Coping With Traumatic Stress Through Trauma-Focused Treatments And Trauma Therapy Techniques For PTSD
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What is post-traumatic stress disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is a serious mental health condition that can have significant impacts on a person’s ability to function. It can develop in some people after they survive a traumatic experience or a series of traumatic experiences, which can range from childhood neglect to sexual abuse to workplace bullying to serving in the military and others. The symptoms of PTSD can also lead to the development of other mental health challenges, such as substance use disorders and suicide ideation. One study found that the estimated societal cost of PTSD in the United States is over $200 billion.
Treatment options: Trauma-focused treatments and trauma therapy techniques
There are effective treatment options for PTSD, such as trauma-focused therapy. Research suggests that over half of people who receive trauma-focused therapy treatment experience a reduction in their PTSD symptoms to the point where they no longer meet diagnostic criteria for the disorder. These therapies include cognitive processing therapy, prolonged exposure therapy, eye movement desensitization, and reprocessing therapy, and, for certain types of trauma, narrative exposure therapy.
Cognitive processing therapy
Cognitive processing therapy (CPT) is one such form of talk therapy. CPT is a variant of cognitive behavioral therapy (CBT), which is also sometimes referred to more simply as cognitive therapy. Cognitive behavioral therapy is based on the idea that a person’s thoughts and behaviors are related, and that changing unhelpful thoughts can then reduce instances of unwanted behaviors. Cognitive processing therapy more specifically focuses on the cognitive side of the equation: examining unproductive thoughts.
CPT can help suppress negative emotions related to a traumatic event
Many PTSD symptoms are related to suppressed negative emotions connected to the trauma, which may then surface in disturbing ways, such as nightmares and flashbacks. CPT can teach people to evaluate and change their thoughts about their trauma, which may then lead to changes in a person’s emotional response to the traumatic memories.
Prolonged exposure therapy
Avoidance is a signature symptom of PTSD. People with PTSD may avoid people, places, and situations that remind them of their trauma, which can impede their ability to function in their day-to-day lives. Alternatively, they may seek to avoid thoughts or emotions related to the trauma, which can then lead to problematic numbing behaviors like self-harm or substance misuse.
PET is a treatment option that helps clients confront their trauma
Prolonged exposure therapy (PET) is a form of PTSD treatment designed to help clients confront what they have been avoiding. This process can help people to retrain their brains, bodies, and nervous systems to become less easily activated. In general, coming to understand that situations and feelings related to the trauma are not going to cause further trauma can help decrease PTSD symptoms.
With PET, a client will work with a therapist to gradually start re-engaging with situations that have prompted avoidance. They will learn breathing and relaxation exercises to calm the anxiety these situations may provoke. Most people begin by confronting the least frightening situations and gradually working their way up to the ones most closely associated with the trauma.
With this therapy approach, therapists and clients also often engage in what is called “imaginal exposure.” With imaginal exposure, a person will talk through the specific details of their trauma with their therapist, who records the conversation. The patient then listens to the recording afterward, which research suggests may help reduce incidences of intrusive PTSD symptoms like flashbacks and nightmares.
Eye movement desensitization and reprocessing (EMDR) therapy
Eye movement desensitization and reprocessing (EMDR) therapy is a newer but promising treatment for PTSD. One of the central concerns with many forms of PTSD therapy is that engaging with traumatic memories can result in re-traumatization, which may sometimes actually make PTSD symptoms worse. With EMDR therapy, however, therapists help clients enter an alternative state of mind in which memories of their traumatic experiences may be compartmentalized. While the therapy can be distressing in the moment, it usually does not result in the kind of lasting emotional turmoil that other PTSD therapies may elicit.
Bilateral stimulation
EMDR therapy sessions involve a technique called bilateral stimulation. This involves the two opposite sides of a person’s brain being activated while they are asked to recall aspects of the trauma, typically by following a therapist’s finger back and forth with their eyes, having a therapist tap on the backs of their hands, or holding alternating buzzers in their palms. The resulting mental state is thought to be similar to rapid eye movement (REM) sleep.
