Post-Traumatic Stress Disorder
- What is PTSD: Post-traumatic stress disorder (PTSD) may develop after an individual either witnesses or experiences a traumatic event, such as serious injury, death, sexual or physical violence. More recent research shows that post- traumatic stress disorder can also develop following “traumatic invalidation.”
- What is traumatic invalidation: is when an environment (often people important to the individual) rejects the person’s character, emotions, and behaviors. The person feels judged, dismissed, and disregarded and develops extreme negative beliefs about oneself, others, emotions, and the world overall.
- What does invalidation do to a person: Persistent and repeated invalidation can lead to self-invalidation, low self-worth, and chronic self-doubt.
- How to recover from traumatic invalidation: DBT-PE is a type of trauma therapy that treats PTSD that develops from persistent invalidation. It helps people overcome chronic shame, invalidating beliefs, and harmful behaviors.
- What are the signs of PTSD: Many people who experience a trauma do not go on to develop post-traumatic stress disorder. When PTSD is diagnosed, there are four main areas of symptoms that people experience for at least two months following the trauma. These areas of symptoms include: re-experiencing the trauma, avoidance of trauma reminders, changes in thinking and mood, and hyper-arousal.
- What triggers PTSD: When trauma is left untreated, many external or internal cues can be triggers. Examples of external cues can be sights, smells, sounds, pictures, music, words. Internal cues may include an image or memory.
- Who does PTSD affect: Around 70% of people have a trauma in their lifetime, and roughly 5% will develop post-traumatic stress disorder. It affects 7.7 million adults or 3.6% of the population. Multiple traumatic events increase the risk of developing PTSD. Women are 5x more likely to develop PTSD than men. Rape is the most common cause of PTSD, and 65% of men and 45% of women who are raped will develop PTSD. Childhood sexual abuse makes it more likely to develop PTSD in a lifetime.
- Can you recover from PTSD: Absolutely! The most effective treatment for PTSD is called Prolonged Exposure, and the response rates are between 65-85%. Results are often maintained in the long-term.
Symptoms of PTSD
- Nightmares, flashbacks, intrusive and unwanted memories
- Avoidance behaviors that are interfering in quality of life
- Self-blame
- Difficulty experiencing positive emotions
- Overwhelmed by emotions or shut off from emotions
- Alert, on guard, easily startled
- Frequent anger, irritability, outbursts
- Reckless behaviors or overly controlling behaviors
- Relationship problems
Treatment for Post-Traumatic Stress Disorder
A type of cognitive behavior therapy (CBT) called Prolonged Exposure (PE) is the leading evidence based therapy for post-traumatic stress disorder. Cognitive processing therapy and Behavior activation therapy are additional treatments for PTSD.
Prolonged Exposure Therapy for PTSD
What is prolonged exposure (PE): PE is an exposure based treatment for trauma. The goal of the treatment is to process traumatic experiences and to reduce avoidances (cognitive behavioral). The following techniques are used:
- Imaginal exposure: to address cognitive avoidance. An individual recalls the traumatic memory with support from the therapist and learns how to organize and process the memory.
- In-vivo exposure: to address behavioral avoidance. An individual is safely and gradually exposed to the trauma reminders including people, places, objects, and situations. People learn that the situations are likely safe and the emotions are tolerable.
- Processing: to reduce problematic emotions related to the trauma.
DBT-PE for PTSD
What is DBT-PE: DBT-PE has not been researched for post-traumatic stress disorder diagnosis alone. It was developed to treat individuals receiving DBT for symptoms of dysregulation. Two-thirds of people with PTSD experience two or more co-morbid conditions (such as personality disorders, substance abuse, eating disorders, psychosis, and mood disorders), and standard PE has historically excluded these symptoms from the treatment.
A difference of DBT-PE from PE is that DBT-PE adds an emotional focus to exposures and targets situations that are avoided due to depression, anxiety, and unjustified shame. The treatment is centered around exposures and processing that will challenge trauma beliefs. These problem beliefs are maintaining PTSD and necessary to resolve for full recovery. The treatment is delivered in stages.
- Stage 1 uses DBT to target life-threatening and therapy interfering behaviors before treating trauma. It also includes teaching DBT skills to regulate emotions, tolerate stress, improve relationships, and build mindfulness.
- Stage 2 treats PTSD using in-vivo, imaginal, and processing.
- Stage 3 focuses on maintaining an exposure lifestyle and treating any remaining quality of life problems.
Wise Mind Counseling is highly trained and has years of experience treating PTSD using PE and DBT-PE.