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anthony
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There are many therapies within the mental health profession nowadays, of which most are extremely good and provide positive results for some people, however; statistics conclusively prove that Cognitive Behaviour Therapy (CBT) provides the greatest chance of success for those with PTSD specificially. The problem why CBT has fallen by the wayside with therapists over the last few years is due to the introduction of Eye Movement Desensitization and Reprocessing (EMDR), which is a proficient method for processing trauma.
The problem with EMDR is that it's not recommended for those with multiple traumatic events due to the risk of causing possible cognitive impairment. Basically, a complete brain meltdown for the simplest of terms. It can open too many memories at once, thus the brain can overload as its not able to process all the trauma at once. EMDR should be cautiously approached for use on veterans due to the diverse scope of trauma a veteran can endure upon an operation. It's not uncommon that EMDR can make a veteran worse.
Don't get me wrong, EMDR is an excellent treatment for assisting the brain to process traumatic memories. It is faster than CBT for traumatic memory processing. Saying that, here in lay the problem. EMDR assists the brain in processing trauma, but with PTSD that is not the only issue. The negative stigma that is attached to trauma can be greatly reduced by EMDR or CBT methods, yet where EMDR stops is once this stigma is reduced. PTSD though is a separate entity now and functions by itself without the need for the negative stigma. Whilst your brains associated negative stigma to your past trauma has been reduced, and resulting in a symptom reduction, the problem is that PTSD is its own entity, is permanent and thus still impacts your daily life. Before you know it your symptoms have increased again and you're back to square one.
PTSD has no cure to date. Acute Stress Disorder (ASD) is PTSD's little brother as such for diagnosis purposes. If you hear someone say they had PTSD and are cured, then they didn't have PTSD in the first instance; they had ASD if they present no further symptoms. To put PTSD simply, once formed it is a permanent change within your brain that will provide symptoms for the rest of your life regardless of past traumatic experiences. Life itself has a constant stream of stressors and trauma, good and bad, past, present and future, and these will affect your day to day symptoms, thus your life. You should now understand where EMDR's ability ends and a rather large void still remains in PTSD management skills. This is where CBT comes into play.
Therapists must get back to providing effective CBT treatment for PTSD sufferers, because this is the only way a sufferer can learn how to manage PTSD within their day to day life. Initially, medication is advised and used in an attempt to stabilize the chemical imbalance within your brain. This hopefully counters the depression and anxiety aspects. Medication is only a temporary aid though, and many often discover the hard way how medication can become a traumatic event within itself. To avoid issues with medication within the future, CBT comprises specific education and exposure techniques for a PTSD sufferer to function within society and manage their own lifestyle to reduce daily anxiety and depression aspects. Control this and you no longer require ongoing medication. The desired result with CBT is that you manage your lifestyle medication free, or with minor medication, and enjoy life once again to the best of your abilities.
CBT typically comprises the following layout:
Session 1: Elicit the account of trauma. Rational discussion for targeting the account of the trauma, avoidance and alienation and involvement of significant other. Assigned homework.
Session 2: Review account of trauma, avoidance and alienation. Elaboration of worst moments, identification of saboteurs ie. drinking, drugs, pain, literacy and remedial strategies. Tackling anger. Rationale for tackling co-morbid disorders.
Session 3: Review account of trauma, alienation, avoidance and anger. Engaging with traumatic material and feared situations without being overwhelmed. Review remedial strategies. Re-authoring the account of the trauma and its effects, cognitive restructuring ie. yes... but... (DeCatastrophising).
Session 4: Review homework set, living in the land of approach and immobilising saboteurs. Managing shifts in mood and pain.
Session 5: Stocktaking, review of MOOD records. Introduction to faulty information processes. Weaning off safety behaviours. Connecting and communicating with others.
Session 6 - 7: Stepping around prejudice against self. Reassessment and review of thought records, Mood management and assigned tasks.
Session 8 - 11: Cover any outstanding issues. Distillation of personal protocol to be used in the event of relapse.
Session 12: One month follow-up, review of skills, fine tuning and formal reassessment.
Realistic timeline for CBT and the healing process is 12 months,
PTSD within veterans is different for any other PTSD sufferer due to the military training instilled within a veteran, which comprises and enhances some of the symptoms for PTSD. CBT when performed correctly by an experienced person has over an 80% success rate. Veteran rates are often higher due to veterans positive military training attributes. Soldiers are trained and taught to push themselves both physically and mentally, and this can be individually applied by soliders more readily than civilians without such training.
There is hope, but like anything, you must want it and be willing to work hard towards it... both the ups and downs. Recovering PTSD is like taking two steps forward, one step back. At times it may be vice versa, though any forward progression is a positive step towards your overall future. Hard work, dedication and willingness to succeed. Sound familiar? Military style ethos?
