contraction75ff.com

УДК616.
895NEUROGENICTREMOR1THROUGHTRETENSION,STRESSANDTRAUMARELEASINGEXERCISESACCORDINGTOD.
BERCELIINTHETREATMENTOFPOST-TRAUMATICSTRESSDISORDERPTSDAndreasHeroldВправидлязняттянапруги,стресутатравматичногодосвду(TRE)складаютьсязсемивправ,яквикористовуютьсядлястимулюваннянейрогенноготремтння.
МетоюцьоготремтннязменшеннясимптоматикипосттравматичнихсиндромвстресовихрозладвПТСРнаступнихскарг,щовикликаютьсястресом.
УданйстаттописуютьсяосновнаспектисиндромвПТСР,методикавправTRE,науковапояснювальнамодель,основнийпринципвправцентральнаспектисаморегуляц.
Ключовслова:травма,стрес,фзичнвправи,нейрогеннетремтння,саморегуляця,травматерапя,посттравматичнийстресовийрозладПТСРTension,StressundTraumaReleasingExercises(TRE)areasequenceofsevenexercisesusedtotriggerneurogenictremor.
Theaimofthistremoristoreducesymptomsofpost-traumaticstressdisorderPTSDandotherstress-inducedsymptoms.
ThisarticledescribesthebasicfeaturesofPTSD,theTREmethod,thescientificexplanatorymodel,theprinciplebehindtheexercisesandthemainfeaturesofself-regulation.
Keywords:trauma,stress,physicalexercises,neurogenictremor,self-regulation,traumatherapy,post-traumaticstressdisorderУпражнениядляснятиянапряжения,стрессаитравматическогоопыта(TRE)состоятизсемиупражнений,служащихдлястимулированиянейрогенногодрожания.
ЦельюэтогодрожанияявляетсяуменьшениесимптоматикипосттравматическихсиндромовстрессовыхрасстройствПТСРипоследующихжалоб,вызываемыхстрессом.
ВданнойстатьеописываютсяосновныеаспектысиндромовПТСР,методикаупражненийTRE,научнаяобъяснительнаямодель,основнойпринципупражненийицентральныеаспектысаморегуляции.
Ключевыеслова:травма,стресс,физическиеупражнения,нейрогенноедрожание,саморегуляция,травматерапия,посттравматическоестрессовоерасстройствоПТСРIntroductionToday,post-traumaticstressdisorder(PTSD)ismoretopicalthaneverbefore.
Thepapers,andthenewsontelevisionortheinternetarealwaysreportingonnaturalcatastrophessuchasearthquakes,floods,tsunamis,typhoonsetc.
Inadditiontothisaretheactsofviolencecausedbyhumans,suchasdomesticviolence,childmistreatmentandabuse,rape,actsofwar,terrorism,torture,politicalinternmentetc.
Accidentsandmedicalprocedurescanalsohaveatraumaticeffect.
TheICD-10definitionoftraumaisan"exceptionalthreat"ora"catastrophiclevelofstress,1RecentlyrenamedSITTSelf-InducedTherapeuticTremor(Berceli2014)77likelytocauseadeepdespairinalmosteveryone"(ICD-10:F43.
1,page207ff.
).
Aneventthatcausesatrauma-relateddisturbanceinonepersonmayelicitadifferentresponseinanother,whomayrecoverafteracertaintimeandshowfewornoneofthesymptomsofPTSD.
Thetraumaticeventshouldnotjustbeconsideredfromtheviewpointoftheevent((severitytypeI–singletrauma),typeII–multipletrauma(Maercker2009,page138ff.
))butalsofromtheperspectiveofpersonalityandsubjectivereality(genetics,lifestory,socialintegration,resilienceetc.
).
Itisthesubjectiveexperienceofthetraumaticsituationthatisrelevant,"theexperienceofcompletehelplessness,powerlessnessandbeingatthemercyofsomebody/somethingoutsideofone'scontroliswhatmatters"(Wller2006,page11ff.
).
