What is Post Traumatic Stress Disorder?
It is normal for people to go through a period of psychological adjustment after facing either one or many traumatic experiences. Following this period of adjustment, memories of the event are filed away in our memory banks and become less distressing to think about. In much the same way as memories of other traumatic or upsetting experiences have been filed away. PTSD is when that filing process gets stuck and the period of adjustment does not settle down.
When the filing process gets stuck, there are three main types of symptoms. These are:
• Re-living the event again and again
• Avoiding thinking about the event or anything that may remind us of what happened
• Being ‘on guard’, unable to relax, anxious and struggling with sleep.
Left untreated, PTSD can last for many years. It can become extremely distressing and have a negative effect upon all areas of our lives. This includes our mental health, physical health, work and personal relationships.
Are there any effective treatments?
The National Institute for Health and Clinical Excellence (NICE) is responsible for recommending the most effective treatments for a variety of health problems. In 2005, NICE published a treatment guideline for PTSD that was based upon the best available research at that time. Today, there is still more research to support the therapies that NICE recommended in 2005 than any other treatment that you may wish to try. The recommended therapies were Cognitive Behavioural Therapy or Eye Movement Desensitization and Re-processing.
Cognitive Behavioural Therapy (CBT)
CBT is a talking therapy that has proven to be very effective at helping people to file away their memories of traumatic events. CBT is usually delivered over a period of approximately 12 sessions of 60-90 minutes duration. However, sometimes more sessions will be needed and sometimes less. Trauma focussed CBT will make use of a range of psychological treatment techniques. Typically, it will involve confronting the traumatic memories, challenging any unhelpful thoughts and gradually restarting activities that we may be avoiding. It is important that your therapist has had specialist training in this therapy.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a comprehensive psychological therapy , it is believed to stimulate the brain to file away the stuck traumatic memories. It is usually delivered over a period of approximately 12 sessions of 60-90 minutes duration. However, sometimes more sessions will be needed and sometimes less. EMDR typically involves bringing up the traumatic memories whilst engaging in some form of left and right stimulation such as eye movements or hand taps. The distress attached to the memory generally reduces as it is filed away in a more adaptive way. As with CBT, it is important that your therapist has had specialist training in this therapy.
How to access treatment?
Your GP is likely to be a good first point of contact. They are able to refer you to specialist services. Those specialist services will have therapists trained in either CBT or EMDR.
Veterans and Reserves Mental Health Programme (VRMHP)
The VRMHP offers veterans and reservists a full mental health assessment and diagnosis. They can also offer guidance about what help is available, as well as offering advice to your GP.
The BABCP and EMDR websites have a list of accredited therapists.
Royal College of Psychiatrists
British Association of Behavioural and Cognitive Psychotherapies (BABCP)
NHS – PTSD treatment
Veterans and Reserves Mental Health Programme
Reserves Mental Health Programme (Referral information)