I don’t think there is clinical level evidence for it, but there’s this thing called Trauma Releasing Exercise which apparently some people swear by. The idea is that you do extremely taxing, high neuromuscular-recruitment static holds etc - til the point of total muscle control loss that turns into widespread trembling. I would speculate that if a big part of feeling bad is getting stuck in a state where tension becomes a problematic passive default state that is hard to get out of, that a short, hard ‘nudge’ in the form of overwhelming exertion might be enough to ‘reset’. All speculation until proven though.

What’s interesting about the origins of the technique is that the guy thought of the possibility that adults learn to suppress visible trauma reactions - uncontrolled shaking, etc - whereas children and animals wouldn’t, and for whatever reason they would also be able to return to normal more quickly. He wondered if maybe that there was a tangible benefit to the shaking itself, in that it could help perturb out of the traumatized state itself.

> I don’t think there is clinical level evidence for it

Even if it's 100% placebo, if it's not harmful, and it works for a person, then it works. But, determining if it's not harmful should be a priority. I found this person saying it made their life worse, for example: https://www.reddit.com/r/CPTSD_NSCommunity/comments/ungaew/t...

I think you are correct. The strangest things I have learned about personality disorder is that diagnosis applies for as long as the disordered behavior exists.

If the disordered person's behavior adapts to "social norms" the diagnosis no longer applies.

You're somewhat implying this but I'm not sure if you know it exactly but others might find it informative...

The reason for that is that the "disorder" part of it is a requirement that it get in the way of normal living. You can have anxiety but if you take a deep breath and you can overcome it, it's not a disorder. If that doesn't help or even if you just haven't tried it, it's a disorder.

Thank you. Does that make it also situational or even relationship specific?

I guess the depth of the relationship might also ramp the disorder.

The holds are not "extremely" taxing, I would say. The tremors can be induced through a simple 7 step sequence of holds like wall sits or calf raises. There are walkthroughs on YouTube.

On the TRE subreddit [0], people report being able to tremor at will once they have enough experience with the technique.

Not trying to be pedantic, just clarifying that it is very accessible! I've personally been experimenting with it and find it to be helpful.

[0] https://www.reddit.com/r/longtermTRE/

Wow, this makes a lot of sense. Nothing like a super intense workout to relieve stress. I need a short one every night after a long day. Feels like it erases all the crap I went through during the day.

I think we're way early to have clinical evidence for a lot of vagal nerve theory that is approachable by anyone outside research fields, but I've had my eyes opened to how much is connected to vagal nerve stimulation (VNS).

For example, basically deep belly breathing reduces stress supposedly through VNS: https://pmc.ncbi.nlm.nih.gov/articles/PMC6189422/. Yoga, yes, but also even popular and known in some military and police cultures where I've seen it labeled "tactical breathing" as a proven way to lower stress responses like heart rates on command. There seems to be growing evidence around some of these responses being real and reproducible.

FWIW, I've personally observed this working in my family with a licensed therapist as a family member was able to develop and rely on belly breathing to interrupt the onset of panic attacks. There's a lot of talk - if not reproducible science yet - about the possibilities of positively outcomes through so much connected to the vagal nerve.

At something more of a stretch, the same pro-VNS therapist posited to me that even swallowing is a way to engage in VNS, and thus might have a connection to eating disorders. Sure enough, maybe there is emerging evidence: https://pmc.ncbi.nlm.nih.gov/articles/PMC8027699/

Emerging therapies seem to always get a sideways glance from the medical industry which loves its double-blind derived protocols, so I've started to be more receptive to being part of the vanguard in experimentation when I or someone I love is acutely suffering and it doesn't have a known protocol to alleviate it. An example of that reluctance in PTSD, of course, is the controversial psychedelic therapies: https://pubmed.ncbi.nlm.nih.gov/38284341/. Sometimes these treatments just need time, and if they're reproducible, they grow in popularity.

> He wondered if maybe that there was a tangible benefit to the shaking itself, in that it could help perturb out of the traumatized state itself.

As someone with a trauma background who never learned to suppress this shaking, I am very skeptical of that idea. I'm middle aged by now and still have severe social anxiety problems in certain moments. My body will still shake when this process gets triggered off.

In the last few years I've definitely learned I get some sort of "release" from practicing/holding handstands and other hand/arm-balancing moves and, later, (less so, but with less weird looks from people) from yoga balances (tree, warrior 3, eagle, [revolved] half moon, dancer).

