An introduction
There are events that happen to us as children or adults that are so overwhelming and inherently frightening that they cause transient (temporary), and in some cases, permanent changes in our physical and psychological responses to stress. In general, post-traumatic stress disorder can be seen as an overwhelming of the body's normal psychological defenses against stress. Thus, after the trauma, there is abnormal function (dysfunction) of the normal defense systems, which results in certain symptoms.
The symptoms are produced in three different ways:
- Re-experiencing the trauma
- Persistent avoidance
- Increased arousal
Re-experiencing the trauma:
- May relive the experience as terrible dreams or nightmares or as daytime flashbacks of the event.
- External cues in the environment may remind the patient of the event.
- The psychological distress of the exposure to trauma is reactivated (brought back) by internal thoughts, memories, and even fantasies.
- Experience physical reactions to stress, such as sweating and rapid heart rate.
- Posttraumatic symptoms can be identical to those symptoms experienced when the actual trauma was occurring.
Persistent Avoidance:
- Refers to the person's efforts to avoid trauma-related thoughts or feelings and activities or situations that may trigger memories of the trauma.
- May develop a diminished interest in activities that used to give pleasure
- Detachment from other people
- Restricted range of feelings
- sad affect that leads to the view that the future will be shortened.
Increased arousal:
- fight or flight feelings
- sleep disturbances
- irritability
- outbursts of anger
- difficulty concentrating
- increased vigilance
- exaggerated startle response when shocked.
What are the treatment options?
Cognitive therapy involves separating the intrusive thoughts from the associated anxiety that they produce. Additionally, it involves changing the sequence of thought patterns that occurs whenever the patient is exposed to the traumatic stimulus. Cognitive therapy seriously diminishes the power of these reminders to cause severe reactions.
Stress inoculation training This therapy includes relaxation. It also involves carefully monitoring the patient's thoughts that follow from thinking about the traumatic event. When thoughts of the trauma do occur, the patient uses a script that was created in therapy to attempt to change their thoughts that follow thinking about the trauma. Patients may even need to imagine themselves as someone else (role playing) to bring about this change in their thought pattern. But then, the role-playing gradually becomes the reality.
Visualization techniques and confidence builders, such as positive self-talk and social skills training. In visualization techniques, patients train themselves to recall and visualize a particularly peaceful or pleasant place or situation whenever thoughts of the trauma occur.
Peer group support. Used for the treatment of numbing, residents learn from one another to reconnect with feelings, decrease isolation, learn new coping strategies, and provide support.
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