any discussion (or even mention) of EMDR? Given the amount i) controlled studies- >20+, and ii) the amount of people who have benefited from it around the world- >1 million; and ii) the amount of practitioners around the world practicing it- tens of thousands, i find this omission just stunning.. As such, they have not presented a discussion of the psychological treatment of trauma, as they purport to. Is it possible that the authors are actually unaware of EMDR? Surely not. The bulk of the book is made up of one case study after another, in which clients are i) urged/trained to change their thinking, and ii) encouraged to seek mutual support from other PTSD sufferers. Research does not support the overall contention that trauma is a problem in thinking; there is more research support for the benefits of mutual support (no doubt, an effective strategy). Many of the case studies end with a statement to the effect that ‘the client still suffers from PTSD, but is now more able to participate in life, and more therapy’. Anything which helps this population, even slightly, is a good thing- but these post-scripts do not support the term used in the book title- ‘Cure’- clearly, no cure has happened, although welcome amelioration has. The authors cite one small scale research study (which they conducted), whereas Zimbardo (in the SRR interview) refers to ‘evidence’ of The Time Cure’s effectiveness,. I argue this is not only premature, but unwarranted- as Zimbardo, steeped in the research tradition that he is, should well know. (the Swords, as clinicians, could be forgiven for their, albeit premature, enthusiasm). No doubt- PTSD and trauma are very difficult problems to work with effectively. Even the most research supported therapies, like EMDR, struggle at times to create a positive impact. I have no doubt the Swords are doing good work with their clients, but to have completely ignored the major breakthrough in psychology in the last 30 years (EMDR, and other similar transformative approaches to psychotherapy, now explicable via memory reconsolidation) is just perplexing. I regualry work with people who have been literally ‘cured’ of PTSD- it is not only possible, but not unusual (and in other cases, much more difficult to shift). I read this book because even though i am very satsified with my practice of EMDR (and related approaches), i am still open to other options, even cognitive-behavioural ones. I would have thought this openness serves all in our profession. The only real value i got from the book (which was not new to me, but nice to see reinforced) was the emphasis that trauma sufferers are not mentally ill, but mentally injured. THis is an important emphasis, and can contribute to the de-medicalisation of trauma, which i believe underlies nearly all presentations of psychological problems. Dr Dave, your final comments in the interview drew attention to the fact that this approach is still just engaging the neo-cortex- spot on. Many of your other interviews clearly demonstrate why this is entirely inadequate.

3. 

   Van Nuys on September 7, 2015 at 7:18 pm

   James, thank you for your very detailed and careful response! It’s a valuable addition here!