SomepeoplewhogothroughatraumaticeventgoontodevelopsymptomsofPTSDwhichareextremelydebilitatingandpreventthemfromleadinganormal,fulfilledlife:theseincludeintrusivethoughts,stressfuldreams/nightmares,flashbacks,symptomsofdissociationandimmobility,acutetriggers,hyperandhypoarousal,sleepdisturbances,avoidanceofsituationsandunwantedthoughtsandothersymptomssuchasdepression,anxiety,compulsionsandobsessions(Maercker2009,page17ff.
,Sachsse2004,page53ff.
).
Eachlargepsychotherapyschoolhasdevelopeditsownapproachtothetreatmentofpost-traumaticstressdisorder:cognitiveprocedure(HorowitzM.
J.
2013),psychodynamic,imaginativeprocedure(PITTReddemann,2008,TRIBMSpangenberg2015),Gestalttherapy(Butolloetal.
2002,Butollo&Karl2014),combinedmethodssuchasEMDR(Shapiro1998)andbrainspotting(Grand2014),resource-orientedprocedure(Sack2010),mindfulness-basedprocedure(Foletteetal.
2015),body-relatedtherapies(SomaticExperiencing,Levine1998,2004),sensorimotortherapy(Ogdenetal.
2010),bodytherapyaccordingtoRothschild(Rothschild2000),yoga(Emerson&Hopper(2012))andtheprocedurepresentedhere(Tension,StressandTraumaReleasingExercisesTRE)accordingtoDr.
DavidBerceli(Berceli2010,2012,2014).
Explanatorymodel/EtiologicalconceptsCognitiveModelAccordingtoHorowitz(1976/1997),cognitivepatterns(attitudes,beliefs,self-image)arealteredbythetraumaticevent.
Inparticular,"thenegativeinterpretationofthetraumaanditsconsequencesmayleadtoapersistentawarenessofthethreatandtheinjury"(Maerker2009,page44ff.
).
Thepatient'shealthcanberestoredifthecognitivepatternsalteredbythetraumaandthecontrolprocesses(avoidance,defense,denial)aretriggered.
EmotionalmodelChildrenlearntoregulatetheiremotionswhentheyinteractwiththeirparents.
Thedevelopmentofemotionaltoleranceandtheregulationofemotionsislearntastheydevelop(Lammers2007page48ff.
)Seriousdisordersofemotionalregulationandthelossofself-regulationaredescribedespeciallyinassociationwithprolongeddevelopmentaltraumas(Wller2006,page75ff.
).
Afloodoftraumaticemotionsisproducedbycorrespondingtriggers.
Thereducedaffectregulationandimpulsecontrolcausedbythis(flightandfightreaction)isofteninterpretedbyoutsidersasinappropriatebehavior.
"Theaggressionshownbythetraumatizedneuroticisnotintentionalordeliberate.
Theiraggressionisalwaysimpulsiveandcannotbestifledforlong":(Kardiner1941,page97,quotedafterVanderKolk2000).
Disturbedmentalization,theabilitytothinkaboutone'sownemotionsorthatofothersandadoptanempatheticattitudecanmanifestasadisorderofreducedemotionregulation.
Themainfeaturesofemotionregulationhavebeenstudied2,1-2,201578inrecentyearswithresearchintotheneurobiologyoftrauma(Rüegg2011,VanderKolk2014,Scaer2014).
NeurobiologicalmodelFromaneurobiologicalviewpoint,post-traumaticstressdisorderPTSDmaybeconsideredasastressprocessingdisorder.
InEnglish,PTSDstandsforpost-traumaticstressdisorder.
Theinterplaybetweentheinformationprocessingsystemsinthebrain(sensoryassociationfieldsoftheneocortex,brainstem,basalganglia,thalamus,limbicsystem)isreduced(Rüegg2011).
Researchhasshown(VanderKolk2000,page200ff.
)thatdisordersexistatthelevelofpsychophysiologicaleffects(over-excitationandlossofstimulusdiscriminationability),neurohormonaleffects(elevatedlevelofnoradrenalin,largefluctuationsincortisolconcentrations(Sachsse2004,page48ff.
),reducedserotoninconcentration,increasedopioidconcentrationandneuroanatomicaleffects(reducedhippocampusvolume,chronicactivationoftheamygdala,reducedactivationofBroca'scenterduringflashbacks).
