Post Traumatic Stress Disorder methods of treatment
28th April, 2009
What is Post Traumatic Stress Disorder?
Any situation that causes a trauma, or severe emotional state of fear, shock, horror etc causes what is known as a traumatic event. Such an event continues to effect the person, long after the trauma itself.
- Battle Trauma: Where armed forces personnel suffer trauma as a result of what they have seen / done / had done to them in a conflict environment.
- Medical environment trauma: Where emergency workers have a similar experience, facing overwhelming levels of shock or horror.
- Death trauma: Violent death can effect all people very deeply. For example finding a loved one who has died, especially in cases of violent death or suicide.
- Abuse Trauma: Where a person has suffered deliberate harm, physical, emotional, sexual or a combination of abuse types.
- Systematic trauma: Although we often think of Trauma as being due to one event, it is possible to "build" a trauma over time. For example a period of abuse, a tour of duty in a war zone, a period of torture or imprisonment or a series of "smaller" traumas combining over time.
Very often a person will face trauma restimulation. this occurs when they seems to have dealt well with the original trauma. If that trauma is compartmentalised or suppressed, rather than truly dealt with, then a smaller similar or linked event can set of the emotion all over again.
Some therapists in behavioural therapy liken the restimulation process to a minefield where you dodge the big mine, but tread on a smaller one, which sets the first one off too.
In each case with PTSD the person can suffer from two main features:
- Long term health effects including mental health effects (like depression or anxiety) and physical effects such as exhaustion and lowered immune response.
- Restimulated response. The person suffers from a negative response to a stimulus. This situation, person or other stimulus triggers a response (e.g. anger, depression, stress, anxiety etc) which is not productive or helpful. This might be caused by a sound, smell, word, or any other reminder that causes the subconcious to remember the trauma.
Restimulation can be caused by any link between the present and the trauma. It can be a very subtle link. For example veterans of the Vietnam conflict report feeling stress as a result of smelling fuel when filling up at a petrol station. The smell reminded them of napalm used in the conflict, and the resultant images of death and destruction.
So what can be done to assist Post Traumatic Stress Disorder?
There are a number of therapy techniques that are used. Unfortunately classic PSTD treatment is brief and in no real depth. It is often provided as a response by an employer so that they can claim to have responded and fulfilled their obligations to their employee. This has caused a popularity in short term intervention methods such as "stress debriefing". The method can help, but in many cases the victim of the trauma only finds some help from the process, and has to complete the healing process elsewhere.
Methods of PTSD Therapy include:
- Stress Debriefing. Often called Critical Incident Stress Debriefing. This is the favourite methods of employers to reduce liability claims. It is also preferred by the armed forces since it is designed to get personnel battle ready again in the minimum time possible.
- Counselling: A longer process that borrows much of its content from grief and bereavement counselling. It recognises that a number of stages are worked through in order to fully recover from trauma or grief. Some of the stages need time to complete and can not be rushed.
- Psychoanalysis: A deeper process that looks at why the trauma made such a different to the individual. This can be effective since some people appear to be traumatised by events that others shrug off. this is due to us all having different formative experiences that combine to make us who we are. Thus different things cause stress for different people. By understanding and treating deeper issues good progress can be achieved.
- Cognitive Behavioural Therapy: Like Psycho analysis this looks at why the events effect us in the way they do personally. CBT however tends to be more practical in that there are many exercises and practice things to do, often referred to as "homework" for the client. Many clients like this approach since it gives them an element of control and a good feeling since they are "doing" something tangible to help themselves.
- Deeper Trauma Debriefing: The state of hypnosis is useful in deeper debriefing, often referred to as a "Trauma Run". As with typical debriefing, the principle is to "run the trauma" flat of emotion. In a hypnotic state however you are likely to achieve more detail and a more comprehensive result. memory is improved in a state of trance, so the chances of missing any essential details is reduced. The hypnotic state also allows remedial work to be added to the process that is not possible in normal debriefing.
- Disassociated debriefing (NLP). Some people find the debriefing model too painful since essentially you are reliving events. NLP and Hypnosis allows disassociated recall. In this recall model the person is watching someone else experiencing the trauma, and the pains and emotions are massively reduced. Understanding and information is still forthcoming, but the pain of therapy is less.
- History Change (NLP). A method of therapy was discovered by Richard Bandler, co founder of NLP (Neuro Linguistic Programming). He discovered that it is possible to rewrite areas of memory, replacing them with positive memories and supportive memories. in this therapy you should always ensure full understanding and learning from any memory before tampering with it. As the old motto goes, "he who fails to learn from history is doomed to repeat it". Once you have learnt however, it is possible to play with memory, giving a positive set of emotions. The therapist is of course limited by ethical constraints, and clients considering this option should remember that a good therapist may refuse to change certain memories if they think doing so is unethical or not in the best interests of you, the client.
- Healing environment: Person Centred Counselling, and holistic therapies both teach us that the body and mind have a good capacity for self healing. For this to occur however the right environment is needed. Therefore resources like a listening ear from a counsellor, regular relaxation therapy and other holistic healing methods are vital if the client is going to self heal.
Different clients respond best to different approaches and many of the best services offer a flexible approach with more than one "tool" or therapy at their disposal. Reducing the effects of trauma can make a lasting difference to a client's quality of life and can mean far fewer fear reactions, more natural emotional responses and fewer maladjusted cognitive or perceptual responses.
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- The psychological effects of traumatic events such as the Manchester bombing
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