Therapy & Counseling
Various types of psychotherapy (talk therapy) are used to help people overcome PTSD. The type of therapy depends on their situation and access to professional care. Although many patients report experiencing increased distress during initial therapy sessions, as they get accustomed to discussing traumatic memories, one study found that talking about trauma in therapy sessions resulted in 86 percent of participants showing improvement in their PTSD and psychotic symptoms by the end of treatment.One type that has been shown to be very effective is cognitive behavioral therapy in which thoughts are examined in order to determine how they affect behaviors and self-perception.
Some of the primary goals of therapy for PTSD include:
- Training a patient to better access their “emotional brain” that has been cut off. Many with PTSD feel “numb” and cannot tie events to emotions. A therapist can help the person open up about how they’re really feeling and form connections.
- Increasing self awareness. A therapist can teach a patient skills to understand how trauma changed their thoughts and feelings, in addition to how it impacts their body and health.
- Regaining a feeling of having control over one’s own life.
- And helping to develop coping strategies for dealing with difficult emotions.
Therapists often work with patients with PTSD to help them learn to become more aware of their inner experience and to begin to befriend what is going on inside themselves. This includes physical sensations, emotions and thoughts. Learning from past experiences and better vocalizing of feelings are other important areas to address. This is because helplessness and social withdrawal are both very common with PTSD.
Desensitization & Exposure to Fears
In addition to common types of talk therapy, several forms of exposure therapy are also used to desensitize patients to perceived threats, relieve stress and help them to face fears directly. A professional therapist usually conducts exposure therapy. The therapist can be a guide as the patient gradually faces situations, objects or locations that bring up strong feelings of the traumatic event.
- Prolonged Exposure— This is a type of therapy that involves discussing, facing and recalling the traumatic event in detail in order to gain control over upsetting thoughts, physical reactions and feelings about the trauma. The idea is that the more someone discusses the upsetting event, the more familiar it becomes and therefore the less feared. There are different ways to expose the patient to their fears. These include using imagining, writing, drawing or painting, or visiting the place where the event happened.
- Cognitive restructuring — This approach is similar to CBT and other forms of exposure therapy. It helps people make sense of the bad memories by discussing them. Feelings of regret, guilt and shame are often a central component to talk about since they can contribute to the patient feeling “stuck.”
- Eye Movement Desensitization and Reprocessing — This involves having the patient focus their attention on physical movement or sensations (like breath, sounds or hand movements) while they recall the trauma and talk about it openly. By doing this, they have something to ground their attention in order to help their brain work through the traumatic memories.
In research supported by the National Institutes of Health, patients that took part in a ten-week program including yoga and mind-body practices on average experienced markedly reduced PTSD symptoms, even patients who had failed to respond to any previously used medications. Yoga has been shown to change the brain by helping to increase “happy” neurotransmitters, reducing the effects of stress, helping to improve coping mechanisms for negative feelings, and more. Participants in the study learned ways to help increase five specific types of positive, comforting feelings. These feelings are: gratitude and compassion, relatedness, acceptance, centeredness and empowerment (GRACE).
Research suggests that another reason that yoga and other forms of mind-body practices work so well for reducing PTSD symptoms is because they positively impact the nervous system. This is because they can change chemical signals sent via the vagus nerve back to the brain. The vagus nerve is a large bundle of fibers that connects the brain with many internal organs. Researchers believe that about 80 percent of the fibers that make up the vagus nerve run from the body into the brain. Studies have found that we can directly influence the type of hormonal and chemical signals sent from the body to the brain. This means signaling to the brain if we should feel aroused versus relaxed depending on how we manipulate our body.
Some of the ways that PTSD patients can directly tap into their body’s “relaxation response” include: controlled breathing, stretching or moving in purposeful ways (i.e. yoga asanas), chanting songs or mantras with a group, and practicing dozens of styles of meditation. These methods have been utilized to help people deal with stress for thousands of years, dating back to the origins of Traditional Chinese Medicine, many religious practices, and yoga.
There is also lots of emerging data supporting mindfulness and meditation as an effective treatment approach for patients with PTSD, due to how “neuroplasticity” (the brain’s ability to change itself based on repetition and focused attention) can improve neurological processes and brain structures, reduce activity of the amygdala (the fear center of the brain), help with emotion regulation, and improve integration of the right and left hemispheres of the brain.
Changes in Brain Structure:
Deregulation of the brain areas associated with emotional regulation and memory is a key contributor to the symptoms associated with PTSD. This is in addition to the overactivity of the fear center, the amygdala. Mindfulness reverses these patterns by increasing prefrontal and hippocampal activity, and toning down the amygdala.
Social & Family Support
One of the strongest predictors of being able to overcome PTSD is “building resilience” through social support and close relationships. Certain factors can help increase resilience that reduces the risk for long-term symptoms tied to stress, including:
- Joining a support group, which helps to decrease feelings of isolation and alienation by opening up to others and forming compassionate relationships
- Visiting a family therapist in order to increase support from family, spouses, children or close friends
- Finding a spiritual or faith-based support group that can offer encouragement, an outlet, hope and positive feedback
- Social support also helps to reduce aggression. It teaches those with PTSD how to respond to fear or other negative feelings without shutting others out. It also can give life a sense of purpose or meaning.
Self Care & Stress Management
In addition to getting support from others, self-care is crucial for managing stress and triggers. Experts recommend some of these strategies for reducing anxiety and sources of stress in your life:
- Engaging in regular, but usually mild, physical activity or exercise
- Getting enough sleep and down time
- Being patient, including having realistic goals for how long it can take to feel better
- Reducing work-related stress and not taking on too much at once
- Spending more time in nature and with other people who help you feel comforted
- Becoming more knowledgeable about the condition through reading, journaling, speaking with a professional, videos, podcasts, etc.
Precautions Regarding Treatment for PTSD
If you suspect that you or someone you know is suffering from PTSD, it’s best to reach out for help right away in order to start the road to recovery. When feelings become unbearable and interfere with normal life, ask a family member, teacher or your doctor for help. You can refer to the National Institute of Mental Health’s Help for Mental Illnesses page to find a qualified mental health provider or social services worker in your area. In the case of an emergency (such as during a period of panic or major depression) an emergency room doctor can also provide temporary help.
- PTSD (or post traumatic stress disorder) is a mental health problem. It affects about seven to eight percent of the population, including children and teens. It typically occurs after someone has experienced or witnessed a life-threatening event. These events may include war combat, a natural disaster, abuse or assault, an accident, illness or sudden death of a loved one.
- Symptoms of PTSD include anxiety, depression, social isolation, sleep trouble and nightmares, aggression, avoiding talking to anybody else about thoughts or feelings related to the traumatic event, and refusal to do certain things tied to the trauma due to fear.
- Treatments for PTSD include use of medications, therapy or counseling, group and family support, yoga, exercise, meditation and other forms of managing stress through self-care.