Duringatraumaticevent,thefollowingareactivatedasasurvivalreaction:thepsychophysicalsystem(autonomicnervoussystemANS,sympatheticandparasympatheticbranch)andtheneurohormonalsystem(activationofthehypothalamic-pituitary-adrenalaxisHPA).
Theseproducethereactionpatternoffight,flightfreeze(immobility).
Thefightorflightresponse(heightenedarousal)istriggeredbytheactivationofthepsychophysical(ANS)andneurohormonalsystem.
Immobility,freezing(physical)anddissociation(cognitive,mental)areorganizedbythesimultaneousactivationofbothbranchesoftheANS(Levine2010,page71ff.
,Scaer2014,page81ff.
).
Inthreateningsituationsimpulsesaretransmittedbythepsychophysicalsystemtothemusculoskeletalsystem,enablingthefight,flightandfreezeresponse.
Thecontractionsequencesfollowthegivenreactionpatterns.
If,duringatraumaticevent,itisnotpossibletoperformthenecessarymovements,habitualmusclecontractionswilloccur,whichareveryfrequentlycontrolledbytheproceduralmemory(Scaer2014page67ff.
),thatleadtopain.
"Myofascialpainis(verycommonlyAH)stress-related,(.
.
.
)anymovementofthebody,thatisassociatedinanywaywithpreviousfaileddefensivemovements,ishighlylikelytoactivateareflex-typetension"(Scaer2014,page277ff.
).
Musclecrampsoccurinparticularinthemusclegroupsofthehead,neck,shoulders,erectorspinaemuscles,hipsandlegs.
Theilio-psoasmusclesshouldbehighlighted,asthesearesubjecttoreflex-typecontractionsinathreateningsituation(Berceli2012,S.
29ff.
).
Themusclesofthefootjoints,calfmuscles,thequadricepsmuscle,adductors,diaphragm,sternocleistomastoidmuscleandmassetermusclearefrequentlyalsoinvolved(Berceli2014).
Tension,StressandTraumaReleasingExercises(TRE)DavidBerceli,aformerCatholicpriest,withaPHDinclinicalsocialworkandacertifiedbioenergeticist,haslivedinnumerousconflictzonessuchasIsrael/Palestine,Sudan,Uganda,Kenya,Yemen,EgyptandLebanon.
Hehasstayedinareasthathaveseenmilitaryaction.
Bercelireports(Berceli2010b,BerceliDVD)thatduringagrenadeattackduringthewarinLebanonhetookshelterinacellarwitheightotherpeopleofvaryingnationalities.
Whilethebombsraineddown,heobservedeveryonehuddlingintothefetalposition.
Inthethreateningsituationthesameautomaticreflex-typemovementswereadoptedbyeveryone.
"Duringanytraumaticexperiencetheextensormusclesareinhibitedsothattheflexormusclescancontract.
"(Berceli2010b,page149).
Thispositionhelpstoprotecttheinternalorgansandmaycreateafeelingofsafety.
Asalready79statedabove,thefollowingmusclesareprimarilyinvolved:thecalfmuscles,thequadricepsmuscle,theadductors,thediaphragm,theneckmusclesandthemusclesofmastication.
Themainmusclegroupsthatcontractinathreateningsituationaretheilio-psoasmuscle,thetrunk,includingthepelvisandlegs.
Theilio-psoascontractswhenweassumethefetalposition.
Thecompensatoryreactionoftheerectorspinaemusclesleadstochronicbackacheinnumeroustraumatizedpeople,sincethetensionintheilio-psoasischronicallyincreased.
Bercelihasobservedthatmanypeoplewhohavebeentraumatizedgoontodevelopaspontaneoustremor.
Manyattempttosuppressthisreaction.
Childrentremblespontaneously.
Thetremorinadultsisoftenpreventedinthepresenceofchildren,sothatchildrendonotinterpretthistremorasanxietyoftheadults(Berceli2010,page47ff.
).
"Tremorisessentiallyanaturalmechanismofthebody,sothatitcandischargethehighleveloftensionandchemicalsubstanceswhichoverloadthebodyatthetimeofatraumaticincident.
