Types of Psychotherapy for Combat PTSD
Wednesday, December 4 2013 Harry Croft, M.D.
As I mentioned last time, combat post-traumatic stress disorder (PTSD) is a subtype of standard PTSD so when we talk about the psychotherapies that effectively treat combat PTSD, we are really talking about psychotherapies for PTSD in general.
The good news is that several psychotherapies have been shown to work in treating combat PTSD.
Psychotherapy and Medication in Combat PTSD
It’s important to realize that psychotherapy may not be enough in severe cases of combat PTSD. Often, medication is used to handle the, sometimes very severe, physical aspects of combat PTSD (read about treatment of PTSD). Once these are controlled, the issues can be more fully dealt with in psychotherapy.
Delivery of Psychotherapy in Combat PTSD
Psychotherapy can be delivered in several ways. It may be delivered one-on-one in a traditional psychotherapy dynamic or it may be delivered in a group setting with others who also suffer from PTSD. Sometimes a group setting works particularly well as the individual learns that others are struggling in the same way, with the same issues.
Combat PTSD psychotherapy may also be delivered to a whole family, rather than just the sufferer. This can help heal the various wounds in the family that tend to come about when one person is experiencing combat PTSD.
Cognitive Behavioral Therapy for Combat PTSD
According to Medscape, a meta-analysis of studies on adults with PTSD showed that trauma-focused cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) should be first-line nonpharmacological treatments. CBT may be delivered in-person or even by computer program.
In cognitive behavioral therapy the therapist helps you change how you think about the trauma and its aftermath. You learn to identify your thoughts around the trauma, how these are distressing you and then replace these thoughts with less distressing ones. You also learn how to cope with strong emotions like those of fear, guilt and anger.
Eye Movement Desensitization and Reprocessing Therapy for Combat PTSD
This psychotherapy also works to change how you react to memories of trauma. According to the National Center for PTSD, EMDR works in the following way: “While thinking of or talking about your memories, you'll focus on other stimuli like eye movements, hand taps, and sounds. For example, your therapist will move his or her hand near your face, and you'll follow this movement with your eyes.”
Experts are still working on determining exactly how EMDR works, but it appears it may lessen PTSD symptoms.
Other Types of Psychotherapy for Combat PTSD
Other types of therapy are also sometimes used to treat combat PTSD and this includes psychodynamic or “talk” therapy and a technique known as exposure therapy which aims to produce less fear around your memories by repeatedly talking about the trauma.
Treating Combat PTSD with Psychotherapy
It’s important to remember that treatment for combat PTSD works and lessens the symptom duration by almost half, on average. Your best chance of full recovery is rapid engagement with treatment, a good support system, avoidance of retraumatization and avoiding substance abuse.