PTSD is usually treated by a combination of psychotherapy (cognitive-behavioral therapy, group therapy, and exposure therapy are popular) and drug therapy (antidepressant or atypical antipsychotics, e. g. brand names such as Prozac (fluoxetine), Effexor (venlafaxin), Zoloft (sertraline), Remeron (mirtazapine), Zyprexa (olanzapine), or Seroquel (quetiapine)). Talk therapy may prove useful, but only insofar as the individual sufferer is enabled to come to terms with the trauma suffered and successfully integrate the experiences in a way that does not further damage the psyche. Forbes et al. (2001) have shown that a technique of “rewriting” the content of nightmares through imagery rehearsal so that they have a resolution can not only reduce the nightmares but also other symptoms. The US FDA recently approved a clinical protocol that combines the drug MDMA (“Ecstasy”) with talk therapy sessions (this doesn’t mean that Ecstasy has proven efficiency for treating PTSD). Basic counseling includes education about the condition and provision of safety and support (Foa 1997). Cognitive therapy shows good results (Resick 2002), and group therapy may be helpful in reducing isolation and stigma (Foy 2002).
Dr. Jan Bastiaans of the Netherlands has developed a form of psychedelic psychotherapy involving LSD, with which he has successfully treated concentration camp survivors who suffer from PTSD.
PTSD is often comorbid with other psychiatric disorders with depression and substance abuse being the most common.
There have been scores of other treatments suggested for the treatment of PTSD. Two of these controversial techniques are Eye Movement Desensitisation and Reprocessing (EMDR) and Traumatic Incident Reduction (TIR). EMDR is a technique developed by Dr. Francine Shapiro (Shapiro 1989), in which the therapist induces eye movements in the client which is meant to access the traumatic event and allow the integration of emotions and sensations that occurred during the traumatic event. Critics claim that EMDR is no more effective than CBT and that it derives its benefits from the therapist client interaction and not the eye movements. The link was once thought to be through the rapid eye-movements (REM) of sleep. During REM sleep the individual is presumably processing what she has experienced during the day. In PTSD the realistic nightmares of reexperiencing the trauma could be seen as unsuccessful processing of the trauma during REM sleep. It was proposed that EMDR then supposedly mimicks the brain’s activities during REM sleep. However, numerous studies have demonstrated that neither eye movements nor alternating attentional movements make any additive effect to the therapy which also demonstrates inferior long term outcome in comparison to exposure based treatments (Devilly & Spence, 1999).
TIR is a less well known technique for reducing and eliminating the effects of a traumatic event. TIR is more of a graduated exposure technique that is controlled by the client. In TIR the client retells the trauma and releases the emotions held in check. In addition the client remembers the event and allows the conscious mind to process any decisions, intentions and cognitive distortions that might have occurred during or after the trauma. Practitioners who have been trained in both EMDR and TIR report that TIR is safer because it is focused on a single event and EMDR can occasionally trigger several events and multiple emotions. Interviews with these practitioners have suggested that, while they continue to use both techniques, TIR is the preferred intervention for known traumatic events where the client wants insight and understanding about the event and the aftereffects of the trauma. Both TIR and EMDR have been described as unscientific. TIR is derived from Scientology and has no controlled outcome studies to back any of their claims. It is not an empirically supported treatment and, under no circumstances, should this be a first-line treatment.
Israel military is experimentally treating PTSD with Marijuana.
Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .
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