Alain Brunet, Ph.D., McGill University, Montreal / Adam Brown, Ph.D., New School for Social Research, New York / & Andrew Rasmussen, Ph.D., Fordham University, New York – Are three academics specializing in the study and treatment of PTSD.


With nearly 3 000 deaths and 6 000 injured, 9/11 is the deadliest act of terrorism in history, not counting those with ongoing health issues stemming from inhaling toxic dust. These attacks,  targeting the World Trade Center twin towers in New York City 19 years ago have cost hundreds of billions of dollars to the US economy and triggered an even more costly global military initiative to combat terrorism. But for most individuals who were attacked or personally witnessed the event, 9/11 meant enduring crippling and long-lasting adverse consequences. Thousands of first responders risked their lives to, later on, develop health and mental health problems. After 9/11, alcohol consumption in Manhattan increased by 25 percent. Tobacco use rose by 10 percent, marijuana by 3 percent. Family members suffered as well: 3,051 children lost a parent on that day, and dozens of pregnant women lost their babies. According to a large representative survey, approximately 375,000 New Yorkers suffered from probable 9/11-related posttraumatic stress disorder (PTSD). This does not include other common 9/11-related diagnoses.

Crises are forced opportunities for societies to learn and to change. Important lessons in mental health were learned as a result of 9/11, and terms previously relegated to mental health professions such as trauma, PTSD, and resilience entered into common parlance. But adoption by laypeople of the concepts and vocabulary of trauma was not the only change. Neuroscience, mental health science and epidemiology and psychiatric research were profoundly invigorated by 9/11. Novel treatments have emerged out of this research that gives us new hope. Here are eleven ‘learning experiences and a few thoughts about the changing science of PTSD:

9/11 – Lessons learned in mental health

1. Contrary to alarmist statements made by so-called experts in the aftermath of 9/11, not all New Yorkers, Washingtonians or Virginians were ‘traumatized,’ although very many were trauma-exposed. Resilience, the capacity to bounce back, is the normative response to stress and upheaval among humans, even after the most horrific events. Before 9/11 there was little information about how people adapted emotionally following major collective trauma.

2. 9/11 opened up conversations about the ubiquity of trauma. Until then, trauma was mostly linked with the military. The American Psychiatric Association referred to trauma as events “outside of the normal range of human experience.” Trauma is not only incredibly common but experiencing a variety of traumatic events in one’s lifetime is the norm.

3. Trauma, and by extension terrorism, can be a life-changing event. Whether we develop PTSD or not, most trauma-exposed individuals will experience the anguish of subsequent uncertainty, the disruption of our assumptive worlds, and the loss of trust in the foundations of our lives. As a brutal and unexpected confrontation with death, trauma is a ‘failed’ encounter with the grim reaper. It remains a permanent landmark in our lives, marking the frontier between the before and the after. Survival comes at a cost of long-term invisible psychological injury. But hopefully, for some, survival will foster posttraumatic growth.

4. In the immediate aftermath of a disaster, survivors’ needs revolve essentially around safety and practical, logistical help that will help them meet their basic needs. This includes connecting with significant others to grieve and obtain emotional support, getting sufficient food, and accessing transportation and money. Less basic needs (e.g., psychological care and the need to find meaning) will emerge later.

5. Trauma survivors should not be pressed to talk about their trauma experiences, although we tend to think that talking is good. Talking with others can create a bond and knits meaning to something that does not make sense. But, thinking and talking about trauma should be done at their own pace with someone who understands and knows how to listen. There is such a thing as negative social support (e.g., ‘get over it’) and it can impair recovery.

6. However popular after 9/11, research shows that the use of structured debriefing groups had no effect—and for some people, it may have made things worse in the long run. Most trauma survivors do not automatically need to see a mental health professional. There is very little evidence for the efficacy of any kind of immediate therapeutic intervention and making normal reactions to abnormal circumstances seem like psychiatric problems may actually hurt people. However, a sizable minority of individuals will not recover spontaneously and deserve help.

7. Many mental health professionals and people of goodwill are compelled to ‘do something in the aftermath of a traumatic event. However, one of the lessons learned after 9/11 is that therapists should not get in the way of public safety personnel and should be even more careful interfering in trauma survivors’ time-dependent, natural coping processes.

8. None of the above suggests that there is no place for psychotherapy following trauma. But instead of trying to provide psychotherapy to an entire population following trauma, a continuum of stepped care approach should unfold over time, whereby mental health advice is being distilled first to the masses via the media from very early on (fostering resilience), and increasingly sophisticated and specialized mental health help is offered with time to more vulnerable subgroups (e.g. firefighters, women, etc.)

