Post Traumatic Stress Disorder (PTSD) is an anxiety disorder caused by one or more distressing, traumatic or unexpected experiences. It can be an overwhelming condition to live with, often involving flashbacks to the distressing incident, avoidance of triggers or reminders, and feeling alert to danger.
The National Institute for Health and Care Excellence (NICE) recommends Cognitive Behavioural Therapy (CBT) as one of the most effective ways of treating PTSD. We asked RSCPP-listed Registered Psychologist Sarah Lack to explain what CBT is and how it works as a treatment for PTSD.
CBT helps to process trauma memories which have not yet been processed in the same way as 'normal' memories. Developing PTSD is likely to be related to certain beliefs you may have adopted about the trauma, or the meaning you may have made of your traumatic experience. In turn, these may be influenced by prior negative beliefs about yourself, the world or others. CBT for PTSD is structured to adapt or rethink these beliefs and appraisals in order to allow you to gain a different perspective on what has happened and how it has affected you.
8-12 weekly sessions of up to 90 minutes each is the recommendation for CBT treatment for PTSD. Weekly 60 minute sessions are also possible, but the session number may therefore need to be increased to about 12-16, sometimes more, depending on the severity.
CBT can be tailored to suit anyone with mild/moderate or severe PTSD. If you have been traumatised by multiple events the treatment can take a slightly different form and may include techniques from other types of therapy. Alternatively, if you experience symptoms such as dissociation as a result of trauma, you are likely to benefit from a more phased approach, which allows you to learn coping strategies for controlling and/or reducing your dissociative symptoms first.
By the end of a course of CBT for PTSD, you can expect that any flashbacks, nightmares and other PTSD symptoms will have reduced considerably and, if they do still exist, that you are much less distressed by them. You can also expect to feel more confident about managing anxiety symptoms in general.
They should be accredited CBT therapists, or other therapists and psychologists with specific PTSD training from an accredited organisation.
You may be worried that you will make your symptoms even worse if you start talking about the trauma or thinking about your memories in detail. However, your therapist will explain to you the rationale for focusing on the difficult memories in a certain way and, after several weeks, you are likely to experience an improvement in your symptoms.