Title page
Title
Auriculotherapy and post-traumatic stress disorder, an observational trial with chromotherapy
Authors
Maugendre Stéphane , GodthjaelpRikke², Andersen AlmindeDina²³, Andersen Drejer ElbaekJasper²⁴, Kristensen MejlvangJeannette⁵
1 Department of Neurosurgery, Pain Center, Adolphe de Rothschild Ophthalmological Foundation, 25 Street Manin Paris, France
2 Institute Godthjaelp, Sortedam Dossering 59, 2100 Copenhagen, Denmark
3 Clinic Asylgade 1b, 7700 Thisted, Denmark
4 Ejbyvej 56, 4070 Kirke Hyllinge, Denmark
5 Mogensgade 65, 8800 Viborg, Denmark
Corresponding author
Maugendre Stéphane, MD
Email: smaugendre@for.paris, dsm@godthjaelp.dk
Running title
Auriculotherapy and post-traumatic stress disorder, an observational trial with chromotherapy<\p>
Keywords
- auriculotherapy
- post-traumatic stress disorder (PTSD)
- vascular autonomic signal (VAS)
- chromotherapy
- psychological trauma
Abstract
Objective
The reclassification of a traumatic image from a post-traumatic chronic stress syndrome is a prerequisite for the healing process. Auricular chromotherapy has already been used following the work of Dr. ASIS (1,2). We performed a study using a specific blue color (Kodak F98), used by Dr. Paul Nogier (3), and localizing the points of interest by following the vascular autonomic vascular signal (3,4).
Materials and Methods
Thirty-one patients were treated with auriculotherapy using Kodak F98 (blue light) stimulation according to Dr. Paul Nogier with the use of vascular autonomic signal (VAS) (5).
Results
Subjective Units of Distress Scale (SUDS) and Validity of Cognition (VOC) scores improve after a session of auriculotherapy. In most cases, 80%, the traumatic image is mentally inaccessible and emotionally neutral.
Conclusions
Using auricular chromotherapy, including the VAS (Vascular Autonomic Signal) with Kodak F98 color used on the ear, decreased symptoms from traumatic images after only one session.
Main text
Introduction
Lifetime prevalence of post-traumatic stress disorder (PTSD) is estimated according to Kessler USA (6) at 7.8% (men 5% women 10.4%). The prevalence of traumatic event exposure is 60.7% male (combat, violent assault) and 51.2% female (plus sexual assault). The prevalence of post-traumatic stress syndrome according to the type of event is relevant for the detection of this syndrome. For rape and assault, it is 60%. For public road accidents, it is between 20% and 40% according to studies.
The traumatic event is constantly experienced as follows: unwanted upsetting memories, nightmares, flashbacks, emotional distress after exposure to traumatic reminders, and physical reactivity after exposure to traumatic recalls.
Prolonged exposure (PE) is an effective first-line treatment for post-traumatic stress disorder (PTSD) (7,8,9).
Reclassifying a traumatic image is essential to the recovery process.
Auricular chromotherapy has demonstrated its utility in this indication (1,2).
In countries such as Sweden, Denmark, and Finland, a considerable amount of violence against women has been reported. Researchers describe this phenomenon as a “Nordic paradox.” In October 2021, the European Institute for Gender Equality (EIGE) released the sixth edition of its EU Country Ranking for Gender Equality, in which Denmark is second only to Sweden. However, in 2017, the same institute reported that Denmark was the third European country with the highest level of violence against women.
In 2014, a survey carried out by the EU Agency for Fundamental Rights revealed that Danish women reported the most physical, sexual, and psychological violence in the EU, and suffered the most sexual harassment. According to the survey, 52% of Danish women reported experiencing physical and/or sexual violence since the age of 15.
In November 2019, Atreyee Sen, Associate Professor at the University of Copenhagen, along with two other academics, Marie Leine and Henrik Hvenegaard Mikkelsen, published a research study (10) on sexual violence in Denmark and the hosting of the EU Agency for Fundamental Rights report.
In France, the High Council for Gender Equality estimates that 16% of women and 5% of men reported having been raped or escaped rape in their lives.
Between 2010 and 2012 in France, 83,000 women (0.5% of women) suffered rape or attempted rape every year. 83 percent of rape survivors know their attacker.
Materials and methods
This study is a multicenter observational study involving five experienced therapists who are accustomed to taking the pulse in search of the VAS signal (four therapists in Denmark and one in France).
The main objective was to reclassify a traumatic image from a post-traumatic chronic stress syndrome by measuring SUD (Subjective Units of Distress Scale) (11) and VOC (Validity Of Cognition) (12,13) scores.
The choice of color Kodak F98 was decided following the publication of the previous international symposium of auriculotherapy in Lyon in 2021 (14) and according to the authors and the GodthjaelpInstitute124.
The recruitment of patients for the study in Denmark took place at centers against violence (Bella Vista Crisis Center and Randers Crisis Center).
All patients have signed consent. Only one session of auriculotherapy was proposed: an auricular chromotherapy session.
The color F (Kodak violet blue 98) resonates on the one hand with the dicephalic subcortical structures, the limbic system, and emotions and on the other with the relational aspects related to the subconscious social interactions (15). It seemed appropriate to test this color on points expressing psychological suffering evoking a traumatic image of post-traumatic stress.
We use the following protocol:
The patient was lying down with their eyes closed for two to three minutes.
The person examined had to search their traumatic memory for an event associated with a recurrent traumatic image with visual revival.
The choice of the traumatic image had to have a score superior to seven on the subjective distress scale (SUDS).
