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Ptsd therapies

Thread starter #1
Therapy comes in many forms today, that creating a page for each type is really quite useless, as most use different names, though fall under a primary technique. Basically, all these entrepreneurs are out trying to make a name for themselves, by taking existing techniques, modifying it a little, then trying to power sell it to the world, in the hope to get rich, get successful, and the list of deception goes on. There are also some very valid therapies that exist and are useful in treating specific aspects well, then undo themselves by trying to branch into areas they have zero scientific impact upon.

This page is going to cover a brief synopsis of most of the therapies available today, both psychotherapy and naturopathic therapies, highlighting what has relevancy for the treatment of Posttraumatic Stress Disorder (PTSD) and what does not. There is a minority who will claim a specific type of therapy cured their PTSD. Firstly, there is no cure for PTSD, secondly, how do you know they had PTSD in the first instance and not simply normal posttraumatic stress due to a traumatic event? It could also have been the placebo effect.

Never confuse a therapy to treat a symptom vs. a therapy to treat the cause of PTSD, being trauma. That is the distinction you must understand reading and trying various therapies for yourself. Trauma therapy treats the cause, most therapies treat the symptoms. If all you want is to treat the symptoms, then pharmacological means will typically achieve that aim.

What Is Therapy?

Therapy in medicine is "treatment". Whether it be a mental or physical therapy, it all comes back to treatment. Talking with your friend about a negative event is therapy. Going to the gym to keep fit is therapy. Seeing a counselor or pain management specialist, is therapy. If you're seeking any form of treatment for yourself, you could call it therapy. Participating on this website is therapy.

Trauma Therapies For The Treatment Of PTSD

I have listed these first, as the rest are in alphabetical order. The following are the only four tried, tested and proven therapies for the treatment of PTSD that actually treat the cause, not the symptoms. They are:
  1. Cognitive Therapy - Often referred as Trauma Focused Cognitive Behavioral Therapy (TF-CBT) (CBT) and Cognitive Trauma Therapy (CTT).
  2. Prolonged Exposure (PE) Therapy - Often referred as Exposure Therapy or Behavior Therapy.
  3. Eye Movement Desensitization and Reprocessing (EMDR)
  4. Stress Inoculation Therapy - Nowadays referred as Stress Management or Mind Body.
Tier 1 treatments are those that have been so fundamentally tested in Government and private practice against PTSD, they have been isolated as the best thing on the market to date. Delivery of the treatment is a whole other subject. Give a good treatment to an average therapist, you get an average result. Give a good treatment to an exceptional therapist who has a lazy client, same less than quality result. Combination of therapy, therapist and your attitude is what derives the outcome.

General Knowledge To Arm Yourself Prior To Therapy

The following headings are brief outlines of each therapy, and its place within PTSD treatment. The above are the only four globally acknowledged methods that have proven without a doubt, as a majority, to be the most effective for the treatment of PTSD at the core level of the cause. Saying that, you should take into account the following points for therapy in general:
  1. Know your therapy by reading a book on the therapy you are partaking within. This gives you an understanding of what you need to do for success, as well as to understand what the therapist will be trying to achieve when they say or ask you to do something. Instead of questioning your therapist, you will understand the basic principles. Knowing your therapy beforehand is also an excellent trait that really says, you are committed to getting better, and not just looking for someone to do the work for you, which cannot be done with treating PTSD.
  2. Only you can help you, no amount of therapy or therapist/s can do the work for you.
  3. Therapy is like medication, you may have to try many, or combination off, even none at all and solely a DIY approach, to get the best results.
Acceptance & Commitment Therapy

Acceptance & Commitment Therapy (ACT) was developed by Steven C. Hayes, Kelly Wilson and Kirk Strosahl. ACT is an empirically proven CBT therapy that focuses on using "acceptance" to what has occurred, or consequences of your actions, in combination with mindfulness as an awareness approach, followed through with "commitment" to change your behavior. As with any CBT therapy, you have a cognitive component through acceptance and awareness, and a behavioral component, being the action stage, or doing stage of the process.

ACT is a valid option to assist a PTSD sufferer at coming to terms with their trauma, treating their emotional state, and in enacting behavioral change to improve recovery outcome.

For more information on ACT, your first step should be to stick with its developers text as much as possible, for a true reflection of its use. The most current text on ACT by these very three co-authors at the time of writing this page is called, "Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change" available through Amazon.

Acupuncture

Acupuncture is an ancient form of Chinese medicine, that has been proven empirically through scientific study to be an approved medical treatment, not merely of placebo basis. Acupuncture works on what the Chinese call qi (pronounced chee), being an energy that flows through the body, and can be accessed at specific points to change the bodies behaviour. Science calls this electrical energy, which is factually proven as basically running the human body. Our brain controls our bodies electrical impulses, and acupuncture manipulates our brains response by manipulating specific points.

