Post Traumatic Stress Disorder
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What is Post Traumatic Stress Disorder (PTSD)?
Post traumatic stress is an anxiety disorder that occurs as a result of either being involved in or being witness to a major traumatic event. It is a common but often a misunderstood condition.
The essential element of PTSD, is that a person either experienced or observed an event which involved actual or threatened death or serious injury to self or someone else. Any number of traumatic events can cause PTSD, including serious accidents, natural disaster, violent attacks (e.g., mugging, rape, physical abuse, terrorists attacks or being held captive), or simply witnessing any of these events happen to another.
What are the symptoms of PTSD?
Symptoms associated with PTSD include,
1) Re-experiencing the event in varying sensory forms (flashbacks)
2) Hyper-arousal in the Autonomic Nervous System
3) Avoiding reminders associated with the trauma
1) The re-experiencing of the trauma in at least one of the following ways:
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Recurrent and intrusive recollections of the event.
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Recurrent distressing dreams of the event.
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Sudden acting or feeling as if the event were recurring e.g. "flashback" episodes, hallucinations, illusions.
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Intense psychological distress at exposure to events that symbolise or resemble an aspect of the traumatic event.
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A numbing of responsiveness or reduced involvement in the external world some time after the trauma, indicated by:
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Diminished interest in activities and/or
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Feelings of detachment or estrangement from others and/or having a constricted effect e.g. unable to have loving feelings or to feel anger.
2) Persistent symptoms of increased arousal (not present before the trauma) as indicated by two or more of the following:
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Hyper-alertness or being easily startled.
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Sleep problems.
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Guilt about surviving or behaviour required to survive.
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Problems with memory or concentration.
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Avoidance of activities that arouse recollection.
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Intensification of symptoms if events symbolise or resemble the traumatic event.
3) Persistent avoidance of a stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three or (or more) of the following:
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Efforts to avoid thoughts, feelings, or conversations associated with the trauma.
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Efforts to avoid activities, places, or people that arouse recollections of the trauma.
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Inability to recall an important aspect of the trauma.
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Markedly diminished interest or participation in significant activities.
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Feeling of detachment or estrangement from others.
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Restricted range of affect.
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Sense of a fore shortened future.
PTSD is present when these symptoms last more than one month and are combined with loss of function in areas such as job or social relationships (APA 1994).
If you are experiencing some of the following symptoms, you may be suffering from Post-Traumatic Stress Disorder and when these reactions persist it is necessary for the sufferer to seek expert help in order to cope with the problem.
It is common for someone who has a suffer a trauma to develop other psychological problems, such as:
· Depression
· Panic attacks
· Obsessive Compulsive Disorder e.g. checking in order to make sure the place is safe, etc…
· Substance and alcohol abuse
Adapted
from:
Diagnostic and Statistical Manual of Mental Disorders. Vol. IV American
Psychiatric Association. 1994
How can PTSD be treated?
1. Cognitive-behavioural therapy, specifically REBT is very effective in treating post traumatic Stress disorder. Cognitive Therapy is involved in identifying and modifying those thinking patterns that may help alter the recollections of the trauma and the feelings associated with the events.
Treatment for PTSD typically begins with a detailed evaluation, and
development of a treatment plan that meets the unique needs of the survivor.
Generally, PTSD-specific-treatment is begun only when the person is safely
removed from a crisis situation. For instance, if currently exposed to
trauma (such as by ongoing domestic or community violence, abuse, or
homelessness), severely depressed or suicidal, experiencing extreme panic or
disorganized thinking, or in need of drug or alcohol detoxification,
addressing these crisis problems becomes part of the first treatment phase.
Cognitive Behavioural Therapy will also be involved in:
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Educating trauma survivors about how persons get PTSD, how PTSD affects survivors and their loved ones, and other problems that commonly come along with PTSD symptoms. Understanding that PTSD is a medically recognized anxiety disorder that occurs in normal individuals under extremely stressful conditions is essential for effective treatment.
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Exposure to the event via imagery allows the survivor to re-experience the event in a safe, controlled environment, while also carefully examining their reactions and beliefs in relation to that event.
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Examining and resolving strong feelings such as anger, shame, or guilt, which are common among survivors of trauma.
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Teaching the survivor to cope with post-traumatic memories, reminders, reactions, and feelings without becoming overwhelmed or emotionally numb. Trauma memories usually do not go away entirely as a result of therapy, but become manageable with new coping skills.
Exposure therapy, is one form of CBT unique to trauma treatment which uses careful, repeated, detailed imagining of the trauma (exposure) in a safe, controlled context, to help the survivor face and gain control of the fear and distress that was overwhelming in the trauma. In some cases, trauma memories or reminders can be confronted all at once ("flooding"). For other individuals or traumas it is preferable to work gradually up to the most severe trauma by using relaxation techniques and either starting with less upsetting life stresses or by taking the trauma one piece at a time ("desensitization").
Along with exposure, CBT for trauma includes learning skills for coping with anxiety (such as breathing retraining, relaxation and grounding techniques) and negative thoughts ("cognitive restructuring"), managing anger, preparing for stress reactions ("stress inoculation"), handling future trauma symptoms, as well as addressing urges to use alcohol or drugs when they occur ("relapse prevention"), and communicating and relating effectively with people ("social skills" or marital therapy).
2. Pharmacotherapy
(medication) can reduce the anxiety, depression, and insomnia often
experienced with PTSD, and in some cases may help relieve the distress and
emotional numbness caused by trauma memories. Several kinds of
antidepressant drugs have achieved improvement in most (but not all)
clinical trials, and some other classes of drugs have shown promise. At this
time no particular drug has emerged as a definitive treatment for PTSD,
although medication is clearly useful for the symptom relief that makes it
possible for survivors to participate in psychotherapy.
3. Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new treatment of traumatic memories which involves elements of exposure therapy and cognitive behavioural therapy, combined with techniques (eye movements, hand taps, sounds) which create an alteration of attention back and forth across the person's midline. The effectiveness of this technique for single traumas is very high and results can be obtained in short period of time. If you want to know more about this therapy click here.
Silvia Buet has extensive experience in dealing with traumas and cases and is also a Level II qualified EMDR practitioner. You can contact her by email or phone (02890 586361) if you require further information or you wish you make an appointment.
Don't Despair Help is at hand
st Modified: 7 January 2006
Copyright ©2006 Silvia Buet
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