This document is Copyright © 2009 and may not be replicated in part or full without express written permission off the author.
The problem with EMDR is that it's not recommended for those with multiple traumatic events due to the risk of causing possible cognitive impairment. Basically, a complete brain meltdown for the simplest of terms. It can open too many memories at once, thus the brain can overload as its not able to process all the trauma at once. EMDR should be cautiously approached for use on veterans due to the diverse scope of trauma a veteran can endure upon an operation. It's not uncommon that EMDR can make a veteran worse.
Don't get me wrong, EMDR is an excellent treatment for assisting the brain to process traumatic memories. It is faster than CBT for traumatic memory processing. Saying that, here in lay the problem. EMDR assists the brain in processing trauma, but with PTSD that is not the only issue. The negative stigma that is attached to trauma can be greatly reduced by EMDR or CBT methods, yet where EMDR stops is once this stigma is reduced. PTSD though is a separate entity now and functions by itself without the need for the negative stigma. Whilst your brains associated negative stigma to your past trauma has been reduced, and resulting in a symptom reduction, the problem is that PTSD is its own entity, is permanent and thus still impacts your daily life. Before you know it your symptoms have increased again and you're back to square one.
PTSD has no cure to date. Acute Stress Disorder (ASD) is PTSD's little brother as such for diagnosis purposes. If you hear someone say they had PTSD and are cured, then they didn't have PTSD in the first instance; they had ASD if they present no further symptoms. To put PTSD simply, once formed it is a permanent change within your brain that will provide symptoms for the rest of your life regardless of past traumatic experiences. Life itself has a constant stream of stressors and trauma, good and bad, past, present and future, and these will affect your day to day symptoms, thus your life. You should now understand where EMDR's ability ends and a rather large void still remains in PTSD management skills. This is where CBT comes into play.
Therapists must get back to providing effective CBT treatment for PTSD sufferers, because this is the only way a sufferer can learn how to manage PTSD within their day to day life. Initially, medication is advised and used in an attempt to stabilize the chemical imbalance within your brain. This hopefully counters the depression and anxiety aspects. Medication is only a temporary aid though, and many often discover the hard way how medication can become a traumatic event within itself. To avoid issues with medication within the future, CBT comprises specific education and exposure techniques for a PTSD sufferer to function within society and manage their own lifestyle to reduce daily anxiety and depression aspects. Control this and you no longer require ongoing medication. The desired result with CBT is that you manage your lifestyle medication free, or with minor medication, and enjoy life once again to the best of your abilities.
CBT typically comprises the following layout:
Session 1: Elicit the account of trauma. Rational discussion for targeting the account of the trauma, avoidance and alienation and involvement of significant other. Assigned homework.
Session 2: Review account of trauma, avoidance and alienation. Elaboration of worst moments, identification of saboteurs ie. drinking, drugs, pain, literacy and remedial strategies. Tackling anger. Rationale for tackling co-morbid disorders.
Session 3: Review account of trauma, alienation, avoidance and anger. Engaging with traumatic material and feared situations without being overwhelmed. Review remedial strategies. Re-authoring the account of the trauma and its effects, cognitive restructuring ie. yes... but... (DeCatastrophising).
Session 4: Review homework set, living in the land of approach and immobilising saboteurs. Managing shifts in mood and pain.
Session 5: Stocktaking, review of MOOD records. Introduction to faulty information processes. Weaning off safety behaviours. Connecting and communicating with others.
Session 6 - 7: Stepping around prejudice against self. Reassessment and review of thought records, Mood management and assigned tasks.
Session 8 - 11: Cover any outstanding issues. Distillation of personal protocol to be used in the event of relapse.
Session 12: One month follow-up, review of skills, fine tuning and formal reassessment.
Realistic timeline for CBT and the healing process is 12 months,
- 1 - 3 months in CBT sessions
- 3 - 6 months in follow-up, retraining and reassessment sessions
- 6 - 12 months recovery to refine skills and learning techniques
PTSD within veterans is different for any other PTSD sufferer due to the military training instilled within a veteran, which comprises and enhances some of the symptoms for PTSD. CBT when performed correctly by an experienced person has over an 80% success rate. Veteran rates are often higher due to veterans positive military training attributes. Soldiers are trained and taught to push themselves both physically and mentally, and this can be individually applied by soliders more readily than civilians without such training.
There is hope, but like anything, you must want it and be willing to work hard towards it... both the ups and downs. Recovering PTSD is like taking two steps forward, one step back. At times it may be vice versa, though any forward progression is a positive step towards your overall future. Hard work, dedication and willingness to succeed. Sound familiar? Military style ethos?
This document is Copyright © 2009 and may not be replicated in part or full without express written permission off the author.