Thetremblingprocessdischargesthebodyofexcessiveenergyanditreturnstoastateofrestandrelaxation.
Infacttheabilitytoshakeoffatraumaisoneofthemostarchaicreactionsofthehumananimal(Berceli2012,page33).
PeterLevine,founderofSomaticExperiencingTraumaHealing,alsodescribeshow,afteranaccidentwhenhewasrunoverbyacar,hewas"overcomebyaspontaneoustremorthatwasabletodischargeenormoussurvivalenergy"(Levine2010,page34)thathehadlearnedtoacceptandwelcomeprimitivetremorsandtremblingandspontaneousbodymovements,insteadoffearingandsuppressingthem"(Levine2010,page38).
Behavioralbiologyhastaughtusthatfollowinglife-threateningsituations(attackbyapredator),mammalsshakeoffthepent-upenergyduringtheflightreactionorfreezereaction.
TherearenumerousvideosonYouTubethatdocumentthistremor.
Itisanaturalmechanismthathelpsmammalstodischargethecompressedenergyfollowingathreatandallowsthemtocontinuetolive"normal"lives.
MammalsinthewildarenotabletodevelopPTSD,becauseafterdevelopingthefreezereactionafterbeingattackedbyprey,theyalwaysdevelopthistremorresponse.
InLevine's(Levine1997,2010)SomaticExperiencingTraumaHealing(SE),theconceptofdischargeofpent-upenergyrepresentsaprimaryfeatureinthetreatmentofPTSD.
"Traumasymptomsarenotcausedbytheexternalevent.
Theydevelopwhenexcessiveenergyisnotdischargedbythebody.
Thisenergyremainstrappedinthenervoussystemandcanhaveadevastatingimpactonbodyandmind"(LevineO.
J,Bl.
4).
TheTREexercisesmaybeusedingroups,inindividualtherapyandasaself-helpmethodaloneathome.
MechanismofactionoftremorThesubjectiveeffectofthetremortriggeredbythesevenTREexercises(seebelowfordescriptionoftheexercises)isexperiencedbyalmostallpeopleasafeelingofpeaceandrelaxation,areductionofhyperarousal,animprovedbodyimage,agreaterabilitytotolerateaffects(containment)andanenlargedWindowofTolerance(Ogdenetal.
2010,page67ff).
AccordingtoScaer(2007,page19ff.
)(Berceli2010a,page3ff.
),thetremormechanismcanreduceorinhibittheactivityoftheamygdala,sothattheneuronalnetworkswithtraumacontentbecomeslowlyerasedintheproceduralmemory.
Theneurogenictremorappearstobeabletoerasenegativeneuralnetsandformpositiveneuralnets.
Scaerconfirmsthatthefreezeorimmobilityresponseisimprintedforeverintheproceduralmemoryunlessitiserasedbythedischargeaction.
Cassiani-Ingoni(Berceli2010a,page4ff.
nobibliographicalreference)describestheeffect2,1-2,201580ofthetremormechanisminthisway:repeatedtremblingcausesachangeintheneuro-muscularinterfacei.
e.
changesaredetectedattheleveloftheneurotransmitters.
Changesintheproprioceptiveinformationmayoccurinthecentralandperipheralnervoussystem.
UsinganEEG,Cassiani-Ingoniwasabletoprovethatsimilarbrainwaveactivityistriggeredbythetremormechanismasoccursduringmeditation(Berceli2014).
Alpha-wavesareknowntobeassociatedwithfeelingsofpeaceandrelaxation,happinessandself-awareness.
Camarotti(Berceli2010a,page6ff.
nobibliographicalreference)describesthatneurogenictremorregulatesthereleaseofserotoninandcerebralGABAandasaconsequencereduceshyperarousalduetothereducedactivityoftheamygdala.
TheTREexercisesAshortdescriptionoftheTREexercisesandthetremormechanism(Berceli2012,BerceliDVD)Exercise1Tiltbothfeet(ifpossibleremoveshoesandsocks)ontotheiredgessotheyarefacinginthesamedirection,withonefootonitsouteredgeandtheotheronitsinneredge.