A Subjective Units of Distress Scale (11) (SUDS – also called a Subjective Units of Disturbance Scale) is a scale ranging from 0 to 10 measuring the subjective intensity of disturbance or distress currently experienced by an individual. Respondents provide a self-report of where they are on the scale. It can be used as a benchmark for a professional or observer to evaluate the progress of treatment.
We asked what unpleasant emotions were associated with this traumatic image.
Taking the pulse allowed us to search on the left or right ear, one or several points that were treated with auricular chromotherapy with the color Kodak F 98 of Dr. Paul Nogier until exhaustion of the VAS. We all used the medical device, Premio 40, from Sedatelec.
Regarding the number of points, the only rule was to treat no more than five points per session, including both ears. The only treatment was with colored Kodak F98 light.
At the end of the session, we asked again what the SUD score was in relation to this traumatic event.
All patients were contacted at least one month after the session. A new SUDS score was established, including a Validity Of Cognition (VOC). This score ranges from one to seven, highlighting the reclassification of the traumatic image.
A VOC, or Validity of Cognition (12), is used to determine the level of validity a patient believes in after a new positive belief is installed during a session of auricular chromotherapy.
They were asked to answer the following question: “In terms of your traumatic image, do you consider it inaccessible in your memory and emotionally neutral? This statement is totally false (score 1/7) or completely true (score 7/7). How do you rate this scale between 1 and 7?”
Results
Some participants in Denmark (no answer n=6) were unable to respond due to their emotional vulnerability.
From the collected data, we were able to analyze 31 people with post-traumatic stress disorder. Of the 31 patients, 25 are right-handed (80.6%) and 6 are left-handed (19.35%).
Trauma was less than 2 years for 32.25% of patients (n = 10) and more than 2 years for the remaining 67.74% (n = 21).
The main unpleasant emotions experienced by the patients during the study were fear (55%), sadness (20%), anger (20%), and others (5%) of cases.
Two people spontaneously healed their traumatic image during mental evocation (within the first two minutes where their eyes were closed). They did not receive any color treatment and the effect was still present after one month.
The average SUD score before treatment was 8.74/10 (Table 1)
The average SUD score after treatment immediately was 1.58/10 (Table 2)
The average SUD score after one month of treatment is 1.22/10 (Table 3)
The average decrease in the SUD score is 7.34.
The average VOC (Validity Of Cognition) score is 6.19/7 (Table 4).
The difference between the SUD score before and after treatment (1month) is statistically significant. The SUD before versus after session test p= 8.33E-28 (p<0.001) according to the student t-test for paired series.
Table 1
| SUD score before treatment |
| Average 8.74/10 |
| Median 9/10 |
| My 5/10 |
| Max 10/10 |
Table 2
| SUD score immediately after treatment |
| Average 1.58/10 |
| Median 1/10 |
| My 0/10 |
| Max 6/10 |
Table 3
| SUD score 1 month after treatment |
| Average 1.22/10 |
| Median 1/10 |
| My 0/10 |
| Max 6/10 |
Table 4
| VOC (Validity of Cognition) |
| Average 6.19/7 |
A total of 116 auriculotherapy points in 29 patients were treated with auricular chromotherapy. Two patients have most likely reclassified their traumatic image by themselves.
An average of 4 treatment points per patient were treated.
The main points established and discussed in this study were:
At least one point has been treated in the prefrontal or frontal cortex (n=33). This result is consistent with the involvement of the prefrontal cortex in the genesis of PTSD (16).
Most of the points treated were in F territory (n=50) with the areas of the hypothalamus, thalamus (n=5), sound line mainly and limbic structures.
The points found in D territory according to the areas of Dr. Paul Nogier are 17, of which a majority are for point O' (n=12).
The two figures below illustrate the location of the 116 points treated on a left ear, without considering therapeutic reality. All the points treated on the right ears were modeled on the symmetrical points on the 3D left ear to facilitate data analysis. This approach is supported by Frangos’ research, which showed bilateral activation of brainstem structures during unilateral electrical stimulation of the auriculotherapy point in functional MRI (17).
Discussion
This study suggests the validity of auricular chromotherapy in the reclassification of a traumatic image.
We know that emotions can trigger VAS reactions (18,19). In this mental exposure protocol, auriculotherapy points are temporarily activated and provide therapeutic access.
The auriculotherapy point is histologically defined by a neurovascular complex (20), sensitive to light on both the diagnostic and therapeutic sides. The rapidity of action of the therapeutic effect suggests a neurological pathway supported by the neurologic vegetative system.
It confirms the first results of the 2021 (14) study on 29 patients also treated with blue light. The results after one month are excellent and comparable with the first study. Validity Of Cognition (VOC) is 6.19/7 for this study (2023) versus 6.05/7 for 2021. Its favorable results in more than 90% of cases are comparable with the two publications of Dr. ASIS. The most frequently treated auricle structures were the prefrontal cortex, frontal cortex hypothalamus, O’, limbic structures, R zone (Bourdiol point), and the thalamus.
Patients reported significant psychological and physical well-being after this single session. The symptoms of PTSD decreased significantly after the correction of this flashback. The neurovegetative system appears to equilibrate after treatment with auricular chromotherapy. Further studies are needed to confirm this approach with Kodak F98 light on the auricle.
CONCLUSION
Auricular chromotherapy is an additional technique in the therapeutic arsenal as well as Eye Movement Desensitization and Reprocessing (EMDR), hypnosis, and cognitive behavioral therapies for the correction of symptoms of chronic post-traumatic stress. Its rapidity of action and its unoccupied nature are significant assets. This study offers hope for those affected and resisting other traumatic image with prolonged exposure (PE) methods.
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