Stones, flowers and a rope

Just back from the International Society for Traumatic Stress Studies annual meeting in Chicago and I’m struck by the diversity of research being conducted on behalf of the many survivors of severe stress and trauma around the world. There were data on everything from prolonged exposure therapy, cognitive processing therapy, and EMDR (eye-movement desensitization and reprocessing) to imagery rehearsal for nightmares and acupuncture – the latter approach being studied by physicians at Walter Reed Army Medical Center in Washington, D.C.


Researchers in Israel are using repeated, brief interventions in the ED to help structure memory and aid in meaning acquisition in patients with acute stress disorder who are still receiving emergency treatment for their physical wounds.


German researchers are treating child survivors of the Rwandan genocide and former child soldiers with narrative exposure therapy in which the person’s life is fully documented from birth through the present day in hopes of inhibiting the fear structure. Few of these children are able to read, so the tools are simple – a clinician’s notebook and a rope to represent the child’s lifeline. Stones are placed on the rope to indicate the traumas they’ve endured, while flowers are used to mark and reinforce the good events. Knowing that conducting therapy among refugees can be a moving target, the researchers also trained laypeople to conduct the therapy.


The simplicity of this effort and the dedication of its practitioners were stunning. It also stands in stark contrast to many of the other meetings I attend in which high-tech or pharmaceutical treatments rule the day. ISTSS attendees inside the poster/exhibition hall were busy snapping up books for sale rather than hearing the latest sales pitch. A nearby sign acknowledged Eli Lilly as the only pharmaceutical company to help sponsor the 3-day event.


In roughly two weeks, I’ll cover what is often billed as the largest medical meeting in the world – the annual meeting of the Radiological Society of North America ( The value of the equipment on the exhibition floor of Chicago’s massive McCormick Place will run into the millions. The detailed images of the human body captured by these machines will be stunning as well. Yet I can’t help but think that ISTSS ( and its 2,464 members have tapped into an equally powerful tool – man’s resourcefulness in caring for those in pain.


—Patrice Wendling


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Filed under Family Medicine, Practice Trends, Psychiatry

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