Stayinthispositionfor30secondsandthendothesameontheothersideforanother30seconds.
Continuewiththisexerciseuntilyouhavedonefiverepetitionsoneitherside.
Thenstandonbothlegsandshakethemvigorously.
Exercise2Shiftyourweightontoonefoot,withtheotherfootremainingonthefloortomaintainyourbalance.
Ifyouhaveproblemswithyourbalanceyoucanputonehandonthewall.
Lifttheheelofthestandingfootashighaspossibleandthenloweritagaintothefloor.
Repeatthismovementuntil,onastressscaleof1-10,youachieveapersonalstresslevelof7.
Thismaycauseatension,aburningoramildpaininthecalf.
Thisiscompletelynormal,howeveryoucandecreasethestressslightly.
Thenstandonbothlegsandshaketheworkedlegvigorouslytorelievethepain,burningortension.
Thenworktheotherleg.
Exercise3Holdonefootbehindthebodyusingthehandofthesameside.
Bendthekneeofthestandinglegaslowaspossibleasifyouweregoingtositdown,andthenlengthenitagain(squats).
Theheelremainsonthefloor.
Repeatthismovementuntilonastressscaleof1-10,youachieveapersonalstresslevelof7.
Exercise4Stretchyourlegswideapartuntilyoufeelatensioninthemusclesoftheinnersidesofthelegs.
Bendforwarduntilyoutouchthefloor.
Youshouldfeelastretchintheinnersideofthethighs(adductors)andinthebacksoftheknees(hamstringtendons).
Takethreedeepbreaths.
Walkbothhandsslowlytowardsoneofyourfeet.
Takethreeslowanddeepbreathsholdingthisposition.
Thenwalkyourhandstotheotherfoot.
Holdthispositionforthreedeepbreaths.
Thenwalkyourhandsbacktothemiddleandstretchyourarmsbackwardsthroughyourlegs.
Holdthispositionforthreedeepbreaths.
Attheendoftheexercisereturnslowlytotheuprightposition.
Exercise5Clenchbothfistsandplacethemdirectlybehindyouaboveyourpelvis.
Pushyourpelvisslightlyforwardsuntilthereisaslightarchinyourback.
Youshouldfeelastretchinthefrontsideofyourthigh.
Thenturngentlytotheback,startingfromthehips,openyourmouthandlookbehind81youintoacorneroftheroom.
Turn,againstartingfromthehips,intheoppositedirectionandlookbehindyou.
Thencometotheuprightpositionagain.
Tremorexercise1againstthewallLeanwithyourbackagainstawall,asiftherewereachairunderyou.
Thiswillloadthethighmuscles(quadriceps).
Youmaystarttofeelaslightpain,burning,tensionorevenatremorinthesemusclesafterafewminutes.
Assoonasitstartstohurt,moveapproximately5cmfurtherupthewall.
Thetremormaybecomemorepronouncedandthepainsubside.
Afterapproximatelyfiveminutesoftremor,peelyourselfoffthewallandallowyourupperbodytohangforwards.
Thetremormayincrease;remaininthispositionforapproximatelythreetofourminutes.
Tremorexercise2onthefloor(preferablylyingonamat)Liedownonamatonthefloorwithkneesopenandthesolesofyourfeettouching.
Liftyourpelvisfromthefloorforoneminuteandmakesurethatthekneesremainrelaxedandwideapart.
Placeyourpelvisbackonthefloorandleaveyourkneesopenandrelaxedforafurtherminute.
Moveyourkneesapproximately5cmclosertogether.
Findthepositionthattriggersatremor.
Simplyallowtheinvoluntarymovementsofthetremororshakingtohappen,untilyoufeelitistimetostop.
Toendtheexercise,stretchoutthefeet.
Anotheralternativeistoplacethesolesofthefeetflatontheground.
Keepthekneesslightlyapartandthetremorandshakingwillresume.
Allowthismovementtospreadintoyourpelvisandyourlowerbackregion.
Toendtheexercise,allowyourfeettoslidebackuntiltheyareflatontheground.
