Many people are surprised to learn that not only veterans of war suffer from PTSD. Civilians can suffer as well. What is PTSD and can it be treated? Let’s take a look.
PTSD, or Post Traumatic Stress Disorder, is a disorder which occurs when one experiences a terrifying trauma which feels life threatening. Traumas which can trigger a PTSD response include war, natural disaster, any form of abuse (physical, mental, sexual, emotional, and verbal), a shooting, a car accident, or any experience which shakes us to our core and paralyzes our ability to move forward.
Symptoms of PTSD include, but are not limited to, intense daily anxiety, a sense of impending disaster, nightmares, flashbacks, panic attacks, misplaced guilt, night terrors, the need to isolate oneself, irritability, hostility, tearfulness, and a sense of re-living the trauma over and over again as if it is currently happening. In some cases, PTSD can result in psychosis or a loss of contact with reality.
Wow! That’s a pretty big syndrome. Is that really treatable?
The good news is that PTSD is very treatable. Clients do suffer from a wide variety of symptoms which cause intense distress when they suffer from PTSD, but remission, and even sometimes recovery, is possible. A large percentage of my clientele suffer from this diagnosis because I work with both victims of crime, as well as veterans of war. Although most clients do not believe they can ever overcome their symptoms, most do recover at least to the point of feeling some sense of well being again; many clients are in remission or even symptom-free after therapeutic intervention if therapy is done consistently and until completion.
How is PTSD treated in my office?
I use a combination of different therapeutic modalities to combat the wide variety of symptoms found in this disorder. A few I use most often with PTSD are CBT (Cognitive Behavioral Therapy), DBT (Dialectical Behavioral Therapy), and PT (Psychodynamic Therapy); I also use a combination of progressive desensitization and progressive relaxation to teach my clients how to help themselves between sessions, and to build positive coping skills for use now and in the future.
CBT is a form of therapy that focuses on the cognitive triad, namely three inter-related concepts: perception of self, perception of others, perception of the future. Perception of one affects perception of the other, so work on one (usually perception of self first!) and the other two will soften in response. CBT believes that thoughts create emotions, and emotions create behavior responses. For example:” I remember seeing my war buddy killed next to me, I feel anguish and terror, I reach for another beer to numb the memory and pain”. The goal of CBT is to bring attention to that emotion-thought-behavior pattern, and change the components of the pattern so the outcome is better. For example: “ I remember seeing my war buddy killed next to me, I feel anguish and terror, I use deep breathing and positive self talk to calm my response, I pick up the phone to speak with a trusted friend and avoid getting drunk.”
DBT is a more complete form of CBT which uses the same concepts as above, but includes mindfulness training. Mindfulness is the state of being present in the moment, paying attention to how we feel and think, what our body feels like, and the environment around us. This is a great skill that can be learned combat the effects of flashbacks and nightmares in particular. DBT also includes learning to take responsibility for our behaviors, even if they are triggered by traumatic events. For example: In the scene in the above paragraph, when the client decides to take a drink to numb his/her feelings, in DBT we would take a step further and acknowledge that it is ultimately our decision to take that drink; that it is not the PTSD causing us to act this way, but rather our response to the pain. This is an empowering concept because we realize we are in control of our behaviors.
I’m a big fan of PT as well, although that’s not always included in PTSD treatment. PT is based on the belief that our childhood upbringing directly affects how we perceive the world as adults. Why is this important in PTSD work? Because in childhood we learn whether the world is safe or not, how to cope with difficult emotions, and how we perceive ourselves and those around us. If we learned that the world is unsafe because we endured physical abuse as a child, for example, then if we are further traumatized by war, our PTSD response will have a snowball effect, deepening and sharpening the impact of each trauma which adds to the symptoms we already endure.
As a therapist, I want to know each event in a client’s life that may have started the trauma response, so that we can address each and every one. That will give us the best chances at remission of the disorder. For example, if I treat a war time incident, but leave an entire abusive childhood untreated, how much better will the client really feel? Somewhat better, but not as great as they could had they dealt with all of it!
PTSD is a distressing, all encompassing disorder triggered by a life threatening experience, and as difficult as it is to endure, it can be treated effectively. With proper intervention and enough time and dedication, sufferers can go on to have their sense of well being restored, living happy and productive lives.