PTSD with ACT, the ACT Matrix, and Pattern Recognition Therapy

PTSD treatment has gone through stages.

1. The "cathartic" model is related to psychodynamic therapy. The person needed to regurgitate the trauma memory. Unfortunately, this therapy does not work. 
2. CBT for PTSD focuses on changing thoughts that lead to evolving behaviors. However, this has had mixed results and does not address the person's relationship with trauma memory.
3. Prolonged Exposure for PTSD (Foa) focuses on trauma memory and exposure to life (in vivo). The person tells the trauma story while being recorded. The person then listens to the recording many times (prolonged exposure). The person was also instructed to go into stressful places (in vivo), take their Subjective Units of Distress (SUD), and stay until the SUD lowered. While shown to work some for PTSD, Dr. Polk and his colleagues could only convince a minority of Veterans to engage in the therapy.
4. Acceptance and Commitment Therapy (ACT) for PTSD. Values and Committed Action work were a kinder way of getting at the in vivo exposure. Trauma memories were "defused," and experiential avoidance was recognized. Essentially all would engage in ACT. This therapy has been very successful at increasing committed actions and less successful in helpfully influencing the person’s relationship with trauma memories.
5. The ACT Matrix simplified the ACT process so it could be engaged in one session. Over time we dropped the ACT language. For example, Values in the lower right became "Who's important?" Everything in the lower left was labeled "yucky stuff." Behaviors were either for Relief or Satisfaction. The point was to get folks to notice their life from the matrix point of view. The Values, Defusion, etc., of ACT occur in the background. 
6. Pattern Recognition Therapy (PRT) was coined in February of 2023 when we noticed that we had dropped all of the ACT languaging from the Matrix. Instead, we focused on getting the pattern of one's life in front of someone. We have the person estimate how much time out of a 24-hour day is spent on the left and right sides. Most people with PTSD say 80. 70, 60% left, 20, 30, and 40% to the right. This pattern of noticing continues from session to session. Most people shift to doing more right-side behaviors and, thus, less left-side behaviors. Again, the person’s relationship with the trauma memories is somewhat shifted for the better, but it’s still a problematic relationship.
7. MDMA (psychedelic therapy) for PTSD shows promising results. In three sessions, the trauma memory is "rewired" in the brain. Thus, no cumbersome exposure or defusion work is needed for a workable relationship with the trauma memories to emerge. However, all humans tend to get stuck in unworkable behavior patterns, resulting in too much time spent on the left. So it would probably be a good idea to show folks the Matrix Pattern after MDMA therapy.