For the treatment of depression and anxiety, acupuncture has empirical data validating its success, as equal to common psychological and pharmacological treatments. The difference with acupuncture though, is it provides not one single negative side effect.

The negative to acupuncture, is cost, as most insurances do not cover ongoing treatment, thus it can be an expensive option if required weekly. Saying that, the cost may be equal to what you pay now, or less than, for therapy and medications.

There is a lot of literature on acupuncture, and like any industry, there are good and bad practitioners. Do your homework, obtain recommendations, and try several practitioners before settling on one, measuring effect and personal choice.

Anger Management

Anger management is not so much a therapy by itself, more a modality of various therapeutic techniques combined to help a person who struggles with excessive anger and aggression. Anger management is typically an exhibited behavior, that through relaxation techniques, communication, cognitive and exposure exercises, a person can change their cognitive functioning as well as physical behavior when triggered.

Anger has always been a response to another emotion/s. A driver cuts you off, thus you become frustrated, which causes anger and aggression. Whilst anger management is catered by courses in some countries, various therapy types listed here are what's used to directly cater anger management therapy itself.

Art Therapy

There are two contexts for Art Therapy, both of which have relevance towards trauma and PTSD.

The first is an actual psychotherapy called Art Therapy, which uses art (drawing) as a form of communication between the therapist and client. The client draws pictures and the therapist interprets. Art Therapy is used in mental imagery and most often with children and highly traumatized patients, as an aid to open communication channels.

The second is the more common form, being the use of Art creation as a therapeutic relaxation technique. Art can range from drawing, painting, building or smashing something to pieces. Art Therapy when discussed as relaxation has no real boundaries. Painting a mural or performing graffiti are both considered Art Therapy.

The main functions of the left and right hemispheres are commonly known by art therapists: The left hemisphere is involved in analytical and sequential processes, whereas the right hemisphere deals predominantly with intuitive and syncretistic processes, in a parallel manner. Verbal information is processed predominantly in the left hemisphere, which is also in control of serial movements. Therefor the benefits of Art Therapy stimulate both hemispheric brain regions simultaneously.

Biofeedback / Neurofeedback

Neurofeedback is also called neurotherapy, neurobiofeedback or EEG biofeedback, that uses realtime displays of ElectroEncephaloGraphy (EEG) or Functional Magnetic Resonance Imaging (FMRI) to illustrate brain activity.

Basically speaking, this helps the therapist identify what regions of the brain are being stimulated during, therapy questioning in order to narrow discussions and focus on topics that are creating significant distress within specific brain regions, that attribute to symptoms. It assists in getting to the core of an issue faster, removing deceptive human behaviour through language that may be attributed to fear or secrecy of a trauma.

Biofeedback by itself is the same principle, yet may use more simple methods ranging from muscle tone, skin conductance, heart rate and pain perception, as well as standard Neurofeedback brain imaging.

Body-Mind Psychotherapy

This is not a hocus-pocus type therapy, this type of therapy is a somatic cognitive therapy. In other words, what is my body doing now, what emotion am I feeling, what is happening within me right now.

Commonly referred as "Mind Body", this is a combination of spirituality and empirically proven cognitive therapy. Spirituality and naturopathic approaches are often placebo based, like taking a sugar pill that you believe is a headache tablet, suddenly you no longer have a headache. Well, placebo effect is very real and empirically valid; spiritual belief is a common part of society within the world today, and the brain can heal trauma through nothing other than belief.

Mind Body therapies are as valid as Cognitive Behavioural Therapy (CBT) for PTSD, when performed correctly with empirically validated therapy, combined with the additional spirituality component, typically entailed in the session structure and approach.

The obvious attraction to this type of therapy is that the person is already a spiritual person. This type of therapy is not necessarily the right option for someone who is not a true spiritual believer.

Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is not a PTSD therapy. DBT is a therapy to treat Borderline Personality Disorder (BPD), which is often its own problem adjunct to that of a PTSD diagnosis.

DBT comprises the standard CBT methods, however; it extends specifically to cater emotion regulation, reality perception, distress tolerance, acceptance and stress management techniques. DBT is the first to extend the basic CBT model into a longevity approach for BPD sufferers, to change distorted functioning that caters its own impairment issues, irrelevant of PTSD itself. DBT has a moderate success rate in treating BPD, being the best to date of all treatments.

DBT can take years, all by itself, without even touching on trauma itself. BPD is as much its own problem to treat and heal as trauma. DBT uniquely combines a formulated approach, that as a result can cater to treat both BPD and then evolve directly into trauma treatment.

Emotion Focused Therapy

EFT, not to be confused with Emotional Freedom Technique, concentrates on bringing a person to an emotion felt in order to understand the emotion. The theory works on the premise that you must arrive before you can leave. So you arrive at an emotion, understand it, process it, before you can leave it in your past as a memory, not a negative emotion that is currently affecting your present.

