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| Narcoanalysis = | |
|---|---|
| ICD-9-CM | 94.21 |
Narcosynthesis [1] is a technique of treating post-traumatic stress disorder [2] popularized by psychiatrists in the post-World War II era. Also called sodium amytal interview, amobarbital interview, or amytal interview, it uses free association as well as dream and transference material[ clarify ] during the session as a basis for uncovering relevant topics for later therapeutic discussion. [3]
While extraordinarily rare today, narcosynthesis procedures (using sodium amytal and pentothal) were widely used in the United States in the post-World War II era when only a very few psychiatric treatments were available. [4] Administered as an inpatient hospital admission and overseen by an anesthesiologist, this procedure remains used in only the most extreme cases in the U.S..[ citation needed ]
In 1930, Dr. William Bleckwenn introduced narcoanalysis as a therapy for severely schizophrenic patients or those who suffered from catatonic mutism. These people after being administered the drug would be released from their somatic state for short periods. They could carry on conversations, partake in meals, and behave as if completely healthy; however, the effect was temporary. After some hours, they returned to their prior condition. Despite these short-lived effects, the treatment was common practice in English asylums through the 1940s and 1950s. [5]
It was from this treatment that cathartic abreaction came into use as a treatment for soldiers following the Second World War. The administration of short-term barbiturates caused disinhibition which facilitated the soldiers' participation in psychotherapy. [6] Therapists worked with the soldiers to recall battle traumas, and subsequently attempt to treat or reduce the effects of "shell shock" and other manifestations of psychological trauma associated with battle. By augmenting standard hypnosis with narcotics and "synthesizing" mental states through the power of hypnotic suggestion, a negative mental state could be replaced by a positive one.
The efficacy of such techniques remains a source of debate among medical professionals; however, it is the ethical aspect of this area of psychology which provides the greatest challenge to society, [7] as the malleability of the human psyche is well documented throughout history.
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Information from outside of the US shows that, in countries such as India, narcosynthesis has been used for the interrogation of possible suspects in criminal cases. There has also been some use of barbiturate hypnosis therapy in the past. [8]
The accuracy of the results is debated. As in frank hypnosis, repressed unconscious thought may be more likely to come forth rather than consciously suppressed.
Opponents of narcosynthesis argue that there is little scientific evidence to warrant its use as a reliable source of interrogation, citing misuses by the CIA and several Indian police agencies.
India is referred to as the narcoanalysis capital of the world with Behavioral Science Consultation Teams using pseudoscience to back illegal interrogations. Though security agencies worldwide have shown interest, inconsistent results have proven objective truth elusive, despite increased suggestibility.
"Truth serum" is a colloquial name for any of a range of psychoactive drugs used in an effort to obtain information from subjects who are unable or unwilling to provide it otherwise. These include ethanol, scopolamine, 3-quinuclidinyl benzilate, midazolam, flunitrazepam, sodium thiopental, and amobarbital, among others.
Dissociative identity disorder (DID), also known as multiple personality disorder, split personality disorder or dissociative personality disorder, is a member of the family of dissociative disorders classified by the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual for diagnosis. It remains a controversial diagnosis.
Neurosis is a term mainly used today by followers of Freudian thinking to describe mental disorders caused by past anxiety, often that has been repressed. In recent history, the term has been used to refer to anxiety-related conditions more generally.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
Dissociation is a concept that has been developed over time and which concerns a wide array of experiences, ranging from a mild emotional detachment from the immediate surroundings, to a more severe disconnection from physical and emotional experiences. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a false perception of reality as in psychosis.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, with extreme examples being violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.
Amobarbital is a drug that is a barbiturate derivative. It has sedative-hypnotic properties. It is a white crystalline powder with no odor and a slightly bitter taste. It was first synthesized in Germany in 1923. It is considered a short to intermediate acting barbiturate. If amobarbital is taken for extended periods of time, physiological and psychological dependence can develop. Amobarbital withdrawal mimics delirium tremens and may be life-threatening. Amobarbital was manufactured by Eli Lilly and Company in the US under the brand name Amytal in bright blue bullet shaped capsules or pink tablets containing 50, 100, or 200 milligrams of the drug. The drug was also manufactured generically. Amobarbital was widely misused, known as "Blue Heavens" on the street. Amytal, as well as Tuinal, a combination drug containing equal quantities of secobarbital and amobarbital, were both manufactured by Eli Lilly until the late-1990s. However, as the popularity of benzodiazepines increased, prescriptions for these medications became increasingly rare beginning in the mid to late-1980s.
Dissociative disorders (DD) are conditions that involve significant disruptions and/or breakdowns "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." People with dissociative disorders also use dissociation as a defense mechanism involuntarily. The individual experiences these dissociations to protect themselves from traumatic stress. Some dissociative disorders are triggered by significant psychological trauma, though depersonalization-derealization disorder may be preceded by lesser stress, psychoactive substances, or no identifiable trigger at all.
Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Recovered-memory therapy (RMT) is a catch-all term for a controversial and scientifically discredited form of psychotherapy that critics say utilizes one or more unproven therapeutic techniques to purportedly help patients recall previously forgotten memories. Proponents of recovered memory therapy claim, contrary to evidence, that traumatic memories can be buried in the subconscious and thereby affect current behavior, and that these memories can be recovered through the use of RMT techniques. RMT is not recommended by professional mental health associations.
Exposure therapy is a technique in behavior therapy to treat anxiety disorders.
Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as well as overdose potential among other possible adverse effects. They have been used recreationally for their anti-anxiety and sedative effects, and are thus controlled in most countries due to the risks associated with such use.
William Jefferson Bleckwenn was an American neurologist, psychiatrist, and military physician, who was instrumental in developing the treatment known as "narcoanalysis" or "narcosynthesis", also known by the lay term "truth serum".
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
Richard Allan Bryant is an Australian medical scientist. He is Scientia Professor of Psychology at the University of New South Wales (UNSW) and director of the UNSW Traumatic Stress Clinic, based at UNSW and Westmead Institute for Medical Research. His main areas of research are posttraumatic stress disorder (PTSD) and prolonged grief disorder. On 13 June 2016 he was appointed a Companion of the Order of Australia (AC), for eminent service to medical research in the field of psychotraumatology, as a psychologist and author, to the study of Indigenous mental health, as an advisor to a range of government and international organisations, and to professional societies.
Hypnoanalysis is the technique of using hypnosis in the practice of psychoanalysis and psychotherapy. It attempts to utilize the trance state induced by hypnosis to effect a conscious understanding of a person's unconscious psychodynamics.
Post-traumatic stress disorder (PTSD) results after experiencing or witnessing a terrifying event which later leads to mental health problems. This disorder has always existed but has only been recognized as a psychological disorder within the past forty years. Before receiving its official diagnosis in 1980, when it was published in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll), Post-traumatic stress disorder was more commonly known as soldier's heart, irritable heart, or shell shock. Shell shock and war neuroses were coined during World War I when symptoms began to be more commonly recognized among many of the soldiers that had experienced similar traumas. By World War II, these symptoms were identified as combat stress reaction or battle fatigue. In the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I), post-traumatic stress disorder was called gross stress reaction which was explained as prolonged stress due to a traumatic event. Upon further study of this disorder in World War II veterans, psychologists realized that their symptoms were long-lasting and went beyond an anxiety disorder. Thus, through the effects of World War II, post-traumatic stress disorder was eventually recognized as an official disorder in 1980.
Imagery Rescripting is an experiential therapeutic technique that uses imagery and imagination to intervene in traumatic memories. The process is guided by a therapist who works with the client to define ways to work with particular traumatic memories, images, or nightmares.