Youmayturnonyoursideifyoupreferthisposition.
Ifyouexperienceanythingunpleasantduringthetremor(thoughts,pictures,physicalsensations),youcaninterruptthetremormechanismatanytimebylettingyourfeetslidedown(seeself-regulationbelow).
IntegrationWhenthetremorhasended,youshouldrestforawhileandintegrateyourexperiences.
IfyouareworkinginagrouporwithaTREpractitioner,additionalintegrationcanoccurthroughthespokenexchange.
Ifyouareexercisingonyourown,itisbeneficialtomakebriefnotesofyourexperiences.
Self-regulationSelf-regulationplaysanextremelyimportantroleduringthetremorintheTREprocess.
(SeeBoonetal.
2013,Vohs&Baumeister2011)Ifsomeonedoesnothavesufficientcapacityforself-regulation,cognitions,emotionsorsensationsduringthetremorcannotberegulated.
ItisveryimportantthatthephysiologicalexcitationthatoccursduringtheTREprocessisregulated:verystrongfeelingsresultinhyperarousal,veryweakfeelings(numbing)inhypoarousal.
Inthemajorityoftraumatizedpeople,thewindowoftolerance(Ogdenetal.
2010,67ff.
)isnarrow.
Theaimofthetremormechanismistoenlargethewindowoftolerance.
Theaimofself-regulationduringtheTREprocessistoteachclientstotoleratephysicalsensations,cognitionsoremotionswithoutbecomingoverloaded.
Ifthetremorprocessisperformedtooquicklyorfortoolong,aftertoorapidanactivationoftheparasympatheticnervoussystemimmobility,freezinganddissociationcansetinagain.
Thereforeitisveryimportanttobeabletorecognizethefirstsignsofoverload(holdingone's2,1-2,201582breath,tension,nervousness).
Ifitprovestoomuchfortheclients,thetremorprocessshouldbestopped.
Overloadcanoccurinthefirstfewminutesofthetremoritmaybecomemoreintensewhenthetremorstarts.
Tostoptheprocess,theclientisaskedtostretchouttheirlegsinordertogroundthemselvesandorientatethemselves.
TheTREexercisesshouldlaterbecarriedoutbyclientsontheirownathomeasaformofself-helpmethod,aftertheyhavelearnedtheminagrouporontheirownwithapractitioner.
Themainprinciplesofself-regulationshouldbeunderstoodandpracticed.
TheaimistobeabletoworkwithTREaloneandwithouttheassistanceofthepractitioner.
DurationofthetremorAcommonly-askedquestionishowfrequentlyshouldtheTREexercisesbeperformed,andforhowlongInBercelli2012,page102,Bercellidescribesthattheseexercisesarenaturalforthebody,andcanthereforebeperformedeverydaywithoutcausinganyharm.
(.
.
.
)Onceyouhavestarteddoingtheexercises,andyouhaveperformedthemforthefirsttime,andyouhaveexperiencednonegativephysical,psychologicaloremotionalreactions,theycanberepeatedeverysecondday.
Inthiswaythebodywillslowlyadjusttothetremorandallowthetensioninthebodytoslowlyreduce.
Afterawhile,theexerciseswillnothavetobedonesooften,maybeapproximatelyeverythreedaysortwiceaweek.
However,ifyouareperformingtheexerciseslessoftenthebodywillstarttobuildupstressagainandbecometense.
Thereforetheexerciseswillhavetobeperformedmorefrequentlyagain.
Twoexamplecases:TREwithsoldiersfromtheATO(anti-terroristoperation)warzoneintheUkraine(TranslationfromRussianintoGermanbyA.
Herold)ApsychiatristinapsychiatricclinicinthetownofV,Ukraine,reportsthatshehadtensessionswithasoldierwhohadreturnedfromtheATO(warzoneinEasternUkraine).
Duringthefirstsessionhewasabletoperformtheexercisesinalimitedcapacityonlybecauseofthetraumahehadsuffered.
Butthesecondtimehewasabletoparticipatemoreactivelyandwasabletoperformtheexercisesastheyshouldbedone.