I personally view this as being a constant already built into most common PTSD therapies, and not something to be pursued uniquely.

Emotional Freedom Technique

This technique is a placebo effect treatment. EFT is based from NLP, pseudo-science and naturopathic approach.

The therapy works on rating the intensity of your emotional distress whilst citing a statement such as "Even though I feel this anxiety, I deeply and completely accept myself" whilst rubbing a spot on your chest, or tapping from the therapist upon an acupressure point.

The placebo effect is real, however; this therapy would work for a minority of PTSD sufferers.

Gestalt Therapy

Gestalt therapy was developed in the early 1950's by a group of avant-garde psychologists, psychiatrists, philosophers and educators, as a movement against the psychoanalytic approach, instead adopting a model of human experience.

Gestalt is all about focusing on the persons experience in the present moment, the therapeutic relationship itself for mutual trust and respect, along with social and environmental aspects that are encompassed within daily life.

Gestalt is as commonly used as Person Centered Therapy for general counselling applications, and even used in most therapy sessions combined with other models. Its more a foundational approach to therapy than a focused trauma treatment. When you see your therapist, the majority actually use parts of Gestalt, regardless what other therapy models is being used that is more specific to trauma treatment itself.

If you were seeking relationship counselling as part of your PTSD, then Gestalt therapy would likely be used.

Hypnotherapy

Hypnotherapy is simply not recommended for the treatment of trauma. Whilst hypnotherapy may have a time and place for use, its not in trauma due to its subjective context and the ability of the therapist to plant memories in order for the patient to find relief. The brain surpasses tricks, and such tricks will hinder the person later in life as trauma will continue to seek outwards and want to be dealt with.

A hypnotherapists intentions may be well and good, but the facts are simple, with leading PTSD experts stating it should not be used for the treatment of trauma.

Massage Therapy

Massage therapy is empirically proven to provide stress relief along with a decrease in depression. Massage is the manipulation of the soft tissues of the body for a curative effect.

Massage involves the therapist using their hands to apply pressure on your body. Massage therapy is extremely beneficial to those who are highly stressed, especially business operators and persons who suffer anxiety and depression. Massage aids with mental relaxation and physical symptoms, such as pain.

Massage can really improve the symptoms of PTSD when done regularly, even if by a partner a few times a week or once weekly from a professional. Short, daily massage of key areas can significantly reduce stress and tension within the body, ie. shoulders, neck or back if sitting at a computer all day.

Massage is used to treat a wide range of disorders, including but not limited to insomnia, muscular tension, headaches and migraines, work related stress, repetitive strain injury, depression, arthritis, eating disorders and digestive dysfunction, pre-natal pregnancy conditions and much more.

The power of healing in massage is the energy that flows through the therapist’s hands in touch to refresh, regenerate and revitalise.

Its a real and viable option for PTSD sufferers to incorporate within their stress management.

Mindfulness Based Cognitive Therapy

Mindfulness-Based Cognitive Therapy (MBCT) is not a trauma therapy. Instead, MBCT was designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines some aspects of cognitive therapy with meditative practices, focusing on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.

MBCT covers some symptoms contained within PTSD, though it is not a trauma therapy. If you endured serious symptomology in depression and moods, and have successfully completed trauma therapy, then this would be a further option to refine and control those symptoms.

Outside of this scope, it has little bearing on PTSD therapy.

Neuro-Linguistic Programming (NLP)

NLP is a communication style programming model. Whilst NLP'ers, as practitioners are referred as, believe NLP has scope in treating trauma, there is currently zero empirical evidence to support such notions. Of studies done using neurological imaging techniques, NLP was found to not activate the key areas within the brain that other Tier 1 trauma therapies are validated for.

NLP could be considered a placebo treatment for some persons, as its focus is about communication and self confidence building, thus self-esteem. So whilst it has no scope in treating trauma whatsoever, I couldn't rule out that it does have a margin of scope for self-esteem improvement. Saying that, there are faster methods to improve self esteem than through communication skills, such as practicable exposure therapy.

Person Centered / Rogerian

Knowingly or not, Person Centered Therapy (PCT) is the foundation that all therapist use in communication with their clients. PCT defines a client to develop a sense of self wherein they can realize how their attitudes, feelings and behaviour are being negatively affected and make an effort to find their true positive potential. In other words, its about the therapist leading a client towards answering their own problem, because the brain responds faster to change a negative into a positive if the person themselves define the actual answer.

The brain accepts more readily a persons own belief system, and that is why PCT is the foundation of all therapy sessions, even when using another therapy type, PCT is being used constantly where practicable and within general communication, building the therapeutic relationship.

