Identifying and treating PTSD

Post-traumatic stress disorder (PTSD) initially developed from the struggle of Vietnam War veterans suffering and coping with the psychological and physiological after-effects of combat. The National Institute of Mental Health describes PTSD as an anxiety disorder which develops after a traumatic event and it can be caused by various types of traumatic experiences. Child abuse, incest, domestic violence, exposure to death and dying, auto collision, repeated physical abuse, repeated mental abuse, medical complications and/or surgery are all situations which can result in PTSD.

Symptoms

The American Psychiatric Association reports the following criteria as symptomatic of PTSD:

Re-experiencing:

  • Flashbacks of the event
  • Dreams of the event
  • Prolonged distress due to traumatic reminders of the event

Avoidance:

Persistent avoidance of trauma-related triggers such as Thoughts, memories and constant reminders of the event

Negative cognitions and mood:

  • Feelings of “otherness” or being misunderstood
  • Feeling alienated or estranged from others
  • Becoming less interested in activities
  • Persistent negative beliefs and expectations
  • Trauma-related emotions such as fear, horror, anger, guilt, shame
  • Constricted affect (sufferer is unable to experience any kind of happiness)

Arousal

  • Aggressive or self-destructive behavior
  • Sleep disturbances
  • Hypervigilance
  • Fight or flight reactions (impulsive reactions without consideration or thought)

Progression

While PTSD can take over a person’s life, it is, thankfully, not without treatment. Dr. Harold Cohen from the University of Liverpool notes the beginning stages of treatment for a client suffering from PTSD:

Phase 1: Achieving patient safety, reducing symptoms and increasing competencies

One of the first steps a person with PTSD must take is ensuring a feeling of safety. In doing so, the patient must learn to regulate emotions and deal with negative thoughts, feelings and triggers effectively. Channeling feelings and emotions can be done through journaling, talking to a counselor or group therapy.  The patient can also learn coping skills that will help them deal with stress at work, home or school. Mindfulness and staying in the present moment is one of the most important aspects of the first phase of trauma therapy as it is a skill that helps patients remain mentally present, keeping them from returning to thoughts of past events.

Many times, thoughts come from past experiences that remind a person of a current event or situation. A very important part of treating PTSD is learning that these thoughts are not facts but are instead based on distorted worldviews or unfounded assumptions. A person can effectively learn how to change their thinking by tracking thoughts and considering the reasons why they might occur. A therapist can help a client work through restricting and reframing their thoughts.

Another part of the first phase of treatment is helping the person suffering from PTSD to gradually start working on some of the behavior that might have been an issue before the traumatic event. If a person keeps an open mind and has developed a safe relationship with their counselor, minister or therapist, they can begin the journey of assessing any negative behaviors that can be altered. An effective way of doing this is to keep a journal, writing down any abnormal, angry or fearful thoughts as well as the reactions that resulted in those thoughts. In this respect, a patient can eventually see the patterns of their thinking.

Phase 2 – Review and reappraisal of trauma

Any reminders of trauma are most likely going to be hurtful before they heal, therefore, a person must be prepared to be reminded of the traumatic event. Experiencing reminders of the event when a patient in unwilling to face them could result in further trauma. It is never healthy to attempt to face a traumatic experience head on without proper therapy and guidance from a mental health professional.

When the time is appropriate and the person suffering from PTSD is prepared mentally and emotionally, they can start the processes of the “reviewing” which involves thinking about, talking about, writing about and/or praying about the event. After this is done, any “reappraising” that might be necessary to more accurately understand the facts of the traumatic event can be accomplished.

Phase 3: Consolidating the gains

The last phase is a wrapup of everything the patient has gone over with their therapist thus far. The patient also designs a plan of action regarding how they will handle triggers and any potential reoccurrences of the traumatic event. The therapist can assist them in forming a strong support group of former and current patients with similar stories. Sharing is one of the most important elements in maintaining “gains” as a person truly absorbs and learns from what he or she shares with others. The more the PTSD client is able to process by talking or writing about their traumatic experience the easier it will be for the patient to move past the experience.