9. Many scientists agree with certain advocacy groups who claim that PTSD is not a ‘disorder’ but rather an ‘injury’. Individuals with PTSD are not crazy or ill; they are injured badly. But contrary to a visible wound, the invisibility of the PTSD injury prevents trauma survivors from attracting sympathy… and appropriate compensation. This remains a problem to this day.

10. In the past PTSD was often considered a fabricated or exaggerated mental condition invoked by the coward or the laggard. 9/11 made us realize that personal weakness has little to do with whether one develops PTSD or not, and that survivors, many of them heroes, need to be cared for.

Some 88,000 individuals are currently members of the WTC Health Program (helped by the U.S. Congress’ Zadroga Act), and more are expected to join.

11. The ideas and concepts that 9/11 brought into the mainstream have been used to highlight the dire conditions of many other trauma survivors as well: child abuse and sexual abuse survivors, victims of racism and anti-LGBTQ discrimination, bullying targets and of course the veterans returning from conflict, to name a few.

9/11 – The day PTSD arrived to stay

American Vietnam veterans are credited for putting PTSD on the map; but as the most well-documented disaster in history, 9/11 put it in our face and forced us to stare at it. Before 9/11 only a handful of people knew what the ‘PTSD’ acronym stood for. Looking back, it is hard to believe that before 9/11, we, academics interested in PTSD, were considered to be working on a marginal, obscure disorder affecting mostly military personnel and victims of gender-based violence.

On 9/11 the image of trauma was completely shattered as the dystopic event intruded into the homes of millions of individuals via the TV set. 9/11 was an electroconvulsive shock, an experience of shock, a painful wake-up call that from then on traumatic stress was lurking behind the ordinary, at every street corner. It was not just for Viet vets anymore. In this day and age, trauma exposure has become the new normal, and PTSD is a misfortune likely to strike anybody.

History books claim that recognition of the existence of traumatic stress has waxed and waned over time, at least since Herodotus described the deleterious effects of the battle of Marathon in antiquity on some of its warriors. This time, PTSD invaded our world as a concept and has been with us ever since. In fact, it would be easy to demonstrate that the mental health consequences of trauma exposure represent the most prevalent psychiatric entity across society; it is a global grand challenge waiting to be resolved by psychiatry and its allied sciences, but also by policymakers and diplomats. PTSD arrived on 9/11, but 20 years later the new question becomes when will it go? Can we eradicate it? Why not try?

9/11 – An explosion … of knowledge

In the early ’80s when PTSD in its modern form was introduced into psychiatric diagnoses, we still knew very little about it: how it developed, who was at risk, its scope in society, its course or its treatment. After 9/11, the annual number of scientific publications in the PubMed database on traumatic stress exploded, doubling every 7 years between the years 2000 (689), 2007 (1 491), and 2014 (2864).

This attention to the disorder has paid off. In just a few decades we have made so much progress in understanding how PTSD develops after a trauma, what are the risk and resilience factors, the neurobiology of PTSD, the genetic and epigenetic influences on PTSD, its prevalence and course. We have developed and refined animal models, questionnaires, structured interviews and inventories to accurately assess PTSD. We’ve found ways to use salivary, blood, urine, and sleep tests to augment these assessment measures. We have imaged the brains of thousands of PTSD patients, developed new drugs to treat PTSD and even discovered several biomarkers—though none that do a very good job of predicting who will get PTSD following trauma, unfortunately. Even the basic science fields of learning and memory and the neurocircuitry of fear have progressed significantly because of the attention paid to PTSD. This makes sense considering that without reminiscing, it is virtually impossible to suffer from PTSD.

Advances in the treatment of PTSD

In 2020, no one should continue to live with PTSD, considering the existence of several evidence-based treatments. While no one would ever want to go back to times when we did not have medications, the pharmacological treatment for PTSD remains only partially effective. The –very lucrative— treatment model in psychiatry has remained unchanged for the last 60 years, and applies to PTSD: one pill a day for an unknown period of time (typically years!) to mask your symptoms, at the cost of serious unwanted side effects (weight gain, inability to achieve orgasm, suicidal impulsivity, etc).

