Research: Sierra Tucson Treatment Center: World Psychiatric Association Virtual Conference March 10-13, 2021

Posted on March 26, 2021 at 11:05 PM

 World Psychiatric Association Virtual Conference

March 10-13, 2021

Mirror Neuron Psychotherapy in the Treatment of Inpatients with PTSD

Heselton L., Rider M., Seymour J., Drachman C., Guilfoyle S., Seek T., Vose S., & DeNunzio D.,

Sierra Tucson Treatment Center



Mirror therapy was first developed by V.S. Ramachandran to decrease phantom limb pain in amputees and stroke victims. Neuroplasticity in the motor cortex was discovered to be the cause of the pain. The mirror therapy decreased the pain by reversing the neuroplasticity back to normal.

 This ‘simulated re-attachment’ has since been used by our group to address neuroplastic changes previously documented in subjects with PTSD. This includes dysfunction within the Mirror Neuron Network (MNN).

 Mirror therapy for PTSD, or ‘Revisioning’, has been found to activate the MNN through using a mirror to reconnect clients with pre- trauma positive identity states.

Revisioning was implemented at Sierra Tucson Treatment Center with PTSD patients in which mood and dissociation were monitored via Likert scales. 62 patients participated in one or more Revisioning sessions.


The following case will help exemplify Revisioning psychotherapy. One of the severest forms of PTSD is Dissociative Identity Disorder (DID). DID is challenging due to the high risk for destabilization during trauma and integration work.

A 56-year-old female diagnosed with PTSD and DID had a history of cult abuse and sex trafficking. She presented with 425 alters within three subsystems. The goal of treatment was to reach a modified fusion of thoughts, feelings, physical bodies, ages, perceptions, positive memories of the past, and present-day memories into one adult self-state prior to trauma work.

Revisioning began with selecting the most nurturing, helping, healing alters out of the highest functioning of three subsystems and merging these together. After 9 sessions of only Revisioning Psychotherapy, she was able to achieve modified fusion of 142 child, adolescent and adult alters into one self-state.

In one session, the client drew the merged “Lead Helpers” represented by a tree, along with 18 alters ranging in age from 3 to 12 represented by separate pink circles. After Revisioning in the mirror, she performed guided mental imagery of moving the pink circles around the tree which then transformed into cotton candy and melted into the center of the tree. The client was tearful and put her arms around her solar plexus saying, “we are so happy to be solid and whole. It is like putting together a puzzle for the first time.”

 See change scores for this patient:


PRE 3 2 84

POST 9 8 46


94% of the 62 patients had significant

increases in ‘happiness’ and ‘calmness’ following Revisioning. These scores significantly predicted decreases in dissociation. 70% of treated patients had significantly lower dissociation scores, most after one session.

 No negative side effects such as suicidality, psychotic decompensation, increased dissociation, or emotional flooding were experienced following Revisioning. Brief grief reactions were experienced by some patients before calming and happiness increased, possibly due to mirror neuron- mediated increases in empathy regarding their lost pre-trauma identity.

Revisioning was well-tolerated by high dissociative patients due to the fact that traumatic events did not have to be re- lived. In this study, Revisioning was found to lead to rapid and stable integration, which then made trauma work more accessible. Because oxytocin is involved in MNN activation, future studies should investigate the neurohormonal effects of Revisioning.


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