 Something probably everyone has thought about in relation to the float tank. Just because there are so few things out there that really help with that and float tanks seem to do an amazing job. So he's going to help educate us on it a little bit and give us a little fodder for our cannon when we want to talk to people about it in our shops. So without further ado, I'll pass it off to David Manview. I'm a clinical psychologist here in Portland area and I'm one of the early people who trained in EMDR, which is at the time of its origination was one of the primary treatments, successful treatments for PTSD. And so I've had my head in it for about 30 years. I have a confession to make. I am a flotation newbie. I am not a virgin, however. I tried it about 10 or 15 years ago. I don't have much memory for it, but I tried it again two nights ago and I had a sublime experience. I think you guys are really into something wonderful and I'm looking forward to introducing it into my practice. I think it's going to make a huge impact. So I'd like to talk to you about PTSD. So let's see. So PTSD, let me give you a classic example of how PTSD arises. Classic being because I was in high school and during the Vietnam War we had a lot of people coming home from war and somehow they didn't get that they were home. And so there was a lot of tragedies, a lot of killing. Veterans were acting out as if they were still at war. And so PTSD became very prominent for a lot of us and of course there's been a lot of research since then. It's basically a set of symptoms that originates after a profound trauma to the system. So oftentimes so out of the ordinary that the brain doesn't know how to deal with it. It's surreal. And there are a host of things that happen both physiologically and neurologically as the brain tries to cope. So it's a kind of people that I tend to encounter are folks who are victims of motor vehicle accidents or arm robberies, rapes. These are the kinds of individuals that are left with what seems like indelible memories that can't seem to shake. So that classic example, think of that Vietnam veteran, well he's not a veteran, think of him while he's in the Fox Hole. And there's bombs dropping, bullets flying, helicopters flying, napalm dropping. I mean he is overwhelmed with the sights and smells and sounds of a man who is, who's survival is really in question. And then his buddy in the Fox Hole gets blown up. So five or ten years later he's walking down the street to Portland. There's a helicopter overhead. He's walking by a petrol station. He hears a car backfire and he is diving for cover. In his experiences he's still there. And there lies the rub, so to speak. His brain has compartmentalized that experience and is sort of lying there in wait. And anytime we're reminded of these traumatic experiences, that part of the brain just takes over. So the trick to resolving PTSD is to somehow introduce that neural network to the rest of the brain. I'll talk about that in a little bit more. There is something here called, there it is, complex PTSD. Complex PTSD is the result of chronic trauma. You can imagine somebody, survival threatened on a daily, if not hourly basis for a prolonged period of time. Somebody who's a victim of chronic sexual abuse as a child or a wife who's battered or somebody who's held imprisoned for prolonged period of time during war. These people are in an overwhelmed state, a prolonged state of fight or flight that will last four, that can last weeks, months, years even. And of course that causes changes in the brain. So let me talk about those changes. During a state of siege, when we're in survival mode, the part of the brain called the amygdala, it's at the top of the spinal cord. It's one of the most primitive parts of the brain. It takes over because it's all about survival. It starts communicating with the pituitary and the hypothalamus and it's saying, hey, we got to motivate. We got to take action right now. So there's adrenaline popping. There's release of cortisol, ACTH, epinephrine, point being that the body mobilizes. But one of the intriguing things that happens is that the contemplative part of the brain, the left brain that our previous presenter was talking about, that part goes offline and the hippocampus also goes offline and that's the part of the brain that's sort of like the filing cabinet. And that's the part that would customarily take an experience and file it where it rightly belongs. For example, if we were to bump our shin on a coffee table, we wouldn't go into fight or flight. The hippocampus says, boy, that was dumb, but let's put that in the file called Stupid Mistakes. It's not fight or flight. So the memory of the experience isn't coded. We don't forget it, obviously. And problem lies in the fact that the memory is maladaptively stored. The trauma itself is held with all its original emotions, negative beliefs, I'm going to die, body sensations, the freeze response. It all gets, the images, it all gets held neurologically and metaphorically speaking in a capsule. And that capsule is not, there are no neural connections between the memory and everything that happens to subsequent to it and everything else we know about life and world. And so consequently, it just loops every time we access that memory gets activated. We flood with all the same anxiety and fears and beliefs like I'm going to die and I better get out of here. So that stuff gets us, so the trick to healing is to somehow create a bridge between the experience, the memory itself and what happens subsequent to the memory. So in case of that veteran, we want him, when he thinks of the memory, to also remember that he flew home and that he's safe with his family now and that he survived. So we need to get those neurons firing to create that association. Yeah, sure. And so we're going to try and promote that association. There's a fun adage in the world of neurology and that is neurons that fire together, wire together. So if we can promote the association in a safe and comfortable and relaxed environment, we're going to get some healing. And that's where flotation comes in, because there's a host of things, this slide would have helped you there. So what we're going to do is we're going to strive for integration of those maladaptively held and isolated traumatic