Understanding PTSD - what it is and how CBT can help

An iceberg is an appropriate analogy for PTSD - most of the distress we experience is hiding below the surface, which therapy can help us access

As PTSD is one of the areas I particularly specialise in, I wanted to spend some time in this blog post exploring the condition. An incredibly wide range of experiences can leave us with PTSD. Rather than rattling off a list, I think it's more helpful to say any situation (whether directly or indirectly experienced, whether one-off or experienced over a longer period of time) which sparked off an intense negative emotion can result in trauma memories being formed.

Trauma memories are very different to usual 'autobiographical' memories (memories of events that we experience - which could literally be eating breakfast this morning!). Naturally the events which tend to produce trauma memories are distressing, overwhelming, confusing...to put it briefly, our brains are not able to process the event neatly into our usual type of memories. This is where the vast majority of PTSD symptoms comes from - all aspects associated with a trauma memory vs an autobiographical memory.

Some traumatic events and the associated memories will be processed naturally over time by our brains. A large proportion (for a range of reasons), aren't and their impacts can be far reaching across multiple parts of our lives. PTSD isn't something we need to live with - Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is an incredible treatment option which I've personally seen transform lives

Common Symptoms of PTSD

Following any kind of significantly stressful event, it's a good idea to monitor for the following signs:

• Intrusive memories (flashbacks) - generally more intense than recalling moments within the event, these can often feel like we're back there reliving those moments all over again

• Intrusive feelings - trauma info/resources often forget to mention we can very often experience feelings associated with the event too. They may be strong emotions (fear, shock, numbness, embarrassment, guilt), they may be bodily sensations (heart racing, shaking, queasiness) or it may simply be a hard-to-describe sense of dread or ill-ease that washes over you

• Hyper-vigilance and hyper-arousal - feeling on edge, on the lookout, all the time. Being easily startled, becoming upset easier than usual. Poor sleep, waking up during the night (sometimes in a panic). A strong sense that whatever happened could happen again, at any moment

• Avoidance - being very wary to dodge certain reminders of the event, including people, places, objects and even thoughts (pushing down thoughts or memories related to the event because they are too distressing)

• Negative impact on mood and thinking - a broad category, but this could involve feeling incredibly anxious, very low or irritable, feeling guilty, feeling different and detached from other people now, feeling like the world is no longer a safe place.

All of these are very natural responses to what you've been through but they can have a profound impact on our day-to-day lives and wellbeing.

How CBT Helps

Decades of research have explored treatment for PTSD, culminating in Trauma-Focused CBT - an intervention that works to process (and 'elaborate') our trauma memories and essentially transform them into the autobiographical memories they were always meant to be.

This process takes the sting out of the memories - no longer easily triggered, no sense of being back there re-experiencing it again, no strong sensory aspects (seeing / hearing / feeling etc.). We will always have those memories as those experiences will always be a part of our story, but they'll no longer feel as distressing.

TF-CBT can also be tailored to meet your own wants and needs, involving a greater emphasis on any of the following:

• Reclaiming your life - getting back to doing the things that PTSD took away from you. Getting back into work or volunteering, feeling more comfortable socialising, doing hobbies, getting out and about, driving...whatever it may be, we can work towards you getting it back!

• Calming your body's responses - learning relaxing and grounding techniques to reduce the physiological intensity which can make day-to-day life a real struggle

• Overcoming triggers - the things which you find generally set off memories or feelings can be further worked on if necessary, breaking those associations and freeing you from unnecessary reminders

• Tackling recurrent nightmares - we can often notice our brain is trying to help process the trauma, but these are distressing, can leave us dreading going to sleep and impact on our energy levels (and tolerance) during the day. We can do some rescripting work to make some positive changes here

• Building your confidence - trauma typically knocks us down, so we can work on building you back up again. CBT is an ideal therapy for improving self-esteem and self-belief (and this is another area I specialise in)

Next Steps

If you're feeling like the above resonates or even if you're feeling a bit confused as to whether what you're experiencing is PTSD or something a little different, help is at hand.

I'm always happy to offer intro chats to explore before we get started, which can be a great way to not only find out more about your experiences but also to get a better feel for my approach.

I offer both video and typed formats for TF-CBT (with typed being a fairly novel but incredibly effective approach particularly when video sessions are a little too daunting and can otherwise be an obstacle to getting started).

Don't hesitate to reach out for more info or comment if you have any reflections on the above!

James

Email: jmpsychcoaching@gmail.com

LinkTree: www.linktr.ee/jm_psych