For clinicians and researchers interested in trauma, resilience and posttraumatic growth, and the neuroscience of a new paradigm for reducing fear and healing disturbing memories
Shira Maguen, PhD
University of California, San Francisco
San Francisco Veterans Administration Health Care System
Paul Siegel, PhD
Purchase College, SUNY
University of Southern California
David Bullard, PhD
University of California, San Francisco
With commentary by
Mark Solms, PhD
University of Cape Town
International Neuropsychoanalysis Society
We may all experience feelings of stress, pain and even fear at various times in our lives. The memories of these feelings can remain disturbing over time, despite our attempts to change them through distraction, meditation, spirituality or even psychotherapy. A major life challenge is to be able to process memories of trauma experiences into resilience, compassion and wisdom.
The current treatment paradigm for trauma-focused therapies assumes that conscious exposure to the memory, even if titrated in small doses, is necessary.
While effective in some cases, such exposure therapy can be distressing, which creates problems with treatment acceptance and has potential for re-traumatization. Can exposure be effectively delivered unconsciously—and thus without causing traumatized or phobic people to experience distress?
In this 90-minute presentation, neuroscientists and psychotherapists studying and treating psychological trauma, PTSD, and phobias will discuss the current efficacy of conventionally recommended "Evidence-Based Psychotherapies" (EBP's) for trauma and PTSD.
Then a discussion of research and clinical data representing a New Paradigm will point toward the neurobiological underpinnings of trauma and its healing, shedding additional light on consciousness and resilience.
Presenters
Shira Maguin, PhD
UCSF Professor, Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences. Mental Health Director of the Post-9/11 Integrated Care Clinic and Staff Psychologist on the Posttraumatic Stress Disorder Clinical Team (PCT), San Francisco VA Health Care System (SFVAHCS). Member, Creating Options for Veterans’ Expedited Recovery Commissio (COVER).
Dr. Maguen will discuss her research on PTSD evidence-based psychotherapy and moral injury in Veterans. Dr. Maguen was the recipient of a DOD grant that examined rates of evidence-based psychotherapy as well as a VA Health Services Research and Development Grant that examined the impact of killing in veterans of war and moral injury. She is currently conducting a multi-site trial examining a novel treatment for veterans who have killed in war. She also works in a clinical capacity within the Post-9/11 Integrated Care Clinic and treating veterans with evidence-based treatments for PTSD. She supervises research health fellows and other trainees in evidence-based treatments for PTSD, and provides mentorship for trauma-focused research fellows.
Recent publications:
Maguen, S., Holder, N., Madden, E., Li, Y., Seal, K. H., Neylan, T. C., Lujan, C., Patterson, O. V., DuVall, S. L., & Shiner, B. (2020). Evidence-based psychotherapy trends among posttraumatic stress disorder patients in a national healthcare system, 2001-2014. Depression and anxiety, 37(4), 356–364. https://doi.org/10.1002/da.22983
Maguen, S., Madden E, Holder N, Li Y, Seal KH, Neylan TC, Lujan C, Patterson OV, DuVall SL, Shiner B.(2021). Effectiveness and comparative effectiveness of evidence-based psychotherapies for posttraumatic stress disorder in clinical practice.Psychol Med. 2021 May 18:1-10. doi: 10.1017/S0033291721001628. Online ahead of print. PMID: 34001290
Maguen, S., Holder N, Li Y, Madden E, Neylan TC, Seal KH, Lujan C, Patterson OV, DuVall SL, Shiner B. (2020). Factors associated with PTSD symptom improvement among Iraq and Afghanistan veterans receiving evidenced-based psychotherapy. Journal of Affective Disorders. 2020 Aug 1;273:1-7. doi: 10.1016/j.jad.2020.04.039. Epub 2020 May 1. PMID: 32421589
Maguen, S., Nichter, B., Norman, S.B., Pietrzak, R.H. (2021). Moral injury and substance use disorders among US combat veterans: results from the 2019–2020 National Health and Resilience in Veterans Study. Psychological Medicine. DOI: 10.1017/S0033291721002919
paul siegel, PhD
Professor, Purchase College, SUNY, and Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, USC, on his research published in Biological Psychiatry (in press, 2022), Behaviour Research and Therapy (2021), Lancet: Psychiatry (2020), Human Brain Mapping (2017), Psychophysiology (2017), etc. on “Very Brief Exposure”....fMRI studies showing greater reduction of fear from subliminal flashing of a photo of a tarantula than from exposure to a "recognizable" photo. Collaborator with Dr. Siegel is Bradley S. Peterson, MD at USC (Chief, Division of Child and Adolescent Psychiatry, Keck School of Medicine of USC; Vice Chair for Research, Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of USC).