neural networks with the wisdom and experience of the healthy, balanced and adaptive brain. How's that for a sense? So flotation. As far as I could find, there are no controlled studies on treatment of PTSD with flotation. There should be. It wouldn't be that difficult to do. I'm kind of intrigued about doing it myself. What we do know, courtesy of the presenter who's going to follow me, who is the man when it comes to doing science on the subject, Peter Sudfeld, that PTSD, well, the float eliminates cortisol, ACTH, and epinephrine, as well as lowers blood pressure and heart rate. And those are the exact things that we want to have happen when we're struggling with PTSD and associated symptoms. So let's look at all the things that flotation does that might help repair the symptoms and allow an individual to create an environment where a person is most likely to heal from a traumatic event. First of all, as I suggested, it inhibits the stress. It inhibits the hormones that are, and so if a person is really relaxed, you get a counter conditioning effect. Secondly, flotation enhances right brain activity. And prior presenter had a beautiful slide about how the right brain is a critical part of creating context, creating it here and now awareness. We know through brain imaging that if you ask a person who's traumatized to think about their memory, you see the left brain lights up and there's very little activity, relatively speaking, in the right. And we also know that people who are meditating, people who are well integrated, people who are relaxed and happy, they have synchrony between left and right hemispheres, and flotation seems to promote right brain integration and activity, so that's promising. Also, flotation enhances the effectiveness of imaginal exposure. Somebody did a study with OCD, and it was his conclusion that if you get somebody focusing on an image and exposing himself to the image, eventually it loses its charge. And that's intriguing because of the VA, the Veterans Administration treats PTSD primarily with imaginal exposure. And so anything that we can do to improve outcomes is going to be of benefit. Fourthly, there's evidence that flotation might promote the release of endorphins. Endorphins are bodies natural opiate. It's that part of the brain. It's a hormone that is a lot like heroin, really. It is very pleasant. And again, anything that we can implement in a person who's exhibiting symptoms, that's going to relax them. It's going to counter condition the anxiety and make it more possible for us to think rationally about the trauma without flooding. Also know that flotation increases theta waves. Theta waves are really interesting because they're very hard things to actively create, but that is the brainwave that is the most creative. It's that time when you're about to fall asleep, about to wake, or you've just woken up, and you know how clear-headed, and you get all your aha experiences in that state of mind. Well, apparently what I've read here is that flotation increases theta wave activity. Well, you know, when you're trying to get a person to get unstuck from their ruminations, their chronic obsession with the memory, that's the way to do it. That's certainly going to help. I mean, finally, some authors are suggesting that flotation induces a hypnagogic state. It's kind of like hypnosis. What do we know about hypnosis? People are very receptive to suggestion. So if you can implement a cognition, positive cognition, suggest it while they're focusing on traumatic memory like I survived, or it's over, where, again, you're increasing likelihood getting a result. I'm not sure I ever showed you the symptoms. I think I'm going to do that once before I summarize. So people with PTSD, they've got this capsule of traumatic memory that they continue to relive, and it's bringing on nightmares. It's people ruminate. They become avoidant of anything that might remind them of the trauma. They have flashbacks, so that memory takes over. They have nightmares, intrusive thoughts. It's hell. They numb out, and they become avoidant. So I've kind of given this some thought. I'm thinking, okay, flotation might be a tremendous augmentation to my work with people with PTSD. And so I came up with this treatment paradigm. It's somewhat based on what I know about EMDR. The first thing I would propose is that you ask a person with PTSD to identify a safe place while they're floating. That's pretty much the standard protocol whenever you're asking somebody to consider, well, work on a traumatic memory, because unfortunately, if your treatment's not successful, people get worse. They can open up a traumatic memory, and it doesn't go away, or people leave the office, and they're more traumatized when they walk in. So what we have learned in the EMDR world is to make sure that people have a mental state that they can return to should they need to, and hopefully they won't need to in this case, but it's important to start there. And then you target the traumatic memory, adding in some bilateral stimulation. Again, bilateral stimulation, we found in the EMDR world, catalyzes new associations, catalyzes synchrony between the left and right hemispheres. So I'm thinking that if you can put some music in the flotation tank that goes from back and forth, right to left, you're implementing a bilateral stimulation. Another way to do it is to have the individual just tap their hips or tap the back of their head, alternating one side to the, or the, you know, back and forth, left and right. That's going to, I think, going to, you know, we're drawing on our success with the EMDR and adding it to the flotation paradigm. Then we can add positive cognition. We know that there's enhanced suggestibility. So why not have the person, after they've kind of focused on the image for a while, you know, there's definitely a diminished reactivity to the memory, ask them to make some positive statements, like, I survived it, it's over, it's behind me. And in my mind, that should promote healing. And finally, you want to encourage the individual to go back to the state imagery before they get out of the flotation tank. It might not be necessary, but it's always worthwhile to encourage it. So I don't know how I'm doing on time, but that was my presentation for today, and thank you for listening.