This medical model has been complemented (and challenged) however by the advances made in the field of psychotherapy. There are now several, evidence-based psychotherapies for PTSD that have held up well in clinical trials. Exposure therapies, inspired by the famous physiologist Ivan Pavlov, have been successfully adapted to the treatment of PTSD in the 1990s. Eye movement desensitization and reprocessing (‘EMDR’), a remarkable therapy involving eye movement was invented to treat PTSD has also shown promise. But even more, stunning therapies are in the pipeline. We and others have shown that, not unlike what was depicted in the movie Eternal Sunshine of the Spotless Mind, we can now selectively and durably decrease (though not erase) the strength of an emotional memory, a specific traumatic memory for instance, for the benefit of our patients, in just a few short visits.

Reconsolidation therapy, which relies on the evocation of a traumatic memory under the beta-blocker propranolol, is based on our most recent understanding of how memories are formed, stored, and retrieved. Because remembering is at the core of a condition like PTSD, blocking in part the re-saving of this memory has proven an astute and effective way of treating PTSD (see Brunet et al., 2018). This method, which may become the first curative treatment in psychiatry, has been used with success in the aftermath of other recent terrorist attacks in Paris in 2015 and Nice in 2016. At that time, as was the case after 9/11, there was a lot of uncertainty concerning the recurrence of other terrorist attacks. There was a pressing need to increase local treatment capacities. Reconsolidation therapy, which can be learned in just 3 days by experienced therapists, was taught to 200 French therapists, who in turn treated hundreds of patients in a matter of weeks, demonstrating the possibility for a community to recover from a massive outbreak of traumatic stress in a relatively short period.

Of course, let’s not forget that the best treatment for PTSD is eliminating the causes from which it comes. All of the resources, data collection, human and non-human research subjects, scientific papers and professional conferences on the study and treatment of PTSD have shown us since 9/11 is that traumatic stress can have long-lasting and profound impacts on our overall health and ripple through every aspect of our relationships and communities. On this anniversary of 9/11, let’s consider everything we know about PTSD – the way it can impact health, relationships, and society. We may not be able to prevent every tragedy, but we’ve come a long way. Today, let’s take those lessons learned and commit ourselves to reduce violence, poverty, population displacement, promoting diplomacy, and investing in sustainable environments.

Reconsolidation Therapy

Based on the latest discoveries in neuroscience, Reconsolidation Therapy™ has been the subject of much scientific research over the last 20 years, allowing today hindsight in its high efficiency. This innovative treatment method involves taking a beta-blocker (propranolol) before each 25 min. therapy session.

Reconsolidation Therapy™ aims to treat Trauma- and Stressor-related Disorders (DSM-5, 2013), like posttraumatic stress disorder, adjustment disorder, complicated grief. These disorders are typically caused by an emotional shock such as losses, bereavements, accidents, assaults, attacks, natural disasters, etc.

Training content

The training is taught in small groups by a clinician with extensive experience in using Reconsolidation Therapy™. This accredited course includes 16 hours of lessons (in person or online), spread over 2.5 days. It comes with a 6-hour academic reading program (in English), a copy of the ppt slides, and a personalized, reusable copy of the three step-by-step treatment protocols (Dx, Rx and Tx).

Cancellation and refund conditions

If a trainee cannot attend part or all of the training, the training organization will offer, at its own discretion, to:
-postpone the training to a later date.
-attend the part of the training is missing at a later date.
-no reimbursement will be made by the training organization.

If the training organization cannot provide the training, the trainee will be offered:
-a replacement teacher.
-a training deferral (of the entire training or only the missing hours of training).
-a refund of the entire training.
-no financial compensation other than reimbursement for the training will be paid by the training organization in the event of cancellation of the training.

An approved training organization

CABA (CONSULTANTS ALAIN BRUNET & ASSOCIATES) Inc. is a business registered in Québec (Canada) that offers accredited training to mental health professionals. In Québec, the training is accredited by the Quebec Board of Psychologists and, by extension, by all Boards of professionals in the province of Québec. In the rest of Canada, the training is recognized by the Canadian Psychological Association (CPA).

In Switzerland, the trainings are recognized by the Fédération Suisse des Psychologues (FSP). For all other cases, we recommend that you check with your professional association whether you can obtain continuing education credits before you register for any training.

Who Should Attend ?

All professionals who can legally practice psychotherapy in their jurisdiction may attend this training. This typically includes board registered physicians (general practitioners and psychiatrists), psychiatric nurses, social workers,
psychologists, counselors, sexologists, and psychotherapists. It is not necessary to have prescribing privileges to attend the training or to use Reconsolidation Therapy™.

Reconsolidation Therapy

Based on the latest discoveries in neuroscience, Reconsolidation Therapy™ has been the subject of much scientific research over the last 20 years, allowing today hindsight in its high efficiency. This innovative treatment method involves taking a beta-blocker (propranolol) before each 25 min. therapy session.

