OPINION: Seidman: 'Rapid' trauma treatment gets results — and resistance
The Herald-Tribune - 7/24/2018
July 24--Earlier this year, Kendra Simpkins, a military veteran turned clinical social worker, received a call at her Sarasota practice from a frantic mother whose son suffered from post-traumatic stress disorder as a result of combat situations during multiple deployments. Over the first three of 12 scheduled weeks of "exposure therapy" at the VA -- a method designed to desensitize a patient to past trauma by "reliving" the stressful experience -- the mother said she had seen her son grow progressively worse, to the degree that she now feared for his safety.
Simpkins, 35, who practices a form of counseling known as "Rapid Resolution Therapy" (RRT), a short-term treatment to neurologically eliminate emotional connections to past events, encouraged the mother to set up an appointment.
When the veteran arrived, he began to shake and have trouble breathing at the mere thought of a firefight he'd endured. But instead of asking him to bring his past experience into the present, Simpkins employed a technique that, without even talking about the trauma in detail, trains the brain to process a memory differently so it can no longer produce the same emotional reaction.
By the time his session ended a little more than two hours later, the veteran could dispassionately describe three separate combat incidents without evidencing any ill effect whatsoever.
"I've never been able to say that before, let alone think about it," he told her. "I can't even bring up the emotion. I try to trigger myself and I can't. It's like reading a phone book."
When Simpkins walked him out to the parking lot, the man reached into his truck and pulled out a Zip-lock bag holding a dozen medications.
"Now, how do I get off these?" he asked.
That, in a nutshell, is why Simpkins has become a fervent believer in the RRT approach, and why she and her partner, Ryan Praefke, have now founded the nonprofit Operation Warrior Resolution (operationwarriorresolution.org) to provide veterans with free RRT and holistic recovery sessions.
It's also why Simpkins has become disillusioned with a mental health care system that fits the patient to a treatment rather than the treatment to a patient, and that operates on the theory that "more is better," whether that's therapy or medication.
"I think what they are doing is often more harmful than good," says Simpkins, who gave up her previous commitment to dialectical behavioral therapy (DBT), a long-term cognitive behavioral training method, after studying with RRT's founder, West Palm Beach therapist Jon Connelly. "Requiring people to go through treatments that cause people already in pain more pain doesn't make sense to me because we're supposed to be trying to get them out of pain."
Many mental health professional dismiss RRT as "quackery" or are threatened by its short-term duration, which could mean a curtailing of their steady revenue stream. (Simpkins charges $350 for an initial appointment and "usually when I meet with someone, I'm intended on it being my only meeting with them.") Therapists have been indoctrinated in the "regularity" of weekly sessions and in the necessity of analyzing all aspects of a person's trauma, while insurance companies perpetuate the structure of a "this is the way we do things" system, Simpkins says.
"But if this will work for you, why wouldn't you use it?" she asks. "We don't analyze anything; we're more solution-based. As Dr. Connelly says, 'You don't need to ask questions; they'll tell us everything we need to know.'"
But because RRT has not received the financial backing necessary to underwrite research trials, a cost that can spiral into the millions, it is considered suspect because it is not "evidence-based." Simpkins understands that notion -- she entered Columbia University's master's program in clinical social work with a firm commitment to evidence-based practices -- but says she's learned research can be misleading.
"Just because a trial makes the 51 percent mark doesn't' mean it's better," she says. "I saw DBT clients every week for two years and they were still suffering. That's why therapy gets such a bad name -- because people spend years in therapy and don't get anything out of it."
Simpkins is also a believer in RRT because of what it has done for her own life. Because of a service-connected injury, she left the military, which she had thought would be a lifetime career, after just two years. At the time her marriage was crumbling, her father and grandfather had just died and her reliance on alcohol had escalated to the point that she was hospitalized and sent to rehab. A 12-step program provided the path to staying sober, but RRT has helped release the guilt and shame she carried over her addiction.
In her own experience, while the duration of RRT is short, the benefits are lasting. Six months later after her appointment with the veteran with PTSD, he called to ask about something unrelated to his trauma. When she asked how he was doing, his response was still euphoric.
"I haven't had a nightmare since," he reported.
Because of her own military background and because she recognizes veterans' unique challenges -- their tendency to see PTSD as a weakness; their feelings of failure; their guilt at having survived when cohorts did not -- Simpkins is devoted to sharing with them the benefits of RRT. That's why she's currently in the process of raising funds to support more free veteran retreats through Operation Warrior Resolution. The retreats, in Florida (a collaboration with the nonprofit CODE at SADLES Ranch in Umatilla) and Costa Rica, incorporate not only RRT, but a "whole body" approach that includes equine therapy, "trauma-informed" yoga, massage, acupuncture and chiropractic treatments.
"People are just now looking at these holistic, non-medical ways of treatment because the other isn't working," Simpkins says. "Even vets are becoming open to these things. I think we're right on the cusp of gaining momentum and opening people's eyes."
Contact columnist Carrie Seidman at 941-361-4823 or email@example.com. Follow her on Twitter @CarrieSeidman or Facebook at facebook.com/cseidman.
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