Lisabeth Wotherspoon, LICSW
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Treatment for Post Traumatic Stress Disorder
The estimated risk for rape survivors developing post traumatic stress disorder (PTSD) is 49%. The risk for those
beaten or experiencing physical assault is 31.9%, whilst the risk for others who experienced sexual assault is
23.7%. Given these figures, it is no wonder women are more likely to develop PTSD than men, as they are
statistically significantly more likely to experience sexual assault.
PTSD is characterized by intense fear, a sense of helplessness, or horror. It can affect all areas of a person's life, their emotions, mental wellbeing, and physical health. And symptoms are generally worse in situations, like rape and abuse, where the trauma was deliberately initiated against those involved.
A person with PTSD may re-live the traumatic events, having flashbacks or other reminders and images that intrude on their waking hours, or in dreams and nightmares. These reminders may also trigger physical symptoms, such as heart palpitations or chills. Emotional problems, like anxiety, depression, and dread may also occur.
People with PTSD may avoid any reminders of the trauma, whether that is people associated with the experience, or places, or even thoughts of the trauma. They can distance themselves from family and friends, and withdraw from everyday activities and things they used to enjoy.
Relationship problems are common for survivors of rape and sexual abuse. Some survivors avoid intimacy, others avoid sex, and some avoid both, and create patterns in their lives where those coping mechanisms are maintained. But sufferers of PTSD who did not experience any sexual abuse can also have problems in their relationships, or in social situations.
Another characteristic of PTSD is being on guard all the time, and suddenly feeling anger or irritability. There can be problems with sleeping and concentrating, and sufferers may be startled easily. Self destructive behaviours, such as gambling, risky sex, drug use, alcohol abuse, or other problems like dangerous driving, may be present. Depression, disassociation, or other mental health problems can develop.
Not all of these characteristics may be present in PTSD, and the degree to which one experiences them may vary also. And PTSD may not develop until months or years after the trauma. Particularly in relation to abuse in childhood, symptoms of PTSD can pass, then reappear later in life. This can make it difficult to recognize when PTSD is occurring, as survivors may not associate their current feeling and behaviours with pas events.
Each time symptoms appear, however, they provide an opportunity for healing. Post traumatic stress disorder can be treated, using a combination of medication and psychotherapy.
Whilst medications were not thought to help in the treatment of PTSD in the past, they have been found to be beneficial now, probably due to newer ones being available. The SSRI's (selective serotonin uptake inhibitors) Zoloft and Paxil are both approved by the FDA for treating PTSD. And newer antidepressants like Effexor and Serzone are also beneficial, and tend to be used when the patient does not tolerate Paxil and Zoloft, or those medications aren't effective.
There are 3 types of psychotherapy that can be used to treat PTSD. These are exposure management, cognitive therapy, and anxiety management. A combination of all 3 may be used, or one individually. Each person is different in what they will respond to.
In exposure therapy, patients confront, in a safe therapeutic environment, the situations, people, and memories associated with the trauma. People with PTSD usually avoid this very thing, but by working through the trauma in this way, exposure therapy is actually very effective at healing PTSD. I use EMDR to help clients access traumatic memories in a safe environment through the use of repeated short-focused attention on the truamatic event. See the page on EMDR for more information.
Cognitive therapy helps in the process of understanding how our thoughts affect our feelings, and provides ways of
shifting negative thinking. Negative thinking can perpetuate a mental prison where joy and interconnectedness is no
longer felt. Changing those dynamics can provide a new framework with which to process the trauma, and allow
healing to occur.
In anxiety management, skills are learned that help one cope better with the symptoms and triggers of post traumatic stress disorder. They can help reduce the intensity of the symptoms, though they need to be practiced to be effective. Anxiety management techniques can be very helpful in controlling anxiety while doing exposure therapy. Some techniques used include relaxation, breathing techniques, assertiveness training, and positive thinking and self talk.
22nd June 2006
For more articles on anxiety and depression, see www.ArticleHealthandFitness.com
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