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Effects canabis PTSD; further research needed:

Conclusions:

Posttraumatic stress disorder is 1 of the approved conditions for medicinal marijuana in some states. While the literature to date is suggestive of a potential decrease in PTSD symptomatology with the use of medicinal marijuana, there is a notable lack of large-scale trials, making any final conclusions difficult to confirm at this time.

Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series.

OBJECTIVES:

 

Cannabidiol (CBD) is a non-psychotomimetic cannabinoid compound that is found in plants of the genus Cannabis. Preclinical research has suggested that CBD may have a beneficial effect in rodent models of post-traumatic stress disorder (PTSD). This effect is believed to be due to the action of CBD on the endocannabinoid system. CBD has seen a recent surge in research regarding its potential value in a number of neuro-psychiatric conditions. This is the first study to date examining the clinical benefit of CBD for patients with PTSD.

 
Methods:

This retrospective case series examines the effect of oral CBD administration on symptoms of PTSD in a series of 11 adult patients at an outpatient psychiatry clinic. CBD was given on an open-label, flexible dosing regimen to patients diagnosed with PTSD by a mental health professional. Patients also received routine psychiatric care, including concurrent treatment with psychiatric medications and psychotherapy. The length of the study was 8 weeks. PTSD symptom severity was assessed every 4 weeks by

patient-completed PTSD Checklist for the DSM-5 (PCL-5) questionnaires.
RESULTS:

 

From the total sample of 11 patients, 91% (n = 10) experienced a decrease in PTSD symptom severity, as evidenced by a lower PCL-5 score at 8 weeks than at their initial baseline. The mean total PCL-5 score decreased 28%, from a mean baseline score of 51.82 down to 37.14, after eight consecutive weeks of treatment with CBD. CBD was generally well tolerated, and no patients discontinued treatment due to side effects.

 

CONCLUSIONS:

 

Administration of oral CBD in addition to routine psychiatric care was associated with PTSD symptom reduction in adults with PTSD. CBD also appeared to offer relief in a subset of patients who reported frequent nightmares as a symptom of their PTSD. Additional clinical investigation, including double-blind, placebo-controlled trials, would be necessary to further substantiate the response to CBD that was observed in this study.

Source: PubMed

 

Remark: N = 11 very small to be reliable

Anonymous: Canabis helps me with my (C)PTSD complaints

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Finding a qualified therapist is the first thing

"He / she who does not know how important trust is in contact does not understand. Because in most cases the client has a disorganized or fearful attachment with the parent."

The way out of your problems will not be short and quickly found. But it means you have to listen more to your feelings and what you really want. Therapy or help with your problems will release sadness, fear, anger and sometimes denial or wanting to be forget. You have (complex) PTSD because you  have a lot of painful experiences. Your pain and real feelings buried deep in your abdomen. Perhaps you can't cry and do not find yourself emotionally worthy of consolation. Perhaps you have learned to ignore feelings of sadness, fear and anger. You may feel numb or you may feel nothing at all. A good therapist is experienced and registered as a qualified therapist and you notice that yourself. With a good therapist you feel at ease or accepted. Painful experiences will have to be discussed here in the consulting room. A good therapist does not blame you, does not force you and makes you feel that who you are and what you know or remember is okay. He / she is not afraid of your experiences the feelings and thoughts that you have, because you do not have to feel responsible for what it does to someone else, as you have been told, guilt. The child in you does not dare to cry because of the pain he/ she is not guilty of. But finding a good therapist takes time. Some do not want someone of the same sex and mistrust that. That's OK. Many people feel little or nothing

