Post Traumatic Stress (PTSD) is a serious condition that affects almost 5.5 million adult Americans. It is very debilitating and typically develops after a terrifying and traumatic event. People with PTSD have persistent and frightening thoughts and memories of their ordeals and exhibit an array of psychiatric and emotional symptoms. PTSD was first brought to public attention by war veterans, but it results from any number of traumatic events. These include violent attacks such as mugging, rape, or torture; being kidnapped or held captive; child abuse; serious accidents, and natural disasters. The event that triggers the PTSD may be something that threatened the person’s life or the life of someone close to him. Or it could be something that one witnessed.
Many people with PTSD repeatedly experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events that remind them of the original traumatic event. Anniversaries of the event can also trigger symptoms. People with PTSD experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. They may experience periods where they are out of touch with reality and immersed in the involuntary recollection or re-living of the traumatic event. This is referred to as a dissociative state.
Women are more likely than men to develop PTSD. The condition occurs at any age, and there is some evidence that PTSD susceptibility may be inherited. PTSD, as may be expected, is often accompanied by depression, substance abuse, or one or more of the anxiety disorders. In severe cases, a person may have difficulties working or socializing.
Treatment of PTSD
Cognitive-behavioral therapy, in conjunction with medications, has been demonstrated to be effective in the treatment of PTSD. When carefully administered by a well-trained professional, exposure therapy, in which the person gradually and repeatedly re-lives the traumatic event under controlled conditions, has been helpful as well. However, there is significant debate regarding the efficaciousness and appropriateness of long-term, in-depth therapy that focuses on the person “re-living” the trauma versus structured, cognitive-based behavioral treatment that seeks to change people’s reactions to anxiety-provoking thoughts and situations and enhance adaptive coping mechanisms.
In my work with persons suffering from PTSD, I permit the client to discuss the traumatic event, but usually do not encourage “re-living” the event, as there is no assurance that engaging in this activity will dispel or eliminate the condition; indeed, it may even exacerbate the symptoms. Often, I am able to de-sensitize the client from the feelings associated with the event by teaching her to recognize and intervene in the “automatic thoughts” that trigger potentially severe symptoms, as described above.
As with other conditions associated with overwhelming emotional activities, a thorough medical assessment is indicated prior to developing a plan for treating persons with PTSD. This assessment should include a detailed psychiatric history, noting any incidents of self-destructive behavior. Effective and successful treatment of persons with PTSD typically takes longer than other conditions. Although the treatment is not necessarily continuous, there may be periods of intensity when symptoms become acute. And, while not primary in the treatment of PTSD, some family or significant other involvement, mostly for psychoeducational purposes, is useful during the treatment process.
