PTSD treatment, PTSD therapy
What is PTSD?
While most people will have a very negative reaction to traumatic events, their symptoms will improve over time. PTSD or Post Traumatic Stress Disorder is a condition in which a stress reaction to a traumatic event persists or even gets worse over time rather than lessening. The symptoms of PTSD generally have a rapid onset following the trauma but they may not occur until months or even years later or may improve temporarily only to reappear suddenly. Even though the event is in the past the alarm reaction continues as though it is still happening in the present. It is as though the essential understanding that the event is over and has been survived is missing. Not everyone who experiences trauma will develop PTSD, for those who do their symptoms cause great distress, interfering with daily functioning and disrupting their ability to maintain relationships. Things may feel hopeless, but PTSD treatment can help.
What causes PTSD?
PTSD can be caused by extremely stressful or scary events that happen directly to the person, something horrible they witness happening to someone else, even by something that they only hear about.
Examples of traumatic events that can lead to PTSD include:
- military combat
- serious accidents
- natural disasters like earthquakes or mudslides
- childhood abuse
- adult sexual or physical assault.
Symptoms of PTSD
There are three main types of symptoms of traumatic stress, made up of both mental and physical components.
During a traumatic event the body mobilizes an alarm reaction to the threat. We’ve all felt this type of rush to differing extents. For example, a driver cuts us off in traffic and we notice our heart rate and breathing are faster and we feel shaky. This reaction is adaptive and is part of the fight-or-flight response. This alarm reaction is generally time limited and our body eventually returns to normal. We would expect that this process will take longer depending on the severity of the incident. In PTSD the alarm reaction caused by the initial event continues even though time has passed. The body reacts as though the event is reoccurring even if the person consciously understands that they are now safe.
These symptoms include:
- increased heart rate
- rapid breathing
- extreme jumpiness
- cold sweating
- nausea, stomach problems
- angry outbursts
This hyper-arousal can lead to sleep disturbances, loss of appetite, chronic fatigue and difficulties with concentration.
In PTSD traumatic memory does not occupy its proper place in time and space. Because it lacks its anchor in the past, it intrudes into the present in such a way that the person “feels” as though the trauma is still occurring.
These symptoms include:
- intrusive thoughts about the event.
- flashbacks where it seems as though the event is happening again.
Avoiding reminders of the trauma
Because memories of the event are so distressing, the person naturally wants to limit experiences that lead to symptoms. Reminders of the trauma can occur suddenly and not always as a result of external cues. Sometimes as a result of a body sensation like increased heart rate due to exercise. These reminders can occur during previously enjoyable experiences and the person may start to avoid more and more of life in an attempt to protect themselves. Other types of avoidance have to do with the brain’s response to the event. Traumatic experiences can cause feelings of altered reality like extreme numbness. Trauma can also affect the way the memory was stored in the first place leaving blank spots in recollection.
Avoidance symptoms include:
- Not wanting to talk about the trauma or trying not to think about it.
- Limiting activities that are reminders of the trauma.
- Loss of interest in life in general.
- Feelings of numbness, feelings of being detached from important others.
- Difficulties remembering all or parts of the traumatic event.
PTSD and Memory
Different types of experiences are stored in different ways in memory. In PTSD the nature of the experience prevents the memories from occupying their proper place in the past. Memories of events continue to intrude into the present as if they were still happening. Often with the same power as the original event.
The memory system is made to process events so that what is useful is stored and the rest is discarded. That is, during processing of the memory, the original negative feelings, thoughts and body sensations are stripped away. So that even though we retain the memory of the horrible incident, it no longer feels as though it is still happening. This processing also hooks the experience into existing memory networks where it can be combined with other positive memories of times we felt powerful or in control.
In PTSD the memory of the traumatic event is unprocessed and has been stored with all of its negative feelings, thoughts and body sensations. It is also stored in isolation so that no positive experiences are connected to it.
PTSD treatment helps the person process the memory so that it can be stored adaptively without all of its negative content, helping the memory find its proper place in the past so that it no longer intrudes into the present.
EMDR therapy is an effective form of post traumatic stress disorder treatment. It is an extensively researched form of psychotherapy that incorporates aspects of many different treatment approaches. It is recognized by the US Department of Defense/Veterans Affairs and the International Society for Traumatic Stress Studies for PTSD treatment. It has the ability to permanently eliminate symptoms of stress and trauma. It is not necessary to discuss the traumatic event in detail in order to achieve this. Significant improvement in symptoms is possible in as little as 12 sessions.
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