Hey! I’m going to pause my retching for a little bit to provide a source because apparently it’s just so goddamn important for someone to mention sources, mention their own (fucked up) stance, and then not provide their own sources, apparently. How’d we get here, again?
This is from Bessel van der Kolk’s The Body Keeps the Score. Bessel is a psychiatrist focused on PTSD and trauma, and has done this since the 90s. Emphasis mine. Note that, shockingly, there’s not one positive implication of directly re-experiencing traumatic stimulus:
CBT was first developed to treat phobias such as fear of spiders, airplanes, or heights, to help patients compare their irrational fears with harmless realities. Patients are gradually desensitized from their irrational fears by bringing to mind what they are most afraid of, using their narratives and images (“imaginal exposure”), or they are placed in actual (but actually safe) anxiety-provoking situations (“in vivo exposure”), or they are exposed to virtual-reality, computer-simulated scenes, for example, in the case of combat-related PTSD, fighting in the streets of Fallujah.
The idea behind cognitive behavioral treatment is that when patients are repeatedly exposed to the stimulus without bad things actually happening, they gradually will become less upset; the bad memories will have become associated with “corrective” information of being safe. (33) … It sounds simple, but, as we have seen, reliving trauma reactivates the brain’s alarm system and knocks out critical brain areas necessary for integrating the past, making it likely that patients will relive rather than resolve the trauma.
Prolonged exposure or “flooding” has been studied more thoroughly than any other PTSD treatment. Patients are asked to “focus their attention on the traumatic material and … not distract themselves with other thoughts or activities.” (35) … Exposure sometimes helps to deal with fear and anxiety, but it has not been proven to help with guilt or other complex emotions. (37)
In contrast to its effectiveness for irrational fears such as spiders, CBT has not done so well for traumatized individuals, particularly those with histories of childhood abuse. Only about one in three participants with PTSD who finish research studies show some improvement. (38) Those who complete CBT treatment usually have fewer PTSD symptoms, but they rarely recover completely: Most continue to have substantial problems with their health, work, or mental well-being. (39)
Patients can benefit from reliving their trauma only if they are not overwhelmed by it. A good example is a study of Vietnam veterans conducted in the early 1990s by my colleague Roger Pitman. (44) … Roger would show me the videotapes of his treatment sessions and we would discuss what we observed. He and his colleagues pushed the veterans to talk repeatedly about every detail of their experiences in Vietnam, but the investigators had to stop the study because many patients became panicked by their flashbacks, and the dread often persisted after the sessions. Some never returned, while many of those who stayed with the study became more depressed, violent, and fearful; some coped with their increased symptoms by increasing their alcohol consumption, which led to further violence and humiliation, as some of their families called the police to take them to a hospital.
I really, sincerely hope anyone capable of firing about ten neurons of critical thought can piece together, from that last paragraph, the implications of trying to reenact a rape or other sexual trauma through kink when even talking about experiences makes people shut down jesus fucking christ.
Here are Bessel’s citations:
33. E. Santini, R. U. Muller, and G. J. Quirk, “Consolidation of Extinction Learning Involves Transfer from NMDA-Independent to NMDA-Dependent Memory,” Journal of Neuroscience 21 (2001): 9009–17.
35. C. R. Brewin, “Implications for Psychological Intervention,” in Neuropsychology of PTSD: Biological, Cognitive, and Clinical Perspectives, ed. J. J. Vasterling and C. R. Brewin (New York: Guilford, 2005), 272.
37. E. B. Foa and R. J. McNally, “Mechanisms of Change in Exposure Therapy,” in Current Controversies in the Anxiety Disorders, ed. R. M. Rapee (New York: Guilford, 1996), 329–43.
38. J. D. Ford and P. Kidd, “Early Childhood Trauma and Disorders of Extreme Stress as Predictors of Treatment Outcome with Chronic PTSD,” Journal of Traumatic Stress 18 (1998): 743–61. (There are 3 other articles lumped into this one.)
39. J. Bisson, et al., “Psychological Treatments for Chronic Posttraumatic Stress Disorder: Systematic Review and Meta-Analysis,” British Journal of Psychiatry 190 (2007): 97–104. See also L. H. Jaycox, E. B. Foa, and A. R. Morrall, “Influence of Emotional Engagement and Habituation on Exposure Therapy for PTSD,” Journal of Consulting and Clinical Psychology 66 (1998): 185–92.
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