Trauma Interventions Using Mindfulness-Based Extinction and Reconsolidation of Memories (TIMBER)
Traumatic memories are the critical factors in maintaining the symptoms of chronic post-traumatic stress disorder (PTSD), treatment resistant depression (TRD), and traumatic psychosis but current treatment strategies don’t address them adequately. Current trauma therapies are based on memory extinction mechanisms which have important limitations in their methodologies, client engagement, and effectiveness. Recent work on memory shows that extinction should be paired with reconsolidation in order to build resilience and skills necessary to deal with the pathologically ingrained traumatic memories (TMs). A mindful state that is alert, calm, and nonreactive is ideal not only for extinction of the traumatic memories but also for reconsolidation of the calming memories created by the meditation practice so that detached reformulation of TMs becomes possible to ameliorate the symptoms of chronic PTSD, TRD, and traumatic psychosis.
TIMBER is a targeted, time limited, and translational (3Ts) mindfulness-based cognitive-behavioral therapy (CBT). Standardized TIMBER sessions allow the clients to access the mindful state initially with the therapist’s guidance and subsequently to generalize the therapeutic gains to the daily life situations through self-practice. Cogently touching upon these points, this chapter covers the data on the efficacy of TIMBER as a stand-alone therapy and also in combination with medications as well as brain stimulation (rTMS) interventions in these often chronic and difficult-to-treat conditions.
KeywordsPTSD Depression Traumatic psychosis CBT TIMBER therapy Graded exposure therapy Yoga Meditation Mindfulness
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