Post-Traumatic Stress Disorder- What it is & What to Do

Post-Traumatic Stress Disorder (PTSD)

Also called a “hidden epidemic” due to people being unaware of loved ones and neighbors being affected, yet it is all around. Post-traumatic stress disorder (PTSD) is defined as “a complex and debilitating psychiatric disorder caused by exposure to traumatic events that is characterized by symptoms of hyperarousal, avoidance, re-experiencing, including intrusive memories and visual flashbacks of the traumatic event.”²

PTSD can be classified in two ways: as Type I trauma, where there is a single circumstance of trauma like getting into an accident, or as Complex Trauma (cPTSD), which differs from typical PTSD in that it is from extended exposure to trauma, like interpersonal emotional or sexual abuse.¹ Complex Trauma has been found to be more complicated to treat because of its duration and impact on the person.¹

Any person experiencing PTSD deals with “triggers”, or reminders of the trauma that make it feel like it is happening now, which makes them avoid these reminders and stay in a hypervigilant condition.¹ With Complex Trauma, the person experiencing it will also feel negatively about themselves, become unable to respond to circumstances with fitting emotional responses, and will have relationship difficulties^1,3, since the trauma involves an inter-personal relationship with another individual.

The following video by the author of "The Body Keeps Score" describes trauma in more detail.

What do I do if I am experiencing PTSD?

There are many different approaches to decreasing the negative impacts from PTSD on individuals, but from the research I conducted, I am going to suggest Compassion Based Therapy as a starting point, specifically for women who have experienced Complex Trauma, or cPTSD, from relational abuse.

Compassion Based Therapy 

Multiple studies have found that addressing emotional safety before trying to expose the individual to trauma processing is vital to the success of treatment.^1,3 Exposure-based therapy options, which we will talk more about later, that are done before a level of safety is established for women and shame is removed, can actually not only be less effective in reducing PTDS symptoms, but can worsen them.³ Shame is defined as “a negative, self-conscious emotion, characterized by an overwhelming sense of the self as negative and undesirable.”³ Not addressing shame in the beginning stages of compassion-based therapy can keep the individual struggling and in a cycle of PTSD symptoms.³

Women, specifically, who have experienced Complex Trauma are triggered more easily and have a take longer to emotionally regulate, therefore they need to form safe relationships in group therapy, understand themselves in a new light, and decrease shame to make further exposure therapy effective.³  Increasing the “window of tolerance”, meaning the amount of exposure to trauma a person can handle before becoming dysregulated, can be achieved through teaching women how to develop an internal compassionate relationship with themselves, provide safe relationships as resources,  and  teach how to self-soothe.³  After these things are achieved, exposure therapies to tackle the trauma can be more effective.^1,3

The chart from this study shows first the negative cycle of women staying in shame/PTSD symptoms versus below how they can reduce the triggers and symptoms through first addressing their self-worth and shame.³

                 

  

Reduction in difficulties

New life

Preparation for 1:1 therapy

Figure 1. The ‘Journey of Change’ model for individuals completing the Compassionate-Resilience group.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is defined as a type of therapy that teaches you coping skills for dealing with different problems by focusing on how your thoughts, beliefs and attitudes affect your feelings and actions.¹ It has been proven effective by many studies for reducing symptoms of PTSD in individuals.^1,2

The brain has many different areas.  As seen in the figure below, the amygdala, prefrontal cortex, and hippocampus are three areas of the brain.  They are responsible for regulating emotions like anxiety and fear, regulating emotions, memory, and decision making.⁴ Because these areas in the brain specifically are affected in PTSD, many people will have memory issues, overactive fear centers, and increased hormones/decreased receptors that can cause depression.⁴ 

People who experience PTSD have been found to have decreased amount of grey matter in the hippocampus and amygdala, which affects their memory, increases anxiety and depression, and decreases their ability to regulate fear.² In one study, the amount of grey matter in individuals with PTSD that practiced Cognitive Behavioral Therapy (CBT) increased significantly, providing them with more resilience to handle stress by creating a more flexible, adaptive brain area.² It is important to note that women who experienced sexual trauma, often categorized as Complex Trauma if it is in an interpersonal relationship, do not see as much benefit from CBT unless they have first established the safety from compassion-based therapy, as mentioned above.¹

So what is CBT exactly and how does it work to help reduce the impact of PTSD on people?

These videos explains it in a simple way.

In short, CBT and other effective therapies available for people struggling with PTSD can help to offer a new reality in a positive way, despite the difficult circumstances of their trauma.  CBT, along with other therapies, has helped me personally in a drastic way.  

Even if you do not have access or are not ready to find safe resources, there are things you can do now to start healing your trauma.  Some good places to start are journaling, practicing mindfulness, express your feelings through art, find at least one safe person that you can confide in, find ways to practice more self-care, and breath through triggers that arise.⁵  One thing is for sure, you CAN heal! 

Here is a video with additional ideas about how CBT type resources can positively affect people even in everyday types of situations.

(Specifically the first 10 minutes)

References

1.      Lee, E., & Bowles, K. (2020). Navigating treatment recommendations for PTSD: A rapid review. International Journal of Mental Health, 52(1), 4–44. https://doi.org/10.1080/00207411.2020.1781407

2.      Butler, O., Willmund, G., Gleich, T., Gallinat, J., Kühn, S., & Zimmermann, P. (2018). Hippocampal gray matter increases following multimodal psychological treatment for combat-related post-traumatic stress disorder. Brain and Behavior, 8(5). https://doi.org/10.1002/brb3.956

3.      Ashfield, E., Chan, C., & Lee, D. (2020). Building ‘a compassionate armour’: The journey to develop strength and self‐compassion in a group treatment for complex post‐traumatic stress disorder. Psychology and Psychotherapy: Theory, Research and Practice, 94(S2), 286–303. https://doi.org/10.1111/papt.12275

4.      Operation Red Wings Foundation. (n.d.). The impacts of trauma on the brain. The Impact of Trauma on the Brain. https://orwfoundation.org/the-impacts-of-trauma-on-the-brain/?gclid=Cj0KCQjwldKmBhCCARIsAP-0rfzHMkCt8l2skyFHbiDW019NmGx1p7z86MOcFNZbqyO2HVZ4kiWDvrsaAlwlEALw_wcB

5.      LiebermanLMFT, W. by:Allison, & MoawadMD, R. by:Heidi. (2023, March 21). Healing sexual trauma: 6 tips from a therapist. Healing Sexual Trauma: 6 Tips From a Therapist. https://www.choosingtherapy.com/sexual-trauma-healing/

Pictures

Trauma, PTSD, and Memory Distortion | Psychology Today

pictures of someone doing virtual reality - Google Search

Hippocampus Functions (news-medical.net)

How to make a Brain Model - Human Body Science for Kids (science-sparks.com)

Videos

What is trauma-focused CBT? | UK Trauma Council - YouTube

What is trauma? The author of “The Body Keeps the Score” explains | Bessel van der Kolk | Big Think - YouTube

The ABCs of CBT: Thoughts, Feelings and Behavior - YouTube

Don't Believe Everything You Think | Lauren Weinstein | TEDxPaloAlto - YouTube