Comparing PTSD Therapies: Cognitive Behavioral Therapy, EMDR, And More

Post-traumatic stress disorder, often referred to as PTSD, is a mental health condition that may develop in people who have witnessed or experienced a traumatic event. The effects of PTSD may lead to distressing symptoms, such as flashbacks, anxiety, and depression. These effects can impact the way a person thinks, behaves, and interacts with the people around them. However, there are effective treatments for managing PTSD symptoms that may even help some people achieve remission. In this article, we’ll explore treatment options for PTSD.

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What is PTSD?

PTSD is a mental health condition that can occur in people who have witnessed or experienced a traumatic event, such as combat, a natural disaster, or physical or sexual assault. Symptoms of PTSD may include:

• Flashbacks: Flashbacks can be defined as recurring, intrusive memories of the traumatic event that can seem as though the event is happening again.
• Nightmares:Nightmares can be described as recurrent, distressing dreams of the event or related themes.
• Avoidance behaviors: Individuals with PTSD may try to avoid people, places, or situations that remind them of the traumatic event.
• Negative thoughts and mood: People with PTSD often experience negative thoughts about themselves and the world. They may experience a sense of emotional numbness and detachment from others.
• Hyperarousal: Hypervigilance, irritability, difficulty sleeping, and an exaggerated startle response can all be symptoms of hyperarousal in PTSD.

PTSD affects approximately 7% of the population at some point in their lives and can significantly impact daily functioning. Only a licensed mental health professional can diagnose PTSD and other mental health disorders.

Risk factors for PTSD

While there's no single cause that leads to PTSD, scientists have discovered many risk factors that can make someone more vulnerable to developing PTSD. Here's what researchers suspect makes someone more likely to face challenges after a traumatic event:

• Genetics: Studies have shown that genes related to neuroendocrine function, the fear response, and immune system regulation may be linked to PTSD. While trauma itself isn't hereditary, some people may have a predisposition to develop the disorder.
• Previous trauma: Having experienced previous traumatic events can increase the likelihood of developing PTSD after a subsequent traumatic event.
• Severity and duration of trauma: The severity and length of exposure to a traumatic event can also contribute to the development of PTSD.
• Lack of social support: People with strong social networks and support systems may be less likely to develop PTSD compared to those who do not have these resources.

Common treatment types for PTSD

The main evidence-based treatments for PTSD include medication and talk therapies. The type of treatment a doctor recommends to someone with PTSD depends on the person’s symptoms and individual needs. The goals of PTSD treatment are to manage symptoms, improve emotional regulation, and improve daily functioning.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy generally teaches people to recognize unhelpful thought patterns that could contribute to negative emotions and unhelpful behaviors. By learning to replace those thoughts with more balanced perspectives, CBT can empower you to feel and act in a healthier way.

One type of CBT frequently used for PTSD is cognitive processing therapy (CPT). Your therapist may guide you in carefully revisiting your traumatic memories, helping you explore how these experiences may have impacted your beliefs. This kind of therapy usually helps you understand how traumatic memories influence your present life, potentially opening the door to change. 

If you prefer a less direct approach to processing the past, cognitive therapy might be a good fit. It usually focuses on reshaping your current beliefs and thought patterns.

In general, CBT isn't a passive process. You and your therapist typically work together to identify thought patterns, and you'll likely have take-home exercises to practice new skills outside of therapy sessions.

Eye movement desensitization and reprocessing (EMDR)

After a traumatic event, some memories can seem to be "trapped" in your brain, keeping the hurt fresh and raw. EMDR is a unique therapy that can directly target those "stuck" memories. It may guide you in processing them in a way that reduces their intensity and makes them less disruptive.

These unprocessed memories might erupt as flashbacks or intense emotional reactions. EMDR normally uses guided eye movements (or other types of rhythmic stimulation) paired with re-engagement with the traumatic memory, with the goal of loosening its emotional grip.

The exact mechanisms of EMDR aren't fully clear, but the therapy seems to alter the brain's way of storing memories in a positive direction. For many, the result is less intrusive and less distressing flashbacks connected to the trauma.

Prolonged exposure (PE)

Fear is often a driving force behind many PTSD symptoms. Prolonged exposure therapy can target that fear head-on. The core idea is generally that avoiding triggers only makes your anxieties worse over time. This therapy can take you, in a carefully controlled way, directly toward the things you fear. 

Your therapist will usually be by your side, guiding you through the process of revisiting the trauma or gradually confronting situations that trigger those painful feelings. The steady work of confronting these triggers can eventually reshape your brain's alarm system, making those fears seem less overwhelming.

Self-care strategies for PTSD

PTSD can come with a sense of constantly being on guard. In general, self-care is about taking some power back. It won't necessarily cure PTSD on its own, but it can help you cope with the symptoms and make day-to-day life seem more manageable. Some ways to incorporate self-care in your daily life include:

• Focusing on basic needs: When your body and mind are under stress, the basics matter. Regular sleep, nutritious meals, and some form of daily movement can provide a stable foundation for managing tough emotions.
• Mindfulness techniques: Trauma can result in a sense of disconnection from the present moment. Mindfulness practices like simple breathing exercises and guided meditation can ground you in your body and ease overwhelming experiences, like flashbacks or anxiety attacks.
• Soothing routines: Our brains tend to crave predictability, something PTSD can disrupt. Calming rituals like a warm bath before bed, a morning walk, or a few minutes of quiet with a cup of tea can signal safety to your nervous system.
• Seeking social support: PTSD can be isolating, but connection can help. Leaning on loved ones and finding support groups may allow you to connect with others who understand your experience. Knowing you're not alone can make a difference.
• Understanding your triggers: Paying attention to the situations, thoughts, and sensations that seem to worsen your symptoms can help you develop coping strategies and avoid unnecessary emotional turmoil.

Self-care isn't a selfish act; it's often a necessary part of healing. You can create a list of self-care strategies that work for you and incorporate them into your daily life.

Additional approaches for managing PTSD

Outside of the mainstream therapies, there are also alternative and complementary approaches to treating PTSD. While research on treating PTSD is still ongoing, many people have found relief from incorporating multiple types of therapies into their treatment plans. Some additional treatments include the following:

• Medication: Antidepressants, specifically those that affect brain chemicals like serotonin, can help with some PTSD symptoms, such as low mood, anxiety, and intrusive thoughts. While medication can be a useful tool for coping with PTSD, it should generally be used in conjunction with therapy.
• Group therapy: Group therapy can offer connection and validation. Hearing others' similar experiences can help you understand that you aren't alone.
• Other therapies: A mental health professional might suggest additional options tailored to your specific needs, like stress-reduction techniques or skill-based therapies focused on emotional regulation.

The best approach to treating PTSD may depend on your unique experiences and preferences. Some people with PTSD may withdraw and may find it difficult to leave their home. With online therapy, you can attend therapy sessions from the comfort of your own home, which may help some people with PTSD engage more with their therapist. You can also message your therapist at any time, and they’ll respond when they’re available, which may be helpful if you’re navigating symptoms of stress and anxiety throughout the day.

The body of research supporting online therapy for PTSD continues to grow. Studies demonstrate that online formats can be just as effective as traditional in-person settings. Certain therapies, like those focusing on processing traumatic memories, can be particularly successful in a virtual environment. 

Healing from PTSD often takes time and effort. Your personal journey might include a combination of traditional and alternative therapies. There isn't always one solution to treating trauma-related disorders. Working closely with a therapist can help you find the best path toward healing and recovery.

Has trauma impacted your life?

Learn coping skills in online therapy