PTSD: Treatment–Part Five

Yet another promising treatment for PTSD is something called Cognitive Behavioral Therapy (CBT).

The National Alliance on Mental Illness defines it as follows:

Cognitive behavioral therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors. By exploring patterns of thinking that lead to self-destructive actions and the beliefs that direct these thoughts, people with mental illness can modify their patterns of thinking to improve coping. CBT is a type of psychotherapy that is different from traditional psychodynamic psychotherapy in that the therapist and the patient will actively work together to help the patient recover from their mental illness.

The website adds, “Studies have shown that CBT actually changes brain activity in people with mental illnesses who receive this treatment, suggesting that the brain is actually improving its functioning as a result of engaging in this form of therapy.”

How does it work?

In trauma, there is a triggering event.

Your mind scrambles to draw conclusions.

These conclusions, in turn, affect your emotions, thoughts, feelings, and actions.

Of course, a deeply scarred, traumatized mind cannot always draw conclusions that are realistic and sensible. More often than not, it does precisely the opposite.

In my own example of PTSD after a shipwreck, my thoughts ran as follows:

  • People died. This means I should’ve died, too. 
  • No way was this an accident. Fate/God/Universe/whatever conspired to put me on that ship, on that exact day, at that exact time, in that exact location.
  • I am never setting foot on a ship again. Fuck that. Ships sink when I am on them–always.
  • I will always be terrified of ships and open water. It’s permanent.
  • Whenever someone reassures me that something is perfectly safe, with “only a small chance of mishap,” I will take that small chance as unavoidable. After all, the chances of a ship running aground in a well-charted port were slim–yet it happened.
  • My panic, anxiety, and terror are forever. There is no hope for me.

You get the idea.

Now, as I stated before, these kinds of conclusions are perfectly understandable. Your mind is severely rattled by the trauma, and the thoughts surrounding it are unlikely to be rational.

The good news? You can challenge them.

This is best done under the guidance of a qualified CBT therapist, whether one-on-one or in a group setting.

First, you talk about the traumatic event.

This can be agonizing, but remember that the setting is a safe, nurturing one, where you can expose your scars without fear of ridicule.

Next, your therapist gently encourages you to re-examine your thoughts about the event.

For example, let’s take my third thought–“Ships always sink when I set foot on one.”

The therapist may ask, “Can you be 100% sure that this is true?”

I would have to admit that no, I can never be 100% sure of anything.

Then I may be asked, “Have there been times when you were on a ship and it didn’t sink?”

Again, I would grudgingly concede that yes, I’ve been on many ships and it went just fine.

“Then,” the therapist might say, “can you draw an alternative conclusion about the event based on these answers?”

This can be tricky, as the mind may still be locked in its traumatized patterns of thinking. It takes effort and skillful guidance to look at an event in a different way.

But it’s possible.

Here, I might employ a writing technique. I would take a piece of paper, draw a line down the middle, and write down my illogical thoughts about the traumatic event on one side. On the other, I would list another way of seeing the issue.

In so doing, I would gradually begin to see that, what I thought was a permanent way of thinking, is actually quite malleable. I don’t have to accept my initial conclusions about the traumatic event. There ARE other ways of looking at it.

This may not sound very helpful at first. It didn’t to me. When my therapist brought up the possibility of CBT, I reacted with scorn–and anger.

I am having full-blown, crippling, debilitating panic attacks and nightmares that keep me from being able to get through the day–and you want to challenge my thoughts? Are you KIDDING me?

This is a valid concern. Before embarking on a course of CBT, the immediate symptoms must be brought somewhat under control. This may be done, for example, by your doctor prescribing a sedative. Things like yoga and meditation also help to quiet the mind and slow down the racing heart.

Once that is done, dive in. Trust your therapist. Challenge your thoughts from every possible angle. You may find yourself realizing surprisingly quickly that what seemed like a foregone conclusion is only one way of looking at what happened.

Over time, this will leave a deep imprint in your thought patterns. Remember the quote at the beginning about how re-thinking the event actually changes brain activity? It’s true.

Slowly but steadily, you will learn to think differently. In turn, this will re-route your behavior, feelings and actions in a much more positive, healing direction.

Find a qualified therapist–and give it a try. It just might work for you.





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