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How to resolve chronic effect of work related traumas and stress with a coherent, simple and self-applied deconditioning technique

By Daniel Kuhn, MD

This article presents a simple, coherent approach and technique that can release traumatic fixations and associated negative states of mind. It can help an individual return to his/her pre-traumatic level of function and pre-traumatic personality.

Mental traumas and Post Traumatic Stress Disorder (PTSD) are universal phenomena, which are not unique to high performers such as surgeons, athletes, performing artisis etc. and could have a detrimental effect on the well-being and peak performance of exposed surgeons.

I will describe the conditions, identify the elements that contribute to its creation and fixation and present a technique that I developed, which consistently releases traumatic fixation and by that help resolving acute or chronic cases of PTSD – I named it “The Kuhn Technique – A Trauma Deconditioning Paradigm.

Surgeons work under a considerable level of pressure and often face unpredictable situations. Surgeons have to be alert and analytical at all times during surgical procedures. However, when facing unpredictable emergencies like sudden uncontrolled bleeding, patient’s unexpected death, operating errors, malpractice suits, etc., such experiences may have a traumatic impact on them, leaving them with a negative experience that can become morbid and entrenched.

It is not always possible to shield oneself from such an exposure and it is even harder to erase its impact on one’s life and health. After having developed chronic anxiety and significant stress in association with their work following exposure to a single or recurrent mental trauma, some surgeons may opt for early retirement or limit their activity.

A traumatic fixation occurs following an unexpected, overwhelming and life threatening event which impinges on one’s performance and composure, i.e. accidents, injury, or high randomness and loss of mental control. At that moment the analytical mind is momentarily frozen as the neo-cortex is taken over by the Limbic system (the reptile brain). It can go instead to a hyper-focus and a fight mode. The individual is in a state of alarm and dissociation (discontinuity.) The charged image of the trauma is then fixated in memory and becomes the seed of a post traumatic condition.

Even if a solution was found a moment later, the traumatic experience is still recorded and has a life of its own. From then on those emotions and conclusions will surface in situations, frequently reminding one of the traumatic events and throwing the person off his/her high level of functioning.

For an analogy – let’s look at a case of a splinter in an athlete’s foot; it causes pain, apprehension, dysfunction, fear of stepping on his foot and avoidance of training and competing. Consequently a cascade of physical and psychological symptoms develop.

The athlete misses tournaments, his career falters and he has a sense of failure. He becomes depressed, and regresses financially and socially. Similarly, let’s consider a concert pianist who has developed a fear of performing after having had a memory lapse during a previous concert. From then on he has a fear that he may stumble again where he had his previous memory lapse.

The trauma has a hypnotic effect. The individual is engulfed and trapped in it like a fish in a fish ball. Alcohol and medications provide no resolution but a momentary symptomatic relief, and most forms of psychotherapy are not effective enough.

The following conditions make you more prone to PTSD: – incomplete understanding or mastery of a skill or technique, missing vital information about a patient, being hungry, tired or jetlagged while operating and being preoccupied with other problems in life such as litigations, divorce or fear of loss of loved ones.

I was a psychiatric resident in New York when the Yom Kippur war erupted in Israel. I returned to Israel, my native land, to join the army Medical Force and was posted in a field hospital in the Sinai Desert. There I treated soldiers who had suffered mental trauma in the battlefield. I had the opportunity to observe the dynamics of trauma and found a new understanding about how to handle it.

For example, I saw a soldier who was evacuated from the Suez Canal front, which was invaded by Egyptian tanks. He was lying with closed eyes on a stretcher in an embryonic position. I asked him quietly “Where are you?” and he mumbled – “near the bridge!” I asked “what do you see?” and he said “Shells!”

I repeated my question and he responded “I see shells!!!” with a higher emotional intensity. Observing that I asked him to repeat “I see shells” many times; he became agitated and then suddenly calmed down, opened his eyes and asked me: “where am I?”

I learned that he was stuck in a traumatic experience, in a mental image that was more real than where he was at the present. I also learned that I could discharge the image and bring him back to the present time. That was the first step and basic principle in developing my technique for treating mental trauma and PTSD.

The basic principle is this: – to locate the moment of trauma and induce a discharge by repeating commands. The technique helps to locate the moment the mental trauma was recorded and evokes it and then discharging by repetitive commands. The discharge resembles erasing a computer file by specific Erase command.

There is a wide spectrum of severity for Post Traumatic Stress Disorder, and elements of it exist in normally functioning individuals who may have traits like being inappropriately angry, irritable, overreacting, emotionally numb or anxious. Those traits can be easily and readily discharged with the Kuhn Technique.

Most people respond to the process in one to two sessions.

The process is not intrusive and the individual maintains control of what he/she wants to share with others during that process. It does not destabilize and I have not seen it precipitate negative reactions. The repetitive command may be as few as 10 times or as many as one or two hundreds repetitions. Eventually it leads to a release; the words are not associated anymore with any experience and have no meaning; the individual’s attention becomes free, extroverted and his breathing becomes deep and free. From that point on the individual becomes unable to recreate the image any more.

For further questions or assistance Dr. Kuhn can be reached at the following address

Daniel Kuhn, M.D.,
Board Certified Psychiatrist
200 West 57th Street, Suite 1205.
New York, N.Y. 10019
Phone: (212) 315-1755 Fax: (212) 333-4209
Cell: (646) 645-1755

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