Treatment of Post Traumatic Stress Disorder

Two Conditions for Recovery

Treatment for post traumatic stress disorder is now fairly well understood. First, numbness must be overcome. Second, the mind must be taught how to make sense of the traumatic event. Often, a third step, reconfronting the event, is required.

Overcoming Numbness

A large percentage of post traumatic stress victims experience a dulling of their daily experience. The brain has been over stimulated, and is unable to make sense of what has happened. Often, memories and emotions associated with the trauma will be ‘locked away’, affecting the victim subconsciously. For healing to begin, the event must be brought to light. This process is known as network activation.

A network (in this context) means a group of stored memories, emotions and thoughts. Activation means delving into the memories, often by attempting to recount them to a therapist. Sessions are long, typically running for two hours or more. The goal is to give the conscious mind access to the memories, emotions and thoughts that went with the trauma. Once a sufferer is comfortable with discussing the event, they are ready to proceed to the next stage of treatment.

Making Sense of Trauma

If the goal of the first stage is network activation, then the goal of the second is network modification. The sufferer’s schemas (frameworks in the mind which categorize experience) must be changed to cope with the new information. The goal is to give the victim more realistic mental frameworks.

For instance, if an earthquake victim once believed, “The world is always good to good people”, then they will be unable to cope with the tragedy that has befallen them. They may have even come to believe the schema, “The world is out to get good people”. Neither extreme view is realistic. Here the therapist will put the victim through a process of education. They may learn about life’s impartially to good or bad people. They will be bought to understand the forces behind the traumatic event.

Negative schemas can be more personal. For example, a victim may have developed a schema that tells them, “You are going crazy”. Social support, essential for all victims, is most necessary here. The sufferer needs concrete evidence of their own non-craziness. Social support can provide perhaps dozens of others with the same symptoms as them. This helps the sufferer form a more realistic view of trauma. The world isn’t out to get them, but bad things do happen to good people. The resulting schema is less simplistic and more realistic.

Confronting Trauma

The brain has extra responses to trauma that make treatment hard for sufferers. When a traumatic event occurs, our brains do their best to make sure that we avoid that situation in future. However, our brains are so desperate to keep us from further danger that they actually overwork on this front. Any stimuli that happen at the time of the event may be marked by the brain as something to avoid. This is why, for example, an assault victim might shake at the thought of an underground car park. An earthquake victim might refuse to go into a large room. Their subconscious is working to protect them from further danger.

Confrontation aims to show the victims that these associated stimuli do not indicate danger in themselves. The therapist will have the victim revisit the site of the event, either physically or (more commonly) in their imagination. Through a guided process known as desensitization, the victim learns that car parks, or large rooms, are not inherently dangerous.

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