Trauma / PTSD

What is Posttraumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental health problem that can develop in people who have experienced or witnessed a traumatic event that threatens their life or safety (or others around them). Examples of traumatic events include car accidents, physical or sexual assault, domestic violence, bullying, war-related events, victim of violent crime, or being exposed to natural disasters.

What are the symptoms to watch out for?

A person with PTSD has four main types of difficulties, being:

• Re-experiencing symptoms – through unwanted and recurring memories and vivid nightmares. There may be intense emotional or physical reactions when reminded of the event. These can include sweating, heart palpitations or panic.
• Avoidance symptoms – avoiding reminders of the event, such as thoughts, feelings, people, activities or situations that bring back memories of the event
• Negative changes in feelings and thoughts, such as feeling afraid, guilty, flat or numb, developing beliefs such as ‘I’m bad’ or ‘The world’s unsafe’, and feeling cut off from others.
• Symptoms of hyperarousal – sleeping difficulties, irritability, lack of concentration, becoming easily startled and constantly being on the lookout for signs of danger.

People with PTSD can also have what are termed ‘dissociative experiences’, which are frequently described as:

• ‘It was as though I wasn’t even there.’
• ‘Time was standing still.’
• ‘I felt like I was watching things happen from above.’

ow is PTSD treated?

There are three main evidence based therapy approaches used to treat PTSD. Two of these approaches (Trauma Focused CBT & EMDR) are recommended by the Australian Centre for Posttraumatic Mental Health, and the third approach (Cognitive Processing Therapy) is the preferred model recommended by the Department of Veterans Affairs.

Eye Movement Desensitisation & Reprocessing (EMDR)

In 1989 a new therapy called Eye Movement Desensitisation and Reprocessing (EMDR) was announced which claimed to rapidly resolve trauma memories, with greater speed and effectiveness than other therapies. Because EMDR stemmed from an accidental discovery, and because no one could explain how it worked, it was initially regarded by many people as controversial. Much research followed, and there are now more studies demonstrating the greater effectiveness and efficiency of EMDR in resolving trauma compared with ANY other treatment. Therapists need extensive training in EMDR before using this therapy approach. EMDR is much quicker and far less confronting that TF CBT and is the preferred approach of many skilled trauma therapists in Australia and indeed the world.

Trauma Focused Cognitive Behaviour Therapy (TF CBT)

In trauma focused Cognitive Behaviour Therapy the client is firstly given skills and education to manage anxiety prior to going through a process of working through the trauma. Working through the trauma is performed in a very structured, safe, and systematic way to ensure that it is applied at the right time and to ensure that therapeutic gains are made.

Cognitive Processing Therapy (CPT)

The theory behind CPT conceptualizes PTSD as a disorder of non-recovery, in which a sufferer’s beliefs about the causes and consequences of traumatic events produce strong negative emotions, which prevent accurate processing of the traumatic memory and the emotions resulting from the events. Because the emotions are often overwhelmingly negative and difficult to cope with, PTSD sufferers can block the natural recovery process by using avoidance of traumatic triggers as a strategy to function in day-to-day living. Unfortunately, this limits their opportunities to process the traumatic experience and gain a more adaptive understanding of it. CPT incorporates trauma-specific cognitive techniques to help individuals with PTSD more accurately appraise these “stuck points” and progress toward recovery.