Duringthefirstthreesessionsthesoldierreportedthathefeltatremorinhisfeetandalsoinhisbody,butverymild,somewheredeepinside.
Thetremorwasbarelynoticeableontheoutside.
Duringthecourseofthesessionsatremordevelopedintherightfoot(hisleftfootwaswounded),howeveritsubsidedrapidly.
Thenthetremordevelopedinbothfeet,andwasnoticeableontheoutsideandalsowithinthebody.
Initially,notremordevelopedintheupperbody,theshouldersorthearms.
Hishandshadonlyaslighttremor.
Duringthelastsessiontherewasasignificanttremorinthelegswhenhewasexercisingagainstthewallandthenalsoonthefloor.
Afterweperformedaninterventionwithahandtowel(wringingoutthetowel),atremordevelopedintheshouldersandarms.
Thetremorwasnotverypowerful,butitcouldbeclearlyseen.
Duringthistimethesoldierreportedthathefeltadeeprelaxationandpeace.
HehadnotfeltsorelaxedsincereturningfromtheATOwarzone.
Hissleepalsoimprovedsignificantly,andthefeelingofinnertensionandtheheadachessubsided.
Aclinicalpsychologist,theheadofacrisisinterventioncenterinthesmalltownofS.
inUkraine,reportsonthefollowingcase:itrelatestoasoldierwhohadtakenpartinhostilitiesinthe83ATOzone.
Duringagrenadeattackthepatientwaspropelledawaybyashock-wavecausedbytheprojectiles,andsufferedconcussion.
Hewasotherwiseunharmed.
Whenadmittedforrehabilitationhecomplainedofpaininthearms,handsandfeet.
Hismuscleswereverytense,hewasnotsleepingwellandhewasveryagitated.
FoursessionsofTREwerecarriedout.
Asthepatienthadsufferedconcussion,exercise4(withtheheadbentforwards)wasnotperformedandonlythefloortremorexercisewasdone.
Duringthefirstsession,thelegmuscles,calfmusclesandquadricepsmusclequicklybegantotrembleveryintensely.
Asaresult,thepelvisbegantomovealot.
Thepatient'seyeswereclosed.
Hewasaskedtoremainincontactwiththetherapistandreporthowhefelt.
Wewereonlyabletodofiveminutesinthefirstsession.
Attheendhereportedthathislegsfeltlikecottonwool.
Whenhewasblownuphealsohadthefeelingthathislegsweremadeofcottonwool,andhebecameanxiousandpanicky.
Thetherapistaskedhimtoorientatehimself,tositupandfeelthegroundandslowlystandupwithherassistance.
Hethenproceededtowalkaroundtheroomwiththetherapist'shelp,stampinghisfeet.
Thefeelingofcottonwoolinthelegsdisappearedandthepatientreportedthathewasverytiredandwouldliketosleep.
Duringthenextthreesessionsthemusclesofthelegsandthepelvistrembledandtherewasalsoatremorinthearmsandribcage.
Thecottonwoolfeelinginthelegsdidnotrecuragain.
Duringtheexercisesthebreathingmovementwassuperficial,lateritbecamedeeperandaclearexhalationwasaudible.
AfterusingTREthepatientreportedthatthepaininhismuscleshaddisappeared.
Initiallyhehadexperiencedastrongfeelingofrelaxationandlaterthischangedtoafeelingofvitality.
Hissleepsignificantlyimproved.
EfficacystudiesD.
Berceli'swebsite(www.
traumaprevention.
com/research)presentssevenstudiesontheefficacyofTRE;thesewerepredominantlyperformedintheUSAandSouthAfrica.
AsfarastheGerman-speakingcountriesareconcerned,Nibel(2015)presentedhisowninvestigationsattheConferenceoftheAssociationofErgonomics(GesellschaftfürArbeitswissenschaft)inKarlsruhe(27.
2.
2015).
Hisfindingswere:betterbodyawarenessandbodyimage,psychologicalchanges,suchasclarityofthoughtandfeeling,greaterself-efficacyandself-confidence,positivechangesinsocialrelationships,fewernegativesymptomssuchasinnerunrest,anxiety,thedisappearanceofspecifichealthdisorderssuchaspain,tinglingandtinnitus(PowerPointslide13).