While the neurological underpinnings of EMDR therapy are still being researched, existing studies suggest that this technique can be an effective treatment for PTSD. Its effectiveness has been so noteworthy that it is now recommended as one of the first courses of PTSD treatment by the American Psychological Association.
Narrative exposure therapy
Narrative exposure therapy (NET) is one of a group of specialized treatments for particular kinds of trauma.
Different traumas that NET can treat
- Complex trauma. Complex trauma refers to traumatic experiences that are not single events, like surviving a one-time natural disaster or sexual assault. Instead, complex trauma involves repeated, ongoing traumatic situations that typically relate to a person’s most formative relationships, like caregivers in childhood or intimate partners in adulthood. Examples of events that can lead to complex trauma include abuse, neglect, domestic violence, and human trafficking.
- Multiple traumas. Like complex trauma, the term “multiple traumas” also refers to traumatic experiences that are repeated over time. However, multiple traumas usually do not center around meaningful relationships but rather larger societal issues. Common examples of multiple traumas include community violence, racism, discrimination, war, poverty, imprisonment, and torture.
Narrative exposure therapy is based on the idea that the stories people tell themselves about their lives can influence their perceptions of their own experiences and well-being.
Steps of narrative exposure therapy
- A person develops a chronological story about their life, focusing in large part on their traumatic experiences but also including other, more positive life events.
- The therapist encourages the person to fill in the details of their traumatic memories, which can often be fragmented. The person is asked to focus on their emotions, thoughts, sensory memories, and physiological response to the trauma.
- The therapist creates an autobiographical document summarizing the person’s story and gives it to them at the conclusion of NET treatment.
It is believed that engaging in NET can help a person refine, process, and understand their perception of traumatic experiences. NET may also help a person build a sense of personal identity and self-respect, acknowledge their dignity and humanity, and help them contextualize their emotional responses to trauma.
Finding mental health support for processing traumatic experiences or a specific traumatic event
Connecting with a therapist to work together using one of the above therapeutic techniques can be a crucial component of recovering from trauma and trauma-related disorders like PTSD. Working with a therapist may help a person reduce PTSD symptoms and learn ways to build their resilience to trauma through techniques like stress inoculation training, which may decrease the odds of PTSD symptoms recurring in the future.
Online therapy as mental health support
Attending an in-person therapy appointment can be a stressful experience for some trauma survivors, though. Online therapy may be a beneficial alternative for people who may be more comfortable being vulnerable in their own homes.
Efficacy of online therapy for treating post-traumatic stress disorder symptoms
Peer-reviewed research indicates that therapy attended online may be just as effective as traditional in-person therapy when it comes to treating symptoms of PTSD. For example, findings from one study suggest that engaging in online CBT—the umbrella term for treatments that include cognitive processing therapy and prolonged exposure therapy—may reduce PTSD symptoms to a similar degree as in-person CBT.
Takeaway
What is one example of effective trauma-focused treatment?
One effective trauma-focused treatment that is highly successful is cognitive processing therapy, or CPT. It is a type of talk therapy that addresses how a traumatic event may affect an individual's mental health. CPT helps clients understand their own unhelpful beliefs related to the trauma. During the therapy process, individuals may learn healthier coping skills and may notice improvements in their physical well-being. Over time, CPT may reduce trauma-related symptoms, guiding people through their healing journey.
What is a trauma-focused therapy approach?
A trauma-focused therapy approach directly addresses how traumatic experiences affect a person's everyday life. It's different from other treatments because it carefully works with the individual's trauma memory, helping them gently face difficult emotions. This type of therapy supports clients' understanding of their reactions and teaches personalized coping methods. It can also provide tools to help someone who has experienced trauma actively resist retraumatization when dealing with challenging trauma reminders. Many people might find this approach useful because it reduces the widespread impact of trauma on their daily lives.