Reconsolidation Therapy™ aims to treat Trauma- and Stressor-related Disorders (DSM-5, 2013), like posttraumatic stress disorder, adjustment disorder, complicated grief. These disorders are typically caused by an emotional shock such as losses, bereavements, accidents, assaults, attacks, natural disasters, etc.

Training content

The training is taught in small groups by a clinician with extensive experience in using Reconsolidation Therapy™. This accredited course includes 16 hours of lessons (in person or online), spread over 2.5 days. It comes with a 6-hour academic reading program (in English), a copy of the ppt slides, and a personalized, reusable copy of the three step-by-step treatment protocols (Dx, Rx and Tx).

Spécificités de la thérapie de la reconsolidation

Basée sur les dernières découvertes en neurosciences, la thérapie innovante de la Reconsolidation™ a fait l’objet de nombreuses recherches scientifiques permettant aujourd’hui un recul sur son efficience. Cette méthode associe la prise d’un agent pharmacologique à une psychothérapie brève.

Elle vise à traiter les troubles engendrés par des chocs émotionnels intenses (pertes, deuils, accidents, agressions, attentats, catastrophe naturelle). S’attachant à réparer les troubles post-traumatiques, elle est le marqueur d’un protocole thérapeutique innovant.


Contenu de la formation

La formation à la Méthode Brunet™ comprend 16 heures de cours, réparties sur 2,5 jours. Elle est assortie d’un programme de lecture de 6 heures (en anglais).

Pour connaitre avec précision le contenu de la formation et le programme d’apprentissage intégral, cliquez sur le lien de la page détaillée.

Elle vise à traiter les troubles engendrés par des chocs émotionnels intenses (pertes, deuils, accidents, agressions, attentats, catastrophe naturelle). S’attachant à réparer les troubles post-traumatiques, elle est le marqueur d’un protocole thérapeutique innovant.

A qui s’adresse cette formation ?

  • à tous les médecins (généralistes et psychiatres)
  • infirmiers, autres professionnels para-médicaux, travailleurs sociaux susceptibles de prendre en charge des patients atteints de troubles de SPT
  • aux psychologues, psychothérapeutes,
  • aux autres professionnels / thérapeutes : déjà formés aux TCC, à l’hypnothérapie, à l’EMDR, à la sexologie, à l’art-thérapie, à la psychanalyse, …

Cette formation permet d’apprendre à utiliser la Thérapie de la Reconsolidation™ appliquée à la résolution des traumas.

Un organisme de formation agréé

CABA (Les Consultants Alain Brunet et Associés) Inc. est une entreprise du Québec (Canada) qui propose des formations aux professionnels en santé mentale. Au Québec, les formations de CABA sont accréditées par l'Ordre des psychologues du Québec (OPQ) et, par extension, par TOUS les ordres professionnels du Québec. Au Canada les formations sont reconnues par la Société Canadienne de Psychologie (SCP).

CABA Inc. a obtenu l’agrément d’Organisme de Formation enregistré en France sous le NDA 93990559883. Les formations sont reconnues par le Datadock (France).

En Suisse, les formations de CABA Inc. sont reconnues par la Fédération Suisse des Psychologues (FSP). Pour les autres cas de figure, nous vous recommandons de vérifier avec votre association professionnelle de la reconnaissance desdits crédits avant de vous inscrire.


Possibilité de prise en charge de votre formation

En France, le professionnel installé en exercice libéral au moment de la formation peut faire une demande de financement de sa formation par le FIF-PL.

Vous trouverez de l’information sur le site www.fifpl.fr.

La formation sera bientôt éligible dans le cadre du Compte Personnel de Formation (CPF).

Conditions d'annulation et de remboursement

Si le stagiaire ne peut assister à une partie de la formation ou à la totalité de la formation : 

  • Il lui sera proposé, à la discrétion de CABA Inc. :
    •  un report de la formation à une date ultérieure.
    • d’assister à la partie de la formation qui n’a pas été suivie.
    • Aucun remboursement ne pourra être réalisé par l’organisme de formation.

 

Responsabilité de l’organisme de formation :

  • Si le formateur ne peut pas dispenser la formation, il sera proposé au stagiaire, à la discrétion de CABA Inc. : 
    • Un enseignant remplaçant.
    • Un report de formation (de la totalité de la formation ou seulement les heures manquantes de formation).
    • Un remboursement de la totalité de la formation. 
    • Aucun dédommagement financier autre que le remboursement de la formation ne sera payé par l’organisme de formation en cas d’annulation de la formation.