Different Therapies for Posttraumatic Stress Disorder (ptsd)

Essay Topic: Compare and contrast effectiveness of different forms of therapies in treating posttraumatic stress disorder.

Different therapies for posttraumatic stress disorder (PTSD)

Introduction

Traumatic events or bad experiences are unavoidable in life. People might have the experience of losing a beloved or being humiliated by others which would generate hard feelings for a period of time. It is not rare to hear from people that they could not fall asleep or feel vulnerable after tragic events. Despite the negative outcomes mentioned above, it is not enough to diagnose someone are suffering from posttraumatic stress disorder (PTSD). PTSD is more than that.

PTSD is an anxiety disorder that develops when someone have been exposed to an extreme and unusual traumatic event, such as sexual assault, witnessing a murder case or natural disasters. To diagnose PTSD, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), the unexpected and sudden traumatic event must have the potential to cause actual harm or threats to life or the physical integrity of self or others. Also, it is crucial that the individual has experienced intense fear, horror and other symptoms persistently for at least one month after the event (Bisson, 2007).

According to HazeIden Foundation (2008), there are three types of characteristic symptoms of PTSD adapted from DSM IV: 'Re-experiencing Phenomena' (re-experience through intrusive memories, dreams, etc.), 'Avoidance and Numbing' (avoid specific places or people or detach from others) and 'Increased Arousal' (increased heart rate, difficulty sleeping, etc.). Eliminating these symptoms is the target of most treatments for PTSD.

The causes of PTSD are mainly genetic predisposition and environmental factors. The severity of the trauma also matters. More severe events are more likely to cause PTSD. Yet, the reason why some people do not develop PTSD after traumatic event is still being investigated.

To treat PTSD, there are mainly two approaches: medication and psychotherapy.

Pharmacological Therapy

In order to help PTSD patients ease their suffering, medication is often prescribed by psychiatrists or clinical practitioners. Several types of medications are effective in treating PTSD. Selective Serotonin Reuptake Inhibitors (SSRIs), which are generally regarded as "antidepressants", are the most popular medications prescribed for PTSD. These antidepressants include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) (Cohen, 2006). According to Mayo Foundation for Medical Education and Research (2011), antidepressants can help increase concentration and ease sleep problem. Other types of medication include antipsychotics and anti-anxiety medications which can relieve intensive anxiety and other emotional problems. Prazosin may also help in reducing nightmares and insomnia situation in PTSD patients.

Psychotherapy

Another important treatment approach is psychotherapy. A range of psychotherapies, including cognitive-behavioral therapy, eye movement desensitization and reprocessing, group psychotherapy, stress inoculation training, etc., are effective in improving the symptoms of PTSD. Pointed out by Cohen (2006), these therapies share some common features. For example, most of them not only focus on reducing symptoms, but also aim at dealing with the memory related to the traumatic experience.

Cognitive-behavioral therapy

Behavioral therapy aims at modifying certain useless actions or behaviors of patients while cognitive therapy focuses on changing wrong perceptions and thoughts in patients' mind. Cognitive-behavioral therapy (CBT) is the integration of behavioral therapy and cognitive therapy that it forms important strategies in counseling and psychotherapy (Corey, 1996). It is one of the most widely used psychotherapy for PTSD. According to Hazelden Foundation (2008), CBT aims at changing the thoughts and behaviors of the patients so as to change their emotions. Negative trauma-related thoughts are uncovered in CBT first so that new thoughts and behaviors which are positive, accurate and adaptive can replace the old ones in the treatment. Several special techniques are designed to help patients achieve this cognitive and behavioral changing.

Exposure therapy is a one of those well-established techniques treating PTSD. It requires the individual to concentrate and recall the content of a traumatic event which has effects on the mental and physical health of that individual. Step-by-step, the patient will be able to face and gain control of their fears and depressed mood. The therapy can be imaginal or in vivo. Yet, therapist should bear in mind that the therapy should be done very carefully to avoid re-traumatization of the patient, as the treatment sometimes involves confrontation with frightening stimuli all at once until the anxious level decreases ("flooding"). It is recommended that the therapy should go on gradually up to the most severe memories and can be accompanied by relaxation techniques (Cohen, 2008; Rothbaum & Schwartz , 2002).

Cognitive restructuring is another primary technique which helps to promote more positive and meaningful thinking in patients. CBT holds that people's feelings and behaviors are the products of our thinking and belief. These cognitions shape people's self-evaluation and interpretation on things happened to them. However, sometimes people unconsciously interpret or evaluate things based on their distorted thinking or belief. Therefore, for change to occur, it is important for them to realize their biases and misconceptions through looking deeper in their own behaviors. In other words, cognitive restructuring helps patients to be aware of their thoughts and replace the distorted ones with more accurate and functional ones (Corey, 1996).

Other techniques include relaxation training, positive coping skills training, breathing retaining, stress inoculation etc., which are also helpful in treating PTSD.

Eye movement desensitization and reprocessing

Here comes another type of integrative treatment for PTSD: eye movement desensitization and reprocessing (EMDR). According to Chemtob et al. (2000), patient in EMDR is asked to focus on an image related to the trauma or certain negative feelings, sensations and thoughts connected to the traumatic event. At the same time, his or her eyes have to focus on something else, such as the therapist's fingers that are moving side