What is the difference between CPT and EMDR?
CPT and EMDR are both trauma-focused interventions designed to address trauma, but their methods may differ significantly. Typically, CPT therapy aims to challenge and change negative beliefs related to the trauma experience. On the other hand, EMDR uses eye movements to reduce emotional intensity linked to trauma memory and help process past experiences. EMDR might also include techniques for nervous system calming and relaxation skills. Both therapies could offer potential benefits, although their processes and tools may vary.
What is the focusing technique for trauma?
The focusing technique for trauma helps people notice feelings in their bodies connected to a specific trauma memory. It builds awareness of how past experiences shape current coping skills. People may learn to handle intense emotions triggered by traumatic reminders with gentle guidance. Over time, this method may support fully integrating knowledge about trauma, leading to personal growth. It generally works well for both acute trauma and chronic trauma.
What is the difference between trauma-focused therapy and CBT?
While trauma-focused therapy specifically targets trauma and how traumatic experiences affect someone, standard CBT typically addresses broader emotional and behavioral concerns. Trauma-focused approaches actively engage with the trauma experience and help individuals process their feelings toward a specific event. Regular CBT often focuses on general coping strategies rather than working directly with a singular traumatic experience. In a trauma-focused approach, treatment emphasizes managing specific adverse effects such as substance abuse, and it may help individuals with past addictions eliminate harmful behaviors. This specialized version of CBT addresses the unique challenges connected to trauma.
What is the most successful trauma therapy?
The most effective and successful trauma therapy depends on each person's specific needs and the kind of trauma they've experienced. Evidence shows that trauma-focused CBT often helps with childhood trauma or ongoing chronic trauma. Still, other options like accelerated resolution therapy or psychodynamic therapy might offer helpful potential paths for different people. Each therapy could support the individual's emotional and spiritual well-being. The success of trauma-focused therapy often involves identifying effective coping skills and methods for resisting retraumatization.
What are the three phases of trauma-focused CBT?
Trauma-focused CBT usually has three phases. First, therapists help clients with stabilization by managing early trauma-related symptoms. Next, they gently work through the person's trauma memory, helping them face difficult feelings and experiences. In the final integration phase, therapists reinforce healthier coping skills to support ongoing personal growth throughout the recovery process. At any stage, therapists may help with other related challenges like personality disorders or risks of substance abuse. The structured nature of this therapy process helps clients understand how to better cope with future traumatic reminders.
What are the trauma-focused care principles?
The principles of trauma-focused care include safety, trustworthiness, choice, collaboration, and empowerment. These ideas help individuals comfortably access trauma-informed treatment. They should follow the guidelines from the Substance Abuse and Mental Health Services Administration, prioritizing each person's comfort and well-being when addressing trauma. Using these principles might lower the chance of developing long-term illness related to unresolved trauma. Overall, trauma-focused care builds awareness about how traumatic experiences affect a person's life.
What are the six components of trauma-focused cognitive behavioral therapy?
Trauma-focused therapy, such as TF-CBT, includes six main components: psychoeducation, relaxation, affective regulation, cognitive coping, trauma narrative, and in-vivo exposure. This structured approach is central to effective trauma treatment. Each component helps individuals who have experienced trauma build skills to manage their reactions. As a specialized type of trauma-informed treatment, this therapy addresses trauma clearly and step by step. Together, these components make trauma-focused therapy practical and supportive.
How is trauma therapy different from regular therapy?
Trauma-focused therapy specifically helps individuals who've experienced trauma, addressing their unique needs directly. Unlike regular therapy, trauma-informed therapy focuses closely on the emotional effects of trauma and helps clients feel safe during sessions. While regular therapy may cover general emotional struggles, trauma-focused therapy works directly with trauma memories and the stress they can cause. The careful attention given to safety, trust, and trauma-specific techniques makes trauma-focused therapy distinct.
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