"My translational research program is testing a clinical implication of emotional neuroscience, which has shown that fear responses can be activated and acquired without conscious awareness. Very brief exposure (VBE) is the presentation of a continuous series of masked – unrecognizable - phobic images to reduce fear. A series of experiments conducted in my lab have shown that VBE reduces avoidance and experienced fear of a live tarantula by spider-phobic participants without causing them to experience fear consciously. A recent study found that VBE has similar fear-reducing effects on highly socially anxious persons. These findings challenge the prevailing clinical belief that a person must directly confront a feared object or situation in order to reduce fear of it.
“With the support of an R21 Research Grant from the National Institute of Mental Health, and a NARSAD Young Investigator Award from the Brain and Behavior Research Foundation, I am conducting fMRI studies of the neurobiological basis of VBE. My collaborator on this research is Dr. Bradley Peterson, Director of the Institute for the Developing Mind, and Chief of Child and Adolescent Psychiatry at Children’s Hospital Los Angeles and the University of Southern California."
Recent publication:
Siegel, P., Cohen, B., Warren, R. (2021). Nothing to fear but fear itself: A mechanistic test of unconscious exposure. Biological Psychiatry, Archival Report Vol 91 Issue 3, DOI:https://doi.org/10.1016/j.biopsych.2021.08.022
david bullard, phD
UCSF Clinical Professor of Medicine - Volunteer
UCSF Clinical Professor of Psychiatry and Behavioral Sciences - Volunteer
Weill Institute for Neurosciences.
Consultant, Symptom Management Service
UCSF Division of Palliative Medicine
President, San Francisco Psychological Association
Past Mentor, Center for Psychedelic Therapies and Research
California Institute of Integral Studies
Dr. Bullard will discuss his clinical experiences and that of over 14,000 trauma-informed therapists who have trained in Manfield’s Flash Technique over the past 6 years. There are now 10 peer-reviewed articles on this new paradigm for healing from disturbing memories and fear.
Recent publications:
Manfield, P., Engel, L., Greenwald, R., & Bullard, D.G. (2021) Flash Technique in a scalable low-intensity group intervention for COVID-19 related stress in healthcare providers. Journal of EMDR Practice and Research. Vol 15, Issue 2, DOI: 10.1891/EMDR-D-20-00053.
Schore, A.N. & Bullard, D.G. (2019). Allan Schore on the science of the art of psychotherapy: Interview. In Schore, A.N., Right brain psychotherapy. New York: Norton.
Discussants
Mark Solms, PhD
Chair of Neuropsychology, University of Cape Town and Groote Schuur Hospital (Departments of Psychology and Neurology).
President of the South African Psychoanalytical Association.
Research Chair of the International Psychoanalytical Association.
Dr. Solms founded the International Neuropsychoanalysis Society in 2000 and was a Founding Editor (with Ed Nersessian) of the journal Neuropsychoanalysis. Director of the Arnold Pfeffer Center for Neuropsychoanalysis at the New York Psychoanalytic Institute, Trustee of the Neuropsychoanalysis Fund in London, and Director of the Neuropsychoanalysis Trust in Cape Town.
Recent publications:
Solms, M. (2021). The Hidden Spring: A Journey to the Source of Consciousness. W. W. Norton & Company.
Sponsor:
UCSF Weill Institute for Neuroscience
Co-sponsors:
UCSF Center to Advance Trauma-informed Health Care
UCSF Division of Palliative Medicine
UCSF Psycho-Oncology, Helen Diller Family Comprehensive Cancer Center
San Francisco Psychological Association
San Francisco Psychotherapy Research Group
Center for Psychedelic Therapies and Research
California Institute of Integral Studies
Bayview Zendo (San Rafael, CA)
Foundation of the Sacred Stream (Berkeley, CA)
TibetHouse.US (NYC, NY)