Multiplicity, Abuse & Healing Network
Peer Support for Abuse Survivors

advertising

The Survivor's Guide to Sex: How to Have an Empowered Sex Life After Child Sexual Abuse
Buy The Survivor's Guide to Sex: How to Have an Empowered Sex Life After Child Sexual Abuse


ISBN-1573440795

Description:
This book offers an affirming, sex-positive approach to recovery from incest and rape.

Home| ShrinkTime| Resources| Self Help| Editorials/Poetry| eTherapy Info| Search

PTSD and Treatment

source: National Center for PTSD


Many methods of therapy have been developed for survivors of trauma. All methods share the following guidelines:

  • Therapy always is individualized to meet the specific concerns and needs of each unique trauma survivor, based upon careful interview and questionnaire assessments at the beginning of (and during) treatment.

  • Trauma therapy is done only when the patient is not currently in crisis. If a patient is severely depressed or suicidal, experiencing extreme panic or disorganized thinking, in need of drug or alcohol detoxification, or currently exposed to trauma (such as by ongoing domestic or community violence, abuse, or homelessness), these crisis problems must be handled first.

  • When a shared plan of therapy has been developed within an atmosphere of trust and open discussion by the patient and therapist, a detailed exploration of trauma memories is done to enable the survivor to cope with post-traumatic memories, reminders, and feelings without feeling overwhelmed or emotionally numb.

  • The goal of "trauma focused" exploration is to enable the survivor to gain a realistic sense of self-esteem and self-confidence in dealing with bad memories and upsetting feelings caused by trauma; trauma memories usually do not go away entirely as a result of therapy, but become manageable with new coping skills.

  • Trauma exploration can be done in several ways, depending upon the type of post-traumatic problems a survivor is experiencing. These types of problems are not limited to PTSD, but include at least five different post-traumatic conditions:

The normal stress response occurs when healthy adults who have been exposed to a single discrete traumatic event in adulthood experience intense bad memories, emotional numbing, feelings of unreality, being cut off from relationships or bodily tension and distress. Such individuals usually achieve complete recovery within a few weeks. Often a group debriefing experience is helpful. Debriefings begin by describing the traumatic event. They then progress to exploration of survivors’ emotional responses to the event. Next, there is an open discussion of symptoms that have been precipitated by the trauma. Finally, there is education in which survivors’ responses are explained and positive ways of coping are identified.

Acute stress disorder is characterized by panic reactions, mental confusion, dissociation, severe insomnia, suspiciousness, and being unable to manage even basic self care, work, and relationship activities. Relatively few survivors of single traumas have this more severe reaction, except when the trauma is a lasting catastrophe that exposes them to death, destruction, or loss of home and community. Treatment includes immediate support, removal from the scene of the trauma, use of medication for immediate relief of grief, anxiety, and insomnia, and brief supportive psychotherapy provided in the context of crisis intervention.

Uncomplicated PTSD involves persistent reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, emotional numbing, and symptoms of increased arousal. It may respond to group, psychodynamic, cognitive-behavioral, pharmacological, or combination approaches.

Group treatment is practiced in VA PTSD Clinics and Vet Centers for military veterans and in mental health and crisis clinics for victims of assault and abuse. A group of peers provides an ideal therapeutic setting because trauma survivors are able to risk sharing traumatic material with the safety, cohesion, and empathy provided by other survivors. It is often much easier to accept confrontation from a fellow sufferer who has impeccable credentials as a trauma survivor than from a professional therapist who never went through those experiences first-hand. As group members achieve greater understanding and resolution of traumatic themes, they often feel more confident and able to trust. As they work through trauma-related shame, guilt, rage, fear, doubt, and self-condemnation, they prepare themselves to focus on the present rather than the past. Telling one’s story (the "trauma narrative") and directly facing the grief, anxiety, and guilt related to trauma enables many survivors to go on with their lives rather than getting stuck in unspoken despair and helplessness.

Brief psychodynamic psychotherapy focuses on the emotional conflicts caused by the traumatic event. Through the retelling of the traumatic event to a calm, empathic, compassionate and non-judgmental therapist, the patient achieves a greater sense of self-esteem, develops effective ways of thinking and coping, and more successfully deals with the intense emotions that emerge during therapy. The therapist helps the patient identify current life situations that set off traumatic memories and worsen PTSD symptoms.

There are two cognitive-behavioral approaches, exposure therapy and cognitive-behavioral therapy. Exposure therapy involves therapeutically confronting a past trauma by either (a) repeatedly imagining it in great detail, or (b) going to places that are strong reminders of the trauma experience(s). Exposure therapy is intended to help the patient face and gain control of the fear and distress that was overwhelming in the trauma, and must be done very carefully in order not to re-traumatize the patient. In some cases, trauma memories or reminders can be confronted all at once ("flooding"), while 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 stressors or by taking the trauma one piece at a time ("desensitization"). Cognitive-behavioral therapy involves learning skills for coping with anxiety (such as breathing retraining or biofeedback) and negative thoughts ("cognitive restructuring"), managing anger, preparing for stress reactions ("stress inoculation"), handling future trauma symptoms and urges to use alcohol or drugs when they occur ("relapse prevention"), and communicating and relating effectively with people ("social skills" or marital therapy). Exposure and cognitive-behavioral therapies are often used together, although it is important not to use too many different therapy methods because this can cause the patient to feel overwhelmed and confused.

Finally, drug therapy 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 symptom relief thereby making it possible for patients to participate in group, psychodynamic, cognitive-behavioral, or other forms of psychotherapy.

PTSD comorbid with other psychiatric disorders is actually much more common than uncomplicated PTSD. PTSD is usually associated with at least one other major psychiatric disorder such as depression, alcohol/substance abuse, panic disorder, and other anxiety disorders. The best results are achieved when both PTSD and the other disorder(s) are treated together rather than one after the other. This is especially true for PTSD and alcohol/substance abuse. The same treatments used for uncomplicated PTSD should be used for these patients, with the addition of carefully managed treatment for the other psychiatric or addiction problems.

Complex PTSD (sometimes called "Disorder of Extreme Stress") is found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood, such as childhood sexual abuse. These individuals often are diagnosed with borderline or antisocial personality disorder or dissociative disorders. They exhibit behavioral difficulties (such as impulsivity, aggression, sexual acting out, eating disorders, alcohol/drug abuse, and self-destructive actions), extreme emotional difficulties (such as intense rage, depression, or panic) and mental difficulties (such as fragmented thoughts, dissociation, and amnesia). The treatment of such patients often takes much longer, may progress at a much slower rate, and requires a sensitive and highly structured treatment program delivered by a team of trauma specialists.

copyright © National Center For PTSD

 

Disclaimer:   I am not a health care professional. I am an abuse survivor. The resources on this site are for information and education only. Information on this website is meant to support not replace the advice of a licensed health care or mental health care professional. Please consult your own physician for health care advice.

Copyright Policy:   Information included on the MAH Network site is in the public domain; however, you will encounter information that is owned/created by others, including copyrighted materials. Those other parties retain all rights to publish or reproduce those documents or to allow others to do so. Any copyrighted materials included on this site remain the property of their respective owners/creators and should not be reproduced or otherwise used. It is not the intent of the MAH Network to have violated or infringed upon any copyrights. If you believe we have, please let us know and we’ll take care of the matter promptly.

© Copyright 1998-2005. All rights reserved. Contact: admin at m-a-h.net Last edited: 01/02/03.