That’s interesting. I have the problem of being tense in the passive state, and I find doing heavy exercise to exhaustion has helped me the most.

I've done it a few time, not sure if it worked for me, but if it really works, I would love to feel those effects. Maybe I need to do it more?

Not surprised, but the headline is pretty terrible. This is a very small, early stage experiment with promising results. The declarative statement-of-fact in the headline is just irresponsible clickbait. That said, the results are promising.

I’m curious about those neck brace style “vagus nerve stimulators” you see on the internet. Anyone have experience with them? Are they legit or snake oil?

Not surprising, it's been conjectured for a long time that suppressing the physiological response would improve the effectiveness of PTSD therapy

https://www.ncbi.nlm.nih.gov/books/NBK562942/

Link to the actual abstract on PubMed: https://pubmed.ncbi.nlm.nih.gov/40097094/

n=9 here folks. I think the certainty in the headline is borderline irresponsible.

Any hope to treat tinnitus? :-\

I realize some people had severe damage to their ears, but for the rest I would recommend having a look at Nada Yoga.

There with you:( ... and actually, scheduled to get that "Lenire" device in a couple of weeks. Hope works

It seems like a more effective bimodal stimulation device is winding its way through the FDA: https://www.reddit.com/r/tinnitus/comments/1d0it8b/comment/l...

The results are very promising, but it's sure taking its time getting approved.

Wow, a big thanks on this! Will enroll on the device's email list, appreciated!!

The Susan Shore device is open source via studies and publications and it's possible to build your own if you're desperate enough. DM me if you want exact hardware specs. I've gone down this road because I have severe tinnitus.

My friend’s startup is doing great stuff in this space to make a VNS device for consumers. https://zenbud.health/

They promote their peer-reviewed clinical trial in the header area. However, the spelling mistake 'Tial' should be fixed asap :)

Maybe you can tell him that and also tell him that I am quite interested in the device to check if it can reduce my heart palpitations!

I'm skeptical of these devices that say they are safe based on CE or FCC testing. (zenbud says it has been CE tested). That's consumer product testing, not health-device testing; I would like to see some evidence that long-term use of a nerve stimulation device causes no long term damage. I don't believe that CE or FCC tests show that. It's disingenuous to have a press release saying "Yay! We passed CE testing!" as if that was like FDA approval.

FWIW the EU also has EUDAMED registry for producers, distributors and importers of medical devices and there are additional regulations beyond CE under the MDR directive.

I don't see "ZenBud" or "NeurGear" in the EUDAMED database.

An ultrasonic device delivering energy to human tissue would be a class 2a or 2b active medical device under MDR.

Neat, sensate is another device in this area.

Bio and neurofeedback devices are going to be an interesting space the next 10 years.

Do these work the same as the professional/medical ones? A friend of mine had one during a study, and she claimed it worked by electrostimulation (small electric shocks), not ultrasonic waves?

She wanted to buy one of those devices because they really helped her but the cost was upwards of 1500€, this would probably be within range for her, assuming it works the same way?

text says "implanted device", which is going to put in by a neuro surgeon

I wasn't talking about the article, I was replying to a comment about the zenbuds

EMDR by someone well-trained and experienced in doing that specifically for PTSD is something I’m more familiar with as a treatment. I think the trick with these treatments is that you need a good therapist with past experience helping people get through it. PTSD is not something you want to mess with if you don’t know what you’re doing as triggering could be dangerous.

Why not use EMDR instead?

https://en.wikipedia.org/wiki/Eye_movement_desensitization_a...

Purely anecdotal, but EMDR was not helpful for me. I’d heard many good things about it and had high hopes, but found it somewhat counterproductive. I think this somewhat depends on the nature of the trauma leading to the PTSD (e.g. a one time major event vs. complex trauma over an extended period).

I was dealing with the latter.

EMDR has been shown in many studies that it can be highly effective also for complex PTSD, see eg. a recent meta-meta-study ( https://doi.org/10.1016/j.janxdis.2025.103017 ). It very much and more depends on the relationship with the therapist, and how they integrate EMDR in a "complete" therapy. EMDR is a technique that can be used in many ways, not a full-fledged form of therapy.

> improving outcomes for therapy-resistant PTSD patients.

