Last week, I attended a well orchestrated day long conference on treating people with Post Traumatic Stress Disorder (PTSD). Organized by Dr. Rex Swanda from the New Mexico VA, the content of the conference primarily focused on therapeutic practices that have been studied and found to be effective in treating those who suffer from this disorder. Treatments that are considered evidence based have been subjected to at least several independent research studies, compared to other types of treatment, or to no treatment. Here is an abbreviated description of PTSD.
PTSD can occur when people suffer or witness a traumatic event in which they are threatened with death, injury, or physical violation. During the time of the trauma these people respond with horror, fear, or helplessness. The symptoms of PTSD include some of the following:
If you have concerns that you or someone you care about has PTSD, please consult with a mental health professional for a diagnosis and treatment plan.
Now, back to the conference. There were multiple sessions that mostly reviewed the effective treatments for PTSD. Not surprisingly the therapies that work are based on mixtures of cognitive and behavioral therapies. These approaches have stood the test of time and science. Cognitive Behavioral Therapy (CBT) has been used to successfully treat a wide range of emotional and behavioral problems.
It’s fun when the conference planners inject a bit of controversy to keep the audience awake, especially after lunch. So I looked forward to the speaker, a psychologist well known for his narrative ability, humor, and intelligence. I was riveted by his stories, but disappointed when he slid into the sad old tale of how empirically validated therapies are woefully insufficient for those with severe trauma. His arguments were dated and dismissive. This same argument has been made for the past several decades. Ostensibly, cognitive behavioral therapies don’t address critically important culture differences, early developmental issues, individual differences, and fail to include warmth, empathy, and concern for clients.
It was too bad that the speaker did not stay at the conference to hear Dr. Evelyn Sandeen, also from the VA, discuss the difference between evidence based treatments and evidence based practice. In her talk she described how in practice, we tailor the treatment to the individual. Therefore, good practice requires a warm, nonjudgmental, supportive therapeutic relationship along with close attention to the client’s background, personality, and individual needs. A good cognitive behavioral therapist takes all of these factors into consideration while delivering validated treatments in an individualized, sensitive, and skillful manner.
I truly appreciate interesting conferences and all of the work that goes into organizing and producing them. Thanks to the New Mexico Psychological Association for consistently delivering quality continuing education!
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PsychCentral (October 18, 2009)
I have a great interest in seeing our veterans treated intensively and effectively for their PTSD resulting from tours in the Middle East. I have great empathy for the men and women who must deal with the aftermath of their service. I also am interested in seeing the psychiatric community pay more attention to average individuals who suffer PTSD from abuse, trauma, and neglect. I suffered all three at different times in my life and found that the burden was my own to work through the issues caused by these incidents. I would suggest that educating the public about PTSD and its symptoms might be helpful. Also, my parents were alcoholic. The syndrome of the child of alcholic parents closely resembles PTSD and I would bet that many are not aware of this. These characteristics can cause crippling problems in adulthood. Again, education is the key to guiding someone with problematic behavior into treatment.
@ Vickie I hope that you get help for your PTSD. I believe that the more information and education people have, the more they will seek treatment. You can get information about trained therapists in your area by going to the ABCT.org website, find a therapist. People who belong to that organization are generally trained in Evidence Based Treatments. Trauma never goes away, but people can live fuller, better lives with treatment. Good luck and take care
Dr. Smith, I agree that you correctly define the symptoms labeled PTSD and that cognitive or behavior therapy appears to work.
I suspect that another little known problem is being diagnosed as PTSD. Subliminal Distraction was discovered to cause mental breaks for office workers forty years ago. The cubicle was designed to deal with it after 1968.
No one is screening patients for this exposure and the panic attacks, fear, paranoia, depression and thoughts of suicide it can cause.
I have searched for seven years and cannot find anyone outside the manufacturers of ‘Systems Furniture,’cubicles, aware it exists. They believe it can only cause a harmless temporary episode of confusion.
But there are other places these mental events happen. When those places are examined they do have the “special circumstances” for the problem.
How many of those with “trauma” related symptoms also have exposure.
Constructing a study to determine SD involvement in PTSD would add a tool to treatment efforts.
An interesting concept that I haven’t heard of before. How was this discovered? I’d be happy to look at the research. Thanks
I’ve been reading studies focusing upon the biochemical alteration of pieces of memory. Seems it’s all about intervening during two windows of opportunity – when the memory is burned and when it’s retrieved. Dutch scientist, Merel Kindt, used the administration of propranolol in his human research and found a fear response to spiders gone. Pretty wild stuff with far-reaching implications.
using propranolol or other beta blockers has also been used for a long time to decrease stage fright or public speaking phobias you’re right could get scary if we are totally able to block fear….
Thanks for sharing this info!
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