after years, live in their heads, dissociate or want to forget. But how do you know if the other person is competent? Simply put, you notice that, you notice the questions, the way in which your problems are looked at. As soon as you feel and notice that you are forced into an apologetic or explanatory attitude, you know that you are dealing with one who probably is not experienced in treating victims. With a good expert you feel and know that you do not have to explain your problems. You have to remember that even a very well-trained psychiatrist or psychologist who has no experience or knowledge first wants to know for sure if what you told is true.  They are people that are of no use to you, because they do not know how it is. They are more concerned with their own thoughts about what you say than that you feel that it is ok. They are people who soon prescribe medication, make it clear to you, that you can better focus on your future or be in the here and now. They are certainly not people if you have or had psychotic symptoms, that they think that psychotherapy is a good thing. But perhaps it is very simple he / she does not believe in recovery or improvement if painful matters are to be discussed. Once again you are not your traumas or you are not your pain, you are a person with bad memories who often experience the past as being present. Besides processing it is also important that you dare to trust your feelings as a natural given thing. Finally, other therapies such as haptonomy, among other things, also work well.

It's time to act, as figures show

no more looking away

According to current estimates, more than 119,000 children in the Netherlands are being abused or molested yearly. In the US many war veterans take their own live. That's after 10 years more than one million victims. It's a huge ignored and neglected problem. Nevertheless, I realize that discussing child abuse and the possible consequences is almost no topic of study for nurses, psychiatrists and psychologists. Methods such as the structured interview are hardly used yet. One prefers to avoid the subject. Or one fears the client starts to worry too much about it or one does not know how to address and treat it. Sexual abuse is a theme that comes to the attention in waves and then disappears into oblivion. Dirty secrets can only be combated or solved with openness. This means that the mental health care simply has to create openness and ask for it in a direct and open manner. Victims expect to be asked about it. There is also the thought that victims will often discontinue or abort therapy if one wishes to deal with the subject. This is in contrast to known practice, which shows that there is little dropout. But good therapy results or experiences must

slowly become more aware in "the forest" of the mental health care or among therapists. What is needed is that, in addition to diagnosis a description of the client's life history and inventory of trauma must be done. That has many advantages. For research into the etiology of disorders one gets a better understanding of environmental factors triggering or causing disorders. The fact that there is hardly any report of life history's is partly due to the opinion that a disorder or even in particular trauma is that the environmental factor is less important than a genetic one. That is certainly still the case concerning psychosis. It is time for the mental health to realize its responsibility and realizes that avoiding the problems only gives rise to problems and thus becomes chronic . But also lack of treatment or wrong diagnosis and thus wrong treatment can ultimately lead to a suicide attempts. But practice shows that victims also have a lot of resilience. Care must be open and provide room for emotional support that victims often lack and have learned to avoid or deny, sometimes because the abuse has been done by organized groups or the church

Is (C)PTSD for life and does therapy help?

In general the results of therapy for (C)PTSD does not differ that much from the results of therapy for other problems. One can say that the intensity of the emotions diminish and also that the flashbacks will disappear. The main objective is that clients go from surviving to living. The past will have lesser influence in ones live. It's also important to develop resilience and for that reason therapist are givers of hope and methods that work. It all comes down simply speaking to have a good cry and start over again. It's clear that what seems traumatic for the one is not so for the other. By definition traumatic experiences has a great impact on a person.

On a certain moment in the development of the mental health care there will be a better understanding of (C)PTSD and treatment will be common. But until people with trauma with severe consequences for them are not helped and understood this organization is necessary, especially if taboo is the case. Therapy or recovery is more than merely digging in ones past. When that time comes another disorder maybe in the picture. There will be a time that clients with trauma will be understood and perhaps cured. To answer the first question; no, (C)PTSD is not for life it merely depends on if you can find a qualified therapist.

"Treatment, please do."

 

Lecture by MA Ineke Koopmans Groningen 2015 The Netherlands

In essence the presentation of M.A. Ineke Koopmans - GZ-psychologist Lentis Groningen - , in my opinion a inspired therapist, for mental healthcare workers of Lentis Groningen (Netherlands). Early on the participants came walking in. One followed the presentation with great attention, which was presented with humoristic pictures. F.i. one in which a therapist said to a client "please spare me the details, i just had breakfast." Ineke gathered some cookies, perhaps she was forgotten that I had organized the catering with coffee, tea and cake. Before the pause I asked the participants to close their eyes and relax. I asked them to imagine them that they had experienced something shameful. Furthermore I asked them what they hope for or expect from the other. With some hesitation people answered. Afterwards Ineke showed a video of clients who underwent treatment and as a result their lives changed for the better. Ineke started to tell about the RCT - random controlled trial - called TTIP which stands for Treating Trauma In Psychosis.

