How Therapy Can Help PTSD

Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder, commonly referred to by the acronym PTSD, is a complex disorder that has a profound effect on those who live with the condition. It can also have a ripple effect on the families and loved ones of those living with PTSD. While PTSD can be challenging to treat and to live with, therapy can help. This article outlines some of the important facts about PTSD, its causes, and the most effective treatments for the disorder.

What is PTSD?

Post Traumatic Stress Disorder is a condition in which an individual has a particularly difficult time recovering from a traumatic event or series of traumatic events. People with PTSD often experience intense flashbacks about the terrifying events they experienced or witnessed. They may also experience some or all of the following symptoms:

• Interpersonal disconnectedness
• Feelings of helplessness and hopelessness
• Difficulty sleeping
• Nightmares
• Anhedonia (loss of interest in pleasurable activities)
• Intense anxiety
• Depressive symptoms
• Intrusive thoughts
• Irritability
• Intense emotional reactions (e.g. angry outbursts, uncontrollable crying)
• Difficulty concentrating
• Avoiding things that remind the individual of the traumatic events
• Memory issues
• Unexplained physical ailments (e.g. headaches, stomach aches, back pain)
• Hypervigilance
• Sensitive startle response

As the symptoms above indicate, PTSD is a disorder that pervades nearly every aspect of a person’s life. These symptoms can interfere with a person’s relationships, work, and other responsibilities in profound ways.

PTSD can develop when someone experiences a traumatic event in which they feel a sense of terror, a serious injury, loss of a loved one, fear that their life is in danger, or fear that someone else’s life is in danger. While one of the most commonly known causes of PTSD is military combat, it can be caused by any of the following and more:

• Being a victim of violence, stalking, or harassment
• Serious accidents or injuries
• Physical, sexual, and domestic abuse
• Serious health problems
• Childbirth
• War or political conflict
• Death of loved ones
• Natural disasters
• Being a victim of racism, sexism, homophobia, transphobia, or any mistreatment targeting aspects of a person’s identity

It is not known for certain why PTSD can develop, but there are some theories as to why it occurs. Some scientists believe that symptoms of PTSD constitute a survival instinct, which is meant to prevent further traumatic events. For example, the symptom of hypervigilance may make a person feel that they are prepared to defend themselves in case of an attack. However, in reality, these symptoms diminish a person’s ability to function normally.

It is also thought that PTSD may be caused by high adrenaline levels. It is known that people who have PTSD produce higher levels of adrenaline, which causes the “fight or flight” instinct. In individuals with PTSD, this instinct might be overactive.

Finally, it is also known that in people with PTSD, there is a shrinking of the hippocampus, an area of the brain which is responsible for processing memories and emotions. It is thought that perhaps people with PTSD have difficulty processing the traumatic events they experience due to the shrinking of the hippocampus.

Who is affected by PTSD?

In theory, it is possible for anyone to develop PTSD. However, some people are more vulnerable to the condition than others. The following risk factors increase the chances that someone will develop PTSD:

• Gender: Women are more likely to develop PTSD than men
• People who have had exposure to traumatic events in childhood are more likely to develop PTSD in response to later traumatic events
• Those who lack social or familial support following a traumatic event are more likely to develop PTSD
• Managing additional stressors following a traumatic event can increase the risk of developing PTSD (e.g. losing one’s home after the death of a spouse)
• Having a personal or family history of substance abuse
• Having a personal or family psychiatric history
• People with lower intelligence levels or cognitive ability may be more vulnerable to developing PTSD
• Having a minority status or lower socioeconomic status can make a person more likely to develop PTSD
• Genetics: Recent research has identified some genetic risk factors for PTSD

The risk factors above apply to everyone, but there are also certain professions that are likely to put a person at risk for developing PTSD. Broadly, any profession that puts someone in a position where they witness traumatic events, injury, illness, violence, or death is a risk factor. People who work in law enforcement, the military, healthcare settings, journalism (particularly in war and natural disaster areas), or are first responders like firefighters or EMTs are at an especially high risk of developing PTSD.

Therapy for PTSD

Although PTSD is a complex condition that can have a profound effect on a person’s life and functioning, there are several types of therapy that have been found to be effective in treating the disorder.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy, commonly referred to as CBT, has been found to be among the most effective treatments for PTSD. CBT is a very structured and short term type of therapy in which a person learns skills to manage their symptoms during their therapy sessions, and then practices those skills outside of therapy. Treatment usually lasts between 12-16 weeks.

Two interventions that are commonly used in CBT for PTSD are exposure therapy and cognitive restructuring. While it may seem counterintuitive, exposure therapy helps a person process trauma by exposing them to the source of their trauma in a safe environment. This does not mean that the patient will be asked to re-experience a trauma directly. Rather, their therapist will ask them to write about their trauma, utilize mental imagery, or visit places that bring up memories of the trauma. Some therapists even use virtual reality to expose patients to traumatic events or places in a safe environment. However, this technology is not always available.

In cognitive restructuring, the therapist will help the patient look at their trauma from a fact-based perspective. Because PTSD can cause issues with memory, some people living with the disorder remember traumatic events differently than they occurred, or believe they are at fault for events that they did not cause. Cognitive restructuring helps patients think about traumatic events differently, which can lead to changes in the way the patient feels about the trauma.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing, or EMDR, is a form of therapy in which the patient is asked to think about their trauma while following a back and forth movement with their eyes. While EMDR has been found to be effective as a treatment for PTSD, it is not known whether the eye movement component of the treatment has any effect, or whether the re-experiencing and remembering of traumatic events in a safe environment simply has the same mechanism of action as exposure therapy.

Present Centered Therapy (PCT)

Present Centered Therapy (PCT) does not focus directly on the trauma a person experienced, but works to alleviate symptoms related to the trauma, and to improve the patient’s daily functioning. PCT also encourages the patient to have adaptive responses to current life circumstances whether they are directly related to the trauma or not. PCT’s effectiveness is also bolstered by the safe, secure relationship that develops between the therapist and patient. This is particularly helpful for people with PTSD who are experiencing the symptom of interpersonal disconnectedness.

Group Therapy

Group therapy for people living with PTSD can also be an effective treatment for the disorder. Group therapy provides factors that individual therapy cannot necessarily offer. In particular, group therapy can provide the social support that is often absent for people experiencing PTSD. It can also help to “normalize” symptoms of trauma by showing participants that they are not the only ones experiencing PTSD symptoms.

Other treatments for PTSD

Therapy can be effective in the treatment of PTSD on its own, but some people with the condition find other treatments helpful in addition to therapy. Medications, including antidepressant, anti-anxiety, and antipsychotic medications can help alleviate some of the acute symptoms of the disorder.

Further, some of the most cutting-edge research being done in this area is on the potential role of psychedelics in treating PTSD symptoms. Research has shown that a psychoactive substance called psilocybin, which is found in “magic mushrooms” can promote nerve cell growth in the hippocampus - the area of the brain responsible for processing memory and emotion. While research appears promising, treatments with psychedelic substances are not widely available, and in fact, are not yet legal in all states and municipalities.

PTSD is a condition that causes tremendous difficulty for sufferers of the condition and their loved ones. Luckily, there are several types of psychotherapy, including CBT, EMDR, PCT, and group therapy, which are proven to be effective in treating the disorder. With ongoing research on the effectiveness of medication and psychedelic substances, treatment for PTSD is likely to change for the better in the coming years.