Reality Therapy

Reality therapy is a cognitive and behavioral therapy, though its focus is purely on the here and now, keeping clear of the past. This makes it more a basis counselling approach than a realistic therapy for treating trauma. To effectively treat trauma, you must go into the past at points to understand the problem towards the emotions being felt presently. Especially with complex trauma, past relationship dynamics must be explored in order to find understanding in the present, especially if abuser relationships are still present due to family orientation.

This makes reality therapy typically unsuitable for past trauma and only suitable for current traumatic events that are treated with immediate counselling.

Solution Focused Therapy

Solution focused therapy is an unrealistic therapy model for treating PTSD, as its focus for treatment is on the present and future only, goal oriented, disregarding the problems present based on why you need therapy.

Again, another general counselling model for minor and insignificant day to day issues, rather than PTSD severity of trauma. This is more the type of therapy you would use if you have healed all past trauma, lowered PTSD symptoms, and now need to maintain present and future goals through focus.

Conclusion

There is a diverse range of names given to the handful of foundational therapy types. These variations are merely renamed by someone looking to become a brand name within the therapeutic industry. Just take a look at this list of therapies from GoodTherapy.org (Types of Therapy), and you quickly understand this statements truth. Read some of the descriptions, and you begin seeing identical words, with one change in order to rebrand and author a new name for an old technique.

The simple conclusion is this. Don't be fooled by marketing. Marketing exists within the therapeutic field, just the same as any niche. There is no such thing as a power therapy to fix PTSD or cure PTSD. The moment you see such things, run the other way. Most of the popular techniques mentioned above are complete nonsense and purely placebo. Most lack empirical evidence to support them outside of the author and some hard core believers. Think cult. Some of the above therapies are absolutely empirically proven, substantiated, tested and proven effective for PTSD or to treat specific aspects of PTSD.

At the end of the day, if it works for you, then it works. Because it works for you does not make it a viable treatment option for PTSD though. As long as you get your end result, then you may be within that minority where you must seek alternative types in order to heal.

Everyone is different, and the end result is the aim, with no one path to achieve the result.
 
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#2
I agree with everything you say with regards to PTSD. The problem is, however, that PTSD is a bit of an umbrella term: it can include BPD, it is also used as an euphemism for ‘pure’ BPD. Then there are other disorders or conditions that don’t exist officially as yet, such as developmental trauma. Once again, an accurate diagnosis is essential, and this diagnosis may even be unofficial, e.g., ‘complex trauma’ (which is often another term for developmental trauma).
 
Thread starter #3
PTSD is not an umbrella for BPD or any other diagnosis. To be honest, BPD is so far from PTSD it really just isn’t funny. The scope of each aren’t even closely related. Not honestly sure what that has to do with this article, being about therapy types.

Complex trauma is not unofficial anything… complex trauma is not a diagnosis, it is a state of trauma infliction to reference those who’s trauma develops complex individual symptoms beyond standardised diagnostic categorisation. Again, developmental trauma is not a diagnosis, but reflects trauma within developmental years. Trauma is not diagnosis, and they should not be intertwined like you’re trying to use them…
 
#4
I’m not talking about DSM or ICD. I’m talking about Judith Herman who said BPD should be renamed complex PTSD. I’m talking about psychologists who use the diagnosis of PTSD for medical aid (insurance) purposes even though – I believe – psychologists are not qualified to make an official diagnosis. I’m talking about people who are given a diagnosis of PTSD even though the official diagnosis might be BPD, but due to the stigma, are not officially informed of that diagnosis.

Not everything happens strictly according to the literature, as has become clear on this forum. I’m referring to members who were ‘officially’ diagnosed with complex PTSD – even though it ‘does not exist’. Not all health care professionals are sticklers for correct labels. In fact, many avoid labels as far as possible, except for insurance purposes.
 
Thread starter #5
Ah, now I get you. I would still ere on the side of caution in calling BPD cPTSD, as they really are vastly different, even from Judith Herman herself, let alone Van Der Kolk as well. cPTSD symptoms seem separate to me, not just PTSD, not just BPD, but a combination of factors which really do call for a specific diagnosis / some serious additions to PTSD to cater complex trauma adequately.

We’re having a discussion about this now in the discussion forum, creating an all encompassing version, and I think the real addition is a regulation cluster, being where the primary difference between PTSD and complex trauma sufferers differ. Maybe you should have a look at it and input as required?
 
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Na2r410

#8
Wing Chun Kung Fu in my opinion is so far the best therapy I have ever encountered and I must be grateful to the art for allowing me to fight and regaining my life back!!!
can I ask what other methods of therapy you have tried? I love the thought of alternative therapy, but I am going through it right now, after years of being ok. For the first time in my life, I'm actually considering medication.
I already googled a Wing Chun place by me, just wanted a little more info from someone who deals with PTSD and their experience, if that's ok?
 
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