Treatments like EMDR en CBT (exposure) were explained. These treatments are based on exposure of the feelings, thoughts and images of the traumatic experience. Both treatments showed good results. The control group or waiting list showed some improvement too during the research. The fact that these client knew they will be treated  - expectation - , could be a reason for the slight improvement. There came some questions about the effect of therapy and why EMDR works. It was mentioned that EMDR by following a finger that it would work the same way as in sleep. (REM). But that appeared not to the explanation, because EMDR also works when one uses sound clicks or taps on the knees. Is some case a headphone is used with altering sound clicks.

The theory of why EMDR works is still in development. The role of the short term memory was mentioned. Further research and testing of the theory is needed f.i. is it a result of a process (neuronal networks) or the extinction according to conditioning. We don't know the answer yet. Following a finger, listening to sound clicks uses the short-term memory in such a way that the accompanied feelings are differently stored in the long-term memory. In such a way that by repeating this there is a extinction of strong feelings of fear and other emotions. In time it will get more like a normal memory. Ineke explained that the problem with PTSD is in essence the avoidance of the trauma mentally and in behavior. Clients have flash-backs namely because they avoid the trauma in thinking and behavior and feelings, images and thoughts that accompanies it.

So clients with PTSD has a lot on his mind, one is alert, quickly anxious or angry. A other question was if EMDR or CBT has sometimes no result.The answer was that it didn't differ so much with therapy for other mental problems. Listening to her presentation one can conclude that clients with psychotic symptoms reported  a great background of traumatic experiences. (98%). It seemed that some distortion could result due to their psychotic complaints, but that their suffering was significant. It appeared - in contract one expects or thinks - that they were quit reliable in reporting traumatic experiences. Significantly though male clients tend to differ in reporting traumatic experiences, according to Ineke due to shame and taboo. 

Also remarkable was the compliance for therapy, there was little drop-out, something one would not expect with such disturbing experiences. Also the difference was mentioned between PTSD and psychosis and in the same time the similarities. There is some overlap, but the difference lies in the way of interpreting or the way we look at the course of the problems. With psychosis we think of nature thus biologically and with PTSD in nurture thus psychologically. Though as Prof. Jim van Os puts it in case of psychosis we tend to think it must be very serious thus biologically and with PTSD much less thus psychologically and so less serious in consequences and so treatable. 

The overlap of psychosis and PTSD was mainly due to similarities in the presentation of PTSD witch point to emotion regulation and feeling numb with little motivation and the negative symptoms like flat emotions and apathy. But also both have intrusive problems. In case of PTSD the flash-backs and in case of psychosis the images and thoughts/feelings. Because of the strong felt conclusion of a clear biological reason there is little or no motivation for research in circumstantial reasons. Furthermore Ineke told that many clients were ruled out of research of effects of trauma therapy. Less  good news was a graphic in which there was reverse causality between the seriousness of the traumatic experiences  and the outcome of therapy. The more serious the trauma's the lesser the prognosis. Also Ineke mentioned the difference between grief and loss. (visiting a graveyard) Also noticeable was the sex of the therapist, if it was a male or opposite a client felt more resistance with the problem.

