Posttraumatic Stress Disorder (PTSD)
It can be common to experience flashbacks or nightmares after witnessing or personally experiencing shocking or dangerous events. While symptoms might gradually decrease after one survives a natural disaster, a catastrophic accident, the death of a loved one, or grievous assault, others might continue to experience intense adverse effects for a much longer time. This is known as Post-Traumatic Stress.
Credit: CrashCourse
Here’s a crash course on PTSD!
Posttraumatic Stress Disorder (PTSD) is a debilitating psychological disorder.
Symptoms may include:
Ψ Recurring, intrusive thoughts of re-experiencing the events involuntarily, in the form of recollections, dreams, nightmares, and triggered flashbacks.
Ψ Hyper-arousal including anxiety, irritability, quickness to anger, and a sense of feeling exhausted from being continuously on alert.
Ψ Intense psychological distress when exposed to cues that resemble aspects of the traumatic event.
Ψ Avoidance of cues associated with the traumatic event.
Ψ Negative emotions and thoughts such as numbness, emotional distancing from others, alienation, or self-blame.
Symptoms typically begin shortly after the traumatic event. Occasionally, this may take a longer time, sometimes even years after the event occurred. Symptoms lasts for at least a month and are sufficiently severe, interfering with your work or relationships.
Why do some people suffer from PTSD and others don’t?
There are many factors affecting a person’s likelihood of developing PTSD, including gender and genetics. Research has evidenced that women are more likely than men to develop PTSD. Other factors include:
Ψ Experiencing immensely dangerous events and traumas (rape, serious injury, childhood trauma etc.)
Ψ Witnessing hurt on another person, a killing or a dead body
Ψ Having little or no social support after the event
Ψ Dealing with unrelated stressors after the event, such as loss of a loved one, pain and injury, or loss of a job or home
Ψ A history of mental illness or substance abuse (alcohol, drugs etc.)
Resilience factors
Just as there are factors increasing the risk of developing PTSD, there are also factors which mitigate it.
Ψ Seeking out support from other people, such as friends and family, or support groups
Ψ Helping others process trauma as part of your therapeutic process
Ψ Learning positive coping strategies
PTSD affects everyone in different ways, so there really is no standard way to address it. However, two concurrent modes of interventions are usually prescribed: medication and psychotherapy.
Medication
Antidepressants may be prescribed, which may help control PTSD symptoms including sadness, anxiety, anger and feeling numb inside. Medication is sometimes prescribed alongside psychotherapy.
We work along with our comrades in psychiatry to provide you holistic care on both ends if you require it.
Psychotherapy
Psychotherapy involves guided talk therapy with a trained mental health professional. It can occur one-on-one or in a group. PTSD specific therapy usually involves education about symptoms, equipping you with skills to identify triggers, and techniques to manage the symptoms.
There are two main forms of therapy used to address PTSD:
Ψ Cognitive Behaviour Therapy
A specific type of Cognitive Behaviour Therapy has been adapted for addressing PTSD in children and adolescents, known as Trauma-Focused Cognitive Behavioural Therapy (TF-CBT).
Ψ Exposure therapy
This involves individuals gradually confronting their fears and anxiety in a safe and controlled environment. Through repetition and regulating the intensity of exposure, Exposure Therapy aims to reduce the emotional intensity of these reactions to a manageable level, allowing individuals to rationalise and cope with their anxiety. The key is to ensure gradual exposure to the trauma experienced, but always in a safe and controlled environment. This may take the form of active imagining, writing, or revisiting the place where the event happened with your psychologist.
There are other types of therapy that are used in PTSD, like Acceptance and Commitment Therapy.
What is Trauma Focused-CBT (TF-CBT)?
TF-CBT is a type of Cognitive Behaviour Therapy (CBT) designed specifically to help children and adolescents suffering from PTSD (between 3 to 18 years of age). In short, CBT combines elements of behavioural therapy and cognitive therapy into a useful and targeted form of therapy.
The goal of TF-CBT is to educate the child and caregivers on PTSD and equip them with skills to identify and cope with emotions, thoughts, and behaviors that have developed after a traumatic event. TF-CBT achieves this by:
Ψ Developing and teaching coping strategies to deal with traumatic stress reactions.
Ψ Reduce symptoms of depression, anxiety, or acting-out behavior common in children exposed to trauma.
Most children will successfully manage PTSD if effective therapy is regularly administered.
Therapy is typically done over 12 to 18 sessions. Sessions include individual ones for the child, and also joint sessions with the child and caregivers. Specific interventions include:
Ψ Psycho-education: Learning about traumatic stress together with the child and caregivers; typical reactions and why they happen; the systems that may be involved (medical personnel, social workers, police, prosecutors etc.); the connection between thoughts, feelings and behavior; and what is involved in therapy.
Ψ Emotion regulation and correcting maladaptive beliefs: Learning to recognise typical trauma-related emotions such as fear, anxiety, sadness, grief, anger, or shame and learn specific skills to handle these difficult emotions in constructive ways. Identifying typical but unhelpful beliefs such as self-blame, that no one can be trusted, or that the world is permanently and constantly dangerous. Children and caregivers will be exposed to helpful and more accurate ways to process trauma.
Ψ Trauma narrative: Encouraging the child to remember and recount the traumatic incident without becoming upset or avoiding certain memories. It will involve handling cues and triggers that might remind your child of the trauma. The child and caregivers must work together to reframe the traumatic experience so it does not affect his or her present life. This is the main part of TF-CBT.
Ψ Positive parenting: This component teaches caregivers the skills to help them handle behaviours that are difficult or that interfere with family relationships.
Early intervention is key. Before trauma spins into a tornado of various mental disorders, it is encouraged to address it as early as possible to keep its impact to a minimum. If you think that you, or someone you know, may be struggling, seek professional help to improve your coping and functioning. Feel free to make an appointment with one of our experienced psychologists, like Max, for support with coping with PTSD!