Cognitive Behavioural Therapy (CBT) Provides The Best Result For PTSD

[william]

My therapist wants to start emdr with me. I am a bit apprehensive. They don't offer CBT in Dayton.

 

[Jimmy1]

EMDR can be good mate, it all comes down to whether you are comfortable with your therapist or not, as they have to get up close and all this while your talking about your trauma.
But in my opinion, I was willing to try anything to get a reprieve.

 

[Fargo1]

William,

Having just started doing EMDR with my psych, I have to say a couple of things about it. I will preface these comments with a "I'm just starting all this so I am no expert."

One, in the beginning it was weird and hard for me to get into. But once I finally got into it, the results were a great relief.
Two, as has been said somewhere else on here, it can occasionally open up too much at a time and overwhelm you. The second time my psych tried it, I had a pretty strong reaction, disassociated and it took me a couple of days to come back from it.

As Jimmy said, I think you have to really trust your psych and clear yourself for a couple of days afterwards as a recovery period, just in case.

Just my two cents.

Fargo

 

[william]

Thanks for telin me.

 

[anthony]

EMDR is one of the four ONLY Tier 1 therapies for the treatment of PTSD... so yes, its just as good and effective as the other three; in actual fact, it will comprise two of the other three methods as part of the overall package delivered, as EMDR is only a substitute for the cognitive aspects, replacing Cognitive Therapy. EMDR is a cognitive therapy and even is a little exposure as well wrapped in, but internal exposure, not the full package of exposure required. Anyone practicing EMDR will also wrap more exposure and stress inoculation within the overall package, rounding it out to a normal CBT package.

EMDR is actually a CBT therapy. If you are confused, then read this quick piece, with diagram, that explains CBT as an overall model: https://www.myptsd.com/threads/removing-therapy-type-confusion.15534/

 

[Chris]

Hey Anthony, what is the difference between Cognitive Behavioral Therapy (CBT) and Cognitive Processing Therapy (CPT)

 

[anthony]

They are actually the same thing... CBT is the name given to an overall therapy model, it is a quick name to say that you are entering a therapy that is both cognitively processing your memories within the correct areas of the brain, and also contains a behavioural component that is realistic for you to apply within your life, done via both exposure based and technique application within situations.

Cognitive processing therapy is just that, one part of a CBT model that is handling only the brain processing of the trauma. EMDR also does this, being it takes care of the actual processing of the trauma within the brain.

Cognitive processing is also a form of exposure, being that you expose yourself to the trauma again in order to process, based on failure to do so is fear based. So even talking about your trauma here, is both cognitive and exposure based, because your brain is processing what you did, and receiving feedback for you to process and apply to change your mental perception of your trauma. Pretty much everything we do in life is exposure therapy... being the act of doing. So the moment you think about something, you are doing. How far doing goes, changes the term exposure therapy into more depth from just normal exposure that is collectively referred to as cognitive processing.

Does that make sense?

In a nutshell, you need three things to make up the overall package, being:

1. Cognitive processing with correct feedback loop,
2. Actually removing fear based emotion through exposure exercises, and
3. Stress reduction / management techniques and/or exercise/s.

All three are needed, which way you incorporate them, is unique.

Some might have EMDR + Prolonged Exposure Therapy + Weekly massage and learning stress management. Another could have, Cognitive Trauma Processing Therapy + PE + stress management techniques, relaxation, weekly golf, exercise, etc.

You get the idea no doubt. You can mix and match. Each complete package is called CBT, because it encompasses a cognitive processing, an exposure element and stress inoculation method/s to manage ongoing daily life.

 

[Andrew1]

There are many names under the CBT umbrella... for example, Dialectic Behavioural Therapy (DBT) is CBT + specific focus on emotional distress control for those with PTSD + personality disorder.

Basically, it works heavily on getting emotional stability first, so the person can then deal better with reactions when they begin looking into their trauma. The personality disorder is normally due to complex childhood trauma / significant long-term emotional and physical abuse. DBT is CBT... just very specialised for a specific branch. Prolonged Exposure (PE) therapy is the most successful for all under the CBT umbrella for the treatment of PTSD, IF, done correctly. It has the best results for military, as military are trained to be very hands on, face the problem type people, do military often pickup and relate the best to PE vs. talking about their emotions.

Anthony,
In the very last sentence of your post you mention we relate best to "PE" vs. talking about our emotions. What does "PE" stand for?

 

[anthony]

Prolonged Exposure.

PTSD is primarily fear based, whether it be fear to face trauma, fear to face emotions, fear to face the world, PE is a desensitization therapy that helps you shift past the fear, which is how most function day to day... they don't have that fear that PTSD instills or envelopes us with due to isolation or other factors.

Its then extremely effective for military, as military have already been trained to endure pain, tolerance, to push past barriers... thus most of the motivational work is already done when applying PE to military.

 

[Andrew1]

Makes sense. Thanks!

 

[Anglesachse]

Where does, if at all DBT fit in Athony. It is what I was taught while in the Clinic here in Germany, mainly due to having also been diagnosed with BPD, and not just PTSD and Depression. For me its seems simliar to CBT, in that it teaches you to Learn about yourself (Actually feeling your feelings and puting them into words etc.) and surroundings (what is actually happening at a specific time, and what effect it is having on you ), so you can act upon Impulsive reactions, ie, retraining yourself, but it has to be kept updated from time to time, as we are constantly in a state of change. I had it allmost 3months solid, and have been over due a refresher, am currently waiting a reply as to when I can step up.

 

[anthony]

DBT is a form of CBT, except it is tailored for people with personality disorders, as you cited BPD. Instead of jumping into trauma therapy, it can go for a year or two focused purely on emotional stabilisation and grounding techniques, stress management, etc... all before you go near trauma itself.

Basically, when a person has a personality disorder it means their brains wiring has deviated from standard and thus more extremely measures must be taken first to get the person back on a more standard and considered "normal" view of the world, people, emotions, understanding feelings, etc.

When you have a personality disorder, you would find it near impossible to identify emotions, to regulate them and so forth... that is what DBT focuses on as a priority.

CBT focuses on these first as well, but its usually a short focus, one or two sessions and a person can get the gist of things to try and regulate the heightened symptoms and emotions that are coming from dredging through trauma and feelings.