Epilogue:

I experienced that walking from it mentally and in behavior of painful experiences do not work and that mutual trust and thus know-how of positive effects of treatment is needed and in which we should believe and must experience by learning. Openness and creating a climate in which it is normal to ask about these experiences is needed. I didn't have psychotic episodes for quit a while although some had a poor prognosis about my recovery. I end with where I started "treatment, just do ït"

Living with (complex)PTSD

Living with traumatic experiences and with it's consequences like (complex) PTSD is almost impossible to explain to by standers. Trying to explain it to them and feeling understood is almost impossible. So I stopped trying. Therapy and counseling is different and therapists who doesn't have knowledge, training or experience is for both a frustration and not understanding each other. It looks like people with psycho trauma tend to talk a different language.  The approach in therapy is different than what clinicians are used to. So many victims go on living with PTSD like symptoms. In many cases they are considered difficult and complex. People who come to believe that after many attempts to find a therapist that has experience, PTSD is what they must get used to. Many get frustrated and feeling hopeless. Some get addicted and their anger and frustration combined with being isolated is not fully understood and recognized.

Many looses their job, get lost in frustrated relationships. Some develop suicidal thoughts or had suicide attempts. People with (C)PTSD are commonly considered hopeless. The message they get is "PTSD is for life" But I wonder why. Is not that because we have little knowledge about how to treat them and little or no exchange in good training and skills. Is it not that we tend to blame victims f.i soldiers for being part of a war we blame them for it. Or for being a liar who blames a nice neighbor for child abuse. So many children got the message "well it didn't happen, shame on you." Their shame let them live with painful memories silently. We must be aware that pedophiles are often organized. Slavery is not a problem of merely underdeveloped nations. Often if the diagnosis is  that of a personality disorder or that of a schizo-spectrum. PTSD is often not diagnosed. But we must speak out and change the situation for the better. But most of them feel too much ashamed to tell their story. They seem to lack confidence in others. We need to gather information about therapies and insights that work for them and start to exchange them in conferences worldwide and in education of social workers and therapists. This is certainly the case nowadays  with many war fugitives worldwide, how must we let them adjust if we can't help them with what they experienced. We must stop the cycle of violence.

My opinion:

I think that clinicians more or less have a common view which is very emotionally crippling for survivors and that is that the origin of a psychosis must always be a genetically one. Even if we assume that trauma can cause a psychosis, we assume automatically a genetic predisposition. Almost every scientist and clinician tend to think that. It is emotionally crippling because the outcome or prognosis of a psychotic disorder is very poor. There seems to be no cure and only medication can prevent a next one. Why do we disbelieve the many stories of prove that childhood abuse can cause psychosis in later life. There is hope and we must do research that will prove otherwise. But there seems to be no indication for it, we are convinced in our perception.

Comprehensive Reviews

 

Child Maltreatment and Psychosis: A Return to a Genuinely Integrated Bio-Psycho-Social Model
John Read1, Paul Fink2, Thom Rudegeair3, Vincent Felitti4, Charles Whitfield5

1 Department of Psychology, University of Auckland, New Zealand

2 American Psychiatric Association, Temple University School of Medicine, U.S.A

3 Auckland District Health Board, New Zealand

4 Kaiser Permanente Medical Care Program, University of California, San Diego, U.S.A

5 Center for Disease Control, Atlanta, Georgia, U.S.A.

 

For several decades the conceptualization and treatment of mental health problems, including psychosis, have been dominated by a rather narrow focus on genes and brain functions. Psychosocial factors have been relegated to mere triggers or exacerbates of a supposed genetic predisposition. This paper advocates a return to the original stress-vulnerability model proposed by Zubin and Spring in 1977, in which heightened vulnerability to stress is not, as often wrongly assumed, necessarily genetically inherited, but can be acquired via adverse life events. There is now a large body of research demonstrating that child abuse and neglect are significant causal factors for psychosis

Ten out of eleven recent general population studies have found, even after controlling for other factors, including family history of psychosis, that child maltreatment is significantly related to psychosis. Eight of these studies tested for, and found, a dose-response. Interpreting these findings from psychological and biological perspectives generates a genuinely integrated bio-psycho-social approach as originally intended by Zubin and Spring. The routine taking of trauma histories from all users of mental health services is recommended, and a staff training program to facilitate this.