PTSD Therapy and Its Role in Healing PTSD
Therapy for PTSD diagnoses can be an important part of healing for those with posttraumatic stress disorder (PTSD). In fact, the U.S. Department of Veterans Affairs, which has studied PTSD therapy efficacy significantly, “strongly recommends” that anyone diagnosed with PTSD be offered a trauma-focused psychotherapy. But what forms of therapy are available for PTSD and what PTSD therapies work best?
Types of PTSD Therapy
There are many types of PTSD therapy that have been tested in trials and there is a wealth of evidence saying that therapy does work in PTSD treatment. The two types of therapy for PTSD with the best evidence are trauma-focused therapy and stress inoculation therapy. Examples of trauma-focused therapy include:
- Exposure-based therapies
- Cognitive-based therapies
- Eye movement desensitization and reprocessing (EMDR)
Other PTSD therapies that may provide some benefit but with a weaker evidence base include:
- Patient education
- Imagery rehearsal therapy
- Psychodynamic therapy (“talk” therapy)
- Relaxation techniques
- PTSD support group therapy
There is considerable overlap between therapy types and many specific therapies incorporate portions of several of the above.
Stress Inoculation Therapy for PTSD
Stress inoculation therapy focuses on anxiety and stress management with the use of PTSD coping skills. Stress inoculation therapy combines many therapeutic techniques, such as:
- Deep muscle relaxation training
- Breathing control
- Positive thinking and self-talk
- Real life exposure to anxiety-provoking stimuli
Exposure-Based Therapies for PTSD
There are several kinds of exposure-based therapies and examples of this include prolonged exposure therapy for PTSD, brief, eclectic psychotherapy, narrative therapy and written exposure therapies for PTSD.
Exposure-based therapies for PTSD emphasize exposure to the stimuli that remind the person of the trauma and cause anxiety. Exposure may be in person, done through imaginings, written or oral. Very small amounts of exposure are initially done and then, little by little, the exposure gradually increases until the person is able to control their anxiety around that stimuli.
While this therapy can sound scary at first, exposure therapy has been well studied and when done by a qualified practitioner, in a safe and steady way, it has been shown to be very effective.
Cognitive-Based Therapies for PTSD
There are many cognitive-based therapies used to treat PTSD including cognitive behavioral therapy and cognitive processing therapy. In cognitive-based therapies for PTSD, the way a person thinks and feels is challenged and, in the end, modified.
For example, the way a person thinks or feels about his or her own safety may have been directly affected by the trauma. A person may not feel safe in a restaurant, for example. In a cognitive-based therapy, the belief that one is not safe in a restaurant would be challenged in a thought-out and logical way in an attempt to “reality test” (see whether the thought is truly reasonable) the belief.
Relaxation techniques and discussion or narration of the traumatic event are also often included in cognitive-based PTSD therapies.
Eye Movement Desensitization and Reprocessing for PTSD
Eye movement desensitization and reprocessing (EMDR) therapy may seem like quite a mouthful, but this type of PTSD therapy has been extensively studied in controlled trials and has been shown effective. EMDR therapy combines an exposure therapy component along with a cognitive component and relaxation/self-monitoring techniques. EMDR differs in that one of its key components is eye movement, as the name suggests, or other forms of distraction or physical stimulation.
Last Updated: 24 October 2018
Reviewed by Harry Croft, MD