You can use EMDR both for anchoring positive experiences, as well as to dip into unprocessed traumatic memories. In a typical therapy setting, you do both. Stabilization techniques are in addition to that; vagus nerve stimulation serves to calm down your nervous system, so it would aid the stabilization, so then in turn you can face more of the unprocessed trauma. It's not an either-or. PTSD therapy requires a combination of various elements, tailored to the specific circumstances, history and personality.

The idea to "try it at home" from some YouTube videos is absurd, unfortunately. It may do you good, OK, but it has nothing to do with real EMDR used in a therapeutic setting.

From wikipedia:

EMDR has been characterized as pseudoscience, because the underlying theory and primary therapeutic mechanism are unfalsifiable and non-scientific. EMDR's founder and other practitioners have used untestable hypotheses to explain studies which show no effect.[55] The results of the therapy are non-specific, especially if directed eye movements are irrelevant to the results. When these movements are removed, what remains is a broadly therapeutic interaction and deceptive marketing.[52][56] According to neurologist Steven Novella:

    [T]he false specificity of these treatments is a massive clinical distraction. Time and effort are wasted clinically in studying, perfecting, and using these methods, rather than focusing on the components of the interaction that actually work.[57]

> because the underlying theory and primary therapeutic mechanism are unfalsifiable and non-scientific

Underlying theory doesn't matter much. Remember that we don't even know the mechanism of action of acetaminophen.

Possibly has placebo effect. I know someone who did EMDR and said it helped them a lot.

It may work, but there's essentially no evidence in the medical literature that it does.

It is one of the few forms of PTSD therapy where there is plentyful research about its effectiveness? In Germany, it is basically the only trauma processing technique covered by health insurance, because of its proven track record.

see e.g. Psychological interventions for adult posttraumatic stress disorder: A systematic review of published meta-analyses (2025) https://doi.org/10.1016/j.janxdis.2025.103017

State of the science: Eye movement desensitization and reprocessing (EMDR) therapy (2024) https://doi.org/10.1002/jts.23012

None of these treatments has a 100% success rate. You can try EMDR on Youtube and if it worked all the time, psychiatrists would be out of a job.

Yeah I said it was dhit when my ex-wife said she was going to do it, but it definitely did something.

And I am well aware of the placebo effect.

But just because something is not provable or falsifiable under current scientific knowledge, it does not mean it is neccesarily quackery, there's a Venn diagram there where some things may be effective.

Automatically discarding something that even occasionally gets results, because it doesn't fit current "knowledge" is the height of arrogance.

> But just because something is not provable or falsifiable under current scientific knowledge

Do you mean unproven instead of "not provable or falsifiable"?

Something not being falsifiable would mean that we can't detect if it's doing anything even if we tried, which doesn't bode well for its effectiveness.

Sadly it made my ex-wife worse off than before - she went from a functioning anxious person to being completely overwhelmed by anxiety all the time.

Unfortunate, the whole landscape on this is littered with mines and finding truly knowledgeable help is difficult, most seem to just push their favourite flavour, regardless of the patient.

Not all licensed therapists or psychiatrists provide EMDR. Or did you mean psychiatrists specifically as they prescribe ssri’s?

Instead of either/or why not try both?

Verbatim the theme of a few episodes of the medical drama "The Resident".

Just 9 patients. :-(

Isn’t that fairly common for the first round of human testing for novel treatments like this? I could certainly understand wanting some small scale reassurance that a wider study won’t be throwing good money after bad.

And, as in study notes, to prioritize understanding safety with this population before worrying about efficacy.

It is quite normal to start with small groups for economic reasons. If the first results look promising, you can scale up. If they are a wash, you haven't spent too much money on chasing yet another placebo.

The problem is that invasive novel treatments like this always have a large placebo effect, so not doing a placebo controlled trial is essentially a waste of time and money.

Not just economic (although it definitely ties into it) -- finding an eligible patient population also another complicating dimension.

Also an opportunity to further design or evolve the study.

Anyone done VNS at home?

Yea, I have. I ordered one from vagus.net in February 2023. Over 6 months, it forcibly kicked me off a 20 year SSRI prescription. I've been using it now for about 2 years, weekly if not daily, and although I still regularly feel depressed about the world, I also feel my other feelings (which were blunted on those SSRIs). I no longer live in a state of fight/flight, though I'm quick to walk away when approached by strangers. Overall the tVNS has been lifesaving for me and my autistic-AFAB-CPTSD friends. (Autism by itself involves vagus dysfunction.)

