PTSD Notes: Causes, Symptoms, Treatment

Psychology Super-Notes
PsychoTech Services Psychology Learners
Version 1.0
Anxiety Disorders
Post-Traumatic Stress Disorder
M. S. Ahluