Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

Abstract

Introduction: Military members and Veterans are at risk of developing combat-related, treatment-resistant posttraumatic stress disorder (TR-PTSD) and moral injury (MI). Conventional trauma-focused therapies (TFTs) have shown limited success. Novel interventions including Multi-modal Motion-assisted Memory Desensitization and Reconsolidation therapy (3MDR) may prove successful in treating TR-PTSD.Objective: To qualitatively study the experiences of Canadian military members and Veterans with TR-PTSD who received the 3MDR intervention.Methods: This study explored qualitative data from a larger mixed-method waitlist control trial testing the efficacy of 3MDR in military members and veterans. Qualitative data were recorded and collected from 3MDR sessions, session debriefings and follow-up interviews up to 6 months post-intervention; the data were then thematically analyzed.Results: Three themes emerged from the data: (1) the participants' experiences with 3MDR; (2) perceived outcomes of 3MDR; and (3) keys to successful 3MDR treatment. Participants expressed that 3MDR provided an immersive environment, active engagement and empowerment. The role of the therapist as a coach and “fireteam partner” supports the participants' control over their therapy. The multi-modal nature of 3MDR, combining treadmill-walking toward self-selected trauma imagery with components of multiple conventional TFTs, was key to helping participants engage with and attribute new meaning to the memory of the traumatic experience.Discussion: Preliminary thematic analysis of participant experiences of 3MDR indicate that 3MDR has potential as an effective intervention for combat-related TR-PTSD, with significant functional, well-being and relational improvements reported post-intervention.Conclusion: Military members and Veterans are at risk of developing TR-PTSD, with worse outcomes than in civilians. Further research is needed into 3MDR and its use with other trauma-affected populations.

Factors associated with the outcomes of a novel virtual reality therapy for military veterans with PTSD: Theory development using a mixed methods analysis

“…Trust was important for the participants in our study and the one person (in the moderate responder group) who dropped out whose data are presented here returned immediately to their more familiar therapist. Consistent with the idea that the number of sessions of 3MDR might best be tailored to the individual [ 36 ], we also suggest that our finding that the moderate improvers who completed their courses of therapy would all have continued is a potentially important one. Avoiding the feeling of being ‘stuck’, or of ending therapy with some experiences not yet reconsolidated, may demand a flexible approach to 3MDR dosing.…”

“…In addition to these ‘technical’ aspects of therapy and the clinic environment as part of the ‘intervention’ domain, our data support the idea that the relationship between therapist and patient remains important. ‘Feeling supported’ is a recurrent theme in van Gelderen et al’s analysis of treatment processes in, and effects of, 3MDR [ 41 ] as is the ‘fireteam partnership’ reported by Hamilton et al [ 36 ]. Trust was important for the participants in our study and the one person (in the moderate responder group) who dropped out whose data are presented here returned immediately to their more familiar therapist.…”

The Redesign and Validation of Multimodal Motion-Assisted Memory Desensitization and Reconsolidation Hardware and Software: Mixed Methods, Modified Delphi–Based Validation Study

“…In other 3MDR publications [ 41 ], it has been noted that the connection between the therapist and client is an important aspect of 3MDR. It is beneficial for the participant to be able to see the therapist alongside them for guidance and reassurance.…”

Quantitative changes in mental health measures with 3MDR treatment for Canadian military members and veterans

“…While the specific mechanisms associated with overcoming these components within 3MDR remain unknown, a key factor may be the immersive virtual reality environment in which participants are safely exposed to traumatic memories and uncomfortable bodily sensations during 3MDR therapy. In van Gelderen et al.’s ( 2020b ) and Hamilton et al.’s ( 2021 ) qualitative explorations of the perceived effective treatment processes of 3MDR, participants noted being unable to use personal avoidance techniques and having to face the most feared part of the traumatic memory. Such results align with emotional processing theory (Foa & Kozak, 1986 ), which holds that a reduction of symptoms requires a modification of the affective memory, enabling emotional processing such that the trauma‐related information no longer evokes fear (Foa & Kozak, 1986 ; Rauch & Foa, 2006 ).…”

“…The theory and progression of 3MDR administration have been detailed in other publications (van Gelderen et al., 2018 ). The RCTs, and subsequent exploratory qualitative works, demonstrate preliminary effectiveness of 3MDR at reducing a number of PTSD, anxiety, and depressive symptoms in military members and veterans with TR‐PTSD at up to 26 weeks postintervention (van Gelderen et al., 2020a , 2020b ; Bisson et al., 2020 ; Hamilton et al., 2021 ).…”