ReferencesBerceliD(2010),TheRevolutionaryTraumaReleaseProcess,Vancouver:NamasteBerceliD(2010a),TheEffectsofNeurogenicTremorsontheHumanBody,ManuscriptBerceliD(2010b),NeurogenesZittern.
EineKrperorientierteBehandlungsmethodefürTraumataingrossenBevlkerungsgruppen,in:Trauma&Gewalt,4.
Jahrgang,Heft2/2010,S.
149ff.
BerceliD(2012),KrperübungenfürdieTraumaheilung,Papenburg:Niba-ev.
BerceliD(2014),PowerpointModulIBerceliD(o.
J.
)DVDTheRevolutionaryTraumaReleaseExercises,NamastePublishingButolloW,HaglM,KrüsmannM(1998),LebennachdemTrauma,München:Pfeiffer2,1-2,201584ButolloW,KarlR(2012),DialogischeTraumatherapie,Stuttgart:Klett-CottaBoonS,SteeleK,VanderHartO(2013),TraumabedingteDissoziationbewltigen,Paderborn:JunfermannDillingHetal.
(2011)InternationaleKlassifikationpsychischerStrungenICD-10KapitelV(F),Bern,HuberEmersonD,HopperE(2012),Trauma-Yoga,HeilungdurchsorgsameKrperarbeit,Lichtenau/Westfalen:ProbstFolleteVM,etal.
(2015),Mindfullness-OrientedInterventionsforTrauma,NewYork,London:GuilfordGrandD(2014),Brainspotting,Kirchzarten:VAKHorowitzMJ(1976/1997),StressResponseSyndroms,Nortvale,NewYork:JasonAronsonHorowitzMJ(2013),StressResponseSyndromes,PTSD,Grief,AdjustmentandDissociativeDisorders,LanhamMaryland:JasonAronsonLammersCH(2007),EmotionsbezogenePsychotherapie,Stuttgart:SchattauerLevineP(1998),Trauma-Heilung,Essen:SynthesisLevineP(2010),SpracheohneWorte,München:KselLevineP(o.
J.
),ManuelSomaticExperiencingTraining,DasersteJahr,B1.
4MaerkerA.
(Hrsg.
)(2009),PosttraumatischeBelastungsstrungen,Heidelberg:SpringerNibelH(2015),Letusshakeit,Baby.
TRETraumaandTensionReleasingExercisesalsneuesvielversprechendesAngebotinderbetrieblichenGesundheitsfrderungPowerpointVortragaufderKonferenzderGesellschaftfürArbeitswissenschaft,Karlsruhe27.
2.
2015OgdenP,MintonK,PainC(2010),TraumaundKrper,Paderborn:JunfermannReddemannL(2004)PsychodynamischImaginativeTraumatherapiePITT–DasManual,Stuttgart:Klett-CottaRothschildB(2000),TheBodyRemembers,NewYork:NorthonRüeggJK(2011),Gehirn,PsycheundKrper,Stuttgart:SchattauerSackM(2010),SchonendeTraumatherapie,Stuttgart:SchattauerScaerR(2007),TheBodyBearstheBurden,NewYork,London:RoutledgeScaerR(2014),DasTrauma-Spektrum,Lichtenau/Westfalen:ProbstShapiroF(1998),EMDR,GrundlagenundPraxis,Paderborn:JunfermannShore,A(2007),AffektregulationunddieReorganisationdesSelbst,Stuttgart:Klett-CottaSpangenbergE(2015),BehutsameTrauma-Integration(TRIMB),Stuttgart:Klett-CottaVanderKolkB,McFarlaneAC,WeisaethL(2000)TraumaticStress,GrundlagenundBehandlungsanstze,Paderborn:JunfermannVanderKolkB(2014),TheBodyKeepstheScore,NewYork:VikingVohsKD,BaumeisterRF(Hrsg.
)(2011),HandbookofSelf-Regulation,NeuYork,London:GuilfordWllerW(2006),TraumaundPersnlichkeitsstrungen,Stuttgart,NewYork,Schattauer24.
08.
2015