Here's more info: https://www.dropbox.com/scl/fo/mr3yksv30dbynz4lk52jv/h?rlkey...

I don't know how I feel about this. The nature of PTSD is that you have a true memory, that the event happened. Imagine if I tell you, 9/11 was real and it happened, but from now you will never feel any feeling about it. What exactly did we accomplish here? The bombings in Gaza are real, but from now on, you will feel nothing about it. You see? It reads like a dystopia.

There's an obsession with erasing the past and not digesting it. The subconscious wants reconciliation, and it will emerge over and over, that's what PTSD is. Lobotomizing someone is certainly one way of reconciling it. The only way out is through imho, that you are forever changed and saw the face of mankind, and your subconscious will not accept any cheap reconciliation for the most part.

"Just zap it", I sense the subconscious will not let you get away with that. You are custodian of the trauma.

Stabilization is a crucial pillar in order to face the traumatic memories and process them. You cannot face the memories without it; any attempt to do it without stabilization training would be ill-advised; actually, PTSD as diagnosis is "proof" that it's too overwhelming for the patient. The goal is not to "zap" memories but to relax the nervous system and to anchor patients sufficiently in a "safe present" so one can then use techniques such as EMDR/hyponosis etc to unpack the trauma, step by step, without getting flooded and potentially retraumatized.

Even the sensationalist headline talks "merely" about "erasing" PTSD: the stress disorder -- NOT the memories.

Until full processing and integration (which can take years, decades!), traumatic memories are LIVE and unprocessed memories; they are re-experienced as if it was happening NOW; again and again (see e.g.: fMRI studies show that they activate brain regions responsible to process the present, in stark contrast to normal memory recall). This is not comparable to "being reminded about a past event and having strong feelings about it". That is the goal. Not erasure as if nothing ever happened.

you're conflating "not having an overwhelming negative reaction to it" with "never feel anything about it"

you can know something is bad and act accordingly without having a disordered and painful relationship with it

Try telling all this to someone who is effectively emotionally/physically disabled because their mind and body either enter a rollercoaster or just shutdown in response to anything vaguely reminiscent of something they experienced.

I think these treatments are better understood as methods to encourage one's mind and body to reprocess some experience so that it is "merely" a terrible thing that happened so they can live a stabler, more balanced, more normal life.

The tribe that you speak of is much much bigger than those who have an official diagnosis of PTSD via psychology. For example, addicts all have PTSD that is commonly related to past childhood/family abuse dynamics. They take drugs over it. So, as a matter of fact, that is exactly what is told to them. You can in fact hold your pain, and I believe it is righteous to do so.

It kind of reminds me of Eternal Sunshine of Spotless Mind. You cannot just erase something. Drugs effectively erase the bad feelings, but they don't last. Okay, so such a treatment being discussed is, I suppose, an everlasting solution. Why would I be against this? Because you cease being you in your entirety (which includes your trauma).

It's not an easy sell by any measure, especially for those who just go "well fuck that, I can erase this with some cocaine right now". Erasing it is a solution, for sure, but it's not a free solution. Something is lost in the process (you). Understanding that, stay with me here, that it's beautiful is part of it, that you have a beautiful part of you forever. It's completely didactic, you have to teach the person that they went through something and are PRETTIER in their surviving of it. Then it stops being traumatic.

If we zap them, we take away the pretty. If I zap you, and then say lets talk about it, and you say "well I don't feel any which way about it anymore", then it's lost. It's gone. So something is lost in the process. So yeah, this is exactly what is told to the most beaten down people in life.

I wouldn't zap the mustard seed.

> from now you will never feel any feeling about it

You're tilting at windmills, mon frere, by exaggerating egregiously.

> You are custodian of the trauma.

True, and beautiful, but debilitating trauma that destroys its vessel is not delivered to the future that would learn from it.

You can't deal with how bad something feels if you have uncontrollable crippling sensations about it. Trauma does not let you mature, learn from experience or grow up. You can't walk it off. If you try to "man up", it comes back even stronger in terms of attention deficit, bouts of anger and OCB. It is very hard to convince people that the sensations trauma causes are real. Especially to people with a hero complex.