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Posttraumatic Stress Disorder and Treatment

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By Luke Dalfiume, PhD, Licensed Clinical Psychologist, Co-Owner, John R. Day & Associates, Christian Psychological Associates

We have all experienced traumatic events. However, some experience highly traumatic events, and have difficulty recovering from them. Posttraumatic Stress Disorder (also known as PTSD) describes a variety of experiences, following exposure to one or more traumatic events. Common traumas include, as indicated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): “. . .exposure to war as a combatant or civilian, threatened or actual physical assault (e.g., physical attack, robbery, mugging, childhood physical abuse), threatened or actual sexual violence (e.g., forced sexual penetration, alcohol/drug-facilitated sexual penetration, abusive sexual contact, noncontact sexual abuse, sexual trafficking), being kidnapped, being taken hostage, exposure to a terrorist attack, torture, incarceration as a prisoner of war, natural or human-made disasters, and severe motor vehicle accidents.”

Some people re-experience the event as though it is happening again, with thoughts, emotions, and even physiological responses similar to what they experienced in the actual event. Other people have depressive or negative thoughts, or difficulty experiencing pleasure. Some disconnect from objective reality, dissociating. This latter disconnect is frequently experienced as emotional numbing, though it can, in more extreme cases, result in feelings of disconnect from one’s own body for hours or days at a time (a dissociative process called depersonalization).

According to the DSM-5, the lifetime risk for PTSD, as evaluated at 75 years of age, is 8.7 percent. The symptoms noted above generally begin within three months of the trauma, though this is not necessary. PTSD can impact a person’s ability to function adequately socially and in school or at work.

There are various treatments for PTSD. They are often best used in combination, as opposed to individually. Psychotropic (psychological) medication treatment can be helpful, particularly the use of antidepressants. Though antidepressants generally take several weeks to reach a therapeutic level, once this level is achieved there can be a significant reduction in the depressive and anxious symptoms associated with PTSD. Specifically antianxiety medications may be used (Xanax, for example). However, there is a risk of dependence with antianxiety medication use, so they should be used with caution.

Traditional psychotherapy, in which the person “works through” their traumatic experience and the consequent thoughts and feelings related to it, is also often helpful. The person with PTSD is able to sort through their experiences, getting to a point where, as I say, they can “put the experience on the shelf” so it is not experiencing their daily functioning so significantly as before. It is useful to identify unhelpful thoughts and behaviors, and to identify more functional ways of approaching experiences both cognitively and behaviorally.

Relaxation training and clinical hypnosis may also be useful. These techniques provide tangible ways of reducing the mental and physical tension that is frequently present for those experiencing PTSD. Both techniques involve using the mind to wind down rather than wind up.

Eye Movement Desensitization and Reprocessing (EMDR) therapy is a newer technique that is now part of the accepted and recommended treatment for trauma. EMDR involves the processing of trauma, either verbally or nonverbally, while experiencing bilateral brain stimulation. The bilateral brain stimulation (in which both hemispheres of the brain are activated while the trauma is processed) may occur in a variety of ways. Some use a motion, such as waving a finger back and forth in front of the client, or alternating lights. The bilateral stimulation may involve other bilateral stimulation, however, such as sounds or vibrations (from paddles held in the hands; this is what I use). It does not matter, as long as the stimulation involves activation of both sides of the brain.

This technique sounds bizarre. I was skeptical of it for many years, but, as I said earlier, it is now considered to be an accepted form of trauma treatment. Researchers have discovered it to be a valuable tool helping those who experience trauma to recover more quickly. After many years of skepticism, I finally received training in this form of treatment slightly more than a year ago. I have found it to be a valuable tool as I help trauma survivors regain a sense of emotional wellbeing.

For more information or to book an appointment, contact John R. Day & Associates, Christian Psychological Associates, located at 3716 West Brighton Avenue, Peoria, or their additional locations in Normal, Canton, Pekin, Princeton, or Eureka. Call us at 309-692-7755 or visit us online at www.christianpsychological.org.

Photo credit: KatarzynaBialasiewicz/iStock