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1. 2003 Symposium of the Japan Society for Traumatic Stress Studies

The 2003 Symposium of the JSTSS was held in Kobe on 14th and 15th of March. This symposium was attended by a wide range of mental health care professionals including nurses, social workers, doctors, psychiatrists, clinical psychologists, psychotherapists, psychiatric social workers, art and dance therapists.

At the symposium there were many interesting presentations and open panel discussions, including the introductory keynote presentation by Dr Asukai, the current president of the Japan Society for Traumatic Stress Studies and including guest presentations from Dr Charles Marmar University of California, San Francisco ("Dynamic Psychotherapy for Acute and Chronic PTSD") and Dr Randall D. Marshall of the New York State Psychiatric Institute ("If We Had Known Then What We Know Now: Learning from 9/11").

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Doctor Marmer spoke "most in terms of psychodynamic approaches (which) have been best developed for 'uncomplicated' post traumatic stress disorder. But also obviously, for those who develop the chronic form and over time develop secondary complications, complex chronic PTSD represents a different challenge".....

He went on to say, "When we speak about the treatment of chronic complex PTSD...... short term psychodynamic psychotherapy obviously would be an inappropriate treatment in itself in this chronic form which requires a program of multiple kinds of treatment."

Doctor Marmer added, "We should be very careful since we know, at least from the American studies, one in two people will experience a traumatic event in their lifetime and we know that the majority of people who have a traumatic event will never go on go on to develop PTSD or any other mental disorder. The majority, at least 75 percent, will cope reasonably well without treatment after the event. We should be very careful not to over diagnose, over pathologise or treat those who are having a normal transient stress reaction. So formal treatment is not indicated."

"There is a world wide industry in debriefing for people who are having transient normal stress reactions and of interest is these debriefing models were based for the most part on a rather old fashioned psychoanalytic notion of abreaction and catharsis.... We should be very careful about the use of abreaction and catharsis among people spilling their emotions out when they are being debriefed after traumatic events. This may be either unhelpful or in many cases harmful."

"What is helpful is education, support, encourage helpful coping. After traumatic events people should have rest, they should take things more slowly, they should exercise, spend time with family and friends. They should be able to tell their trauma story to someone they trust when they are ready to do so and probably not before they are ready to do so."

Doctor Marshall drew from his professional and personal experiences in New York after the events of 9/11, "We felt that peoples well-being and peoples lives in our community depended on getting the answers right. One of the first problems we noticed at New York State Office of Mental Health, one of the first tasks we found thrust upon us really, was having to go around putting out mental health fires. This is where Dr Marmer's point about debriefing became extremely clear to us, because the findings that debriefing is in fact not helpful after a traumatic experience and is sometimes harmful. The New York of Office of Mental Health consistent with the American Psychological Association had put out a bulletin saying that we thought that debriefing should not be done, certainly not forced formal debriefing. Nevertheless there were literally hundreds of debriefing sessions springing up all over the greater New York area because a number of major organizations supported this and unfortunately there were 'for profit companies' who specialized in providing debriefings."

The JSTSS has now has a membership of over 600 health care professionals concerned with all trauma and PTSD related problems within Japan, including domestic violence, sexual abuse and traumatic bereavement, as well as natural disasters. Again this year it was encouraging to see that women were well represented both within the membership of the JSTSS and also among those members who gave presentations and participated in the panel discussions.

The first announcement of the 3rd Symposium has been made by the Japan Society of Traumatic Stress Studies. It is scheduled to be held on of March 2004 at in Tokyo and guest speakers will include A. Y. Shalev, MAD from the Hadassah University Hospital, Israel and M. Cloitre, Ph.D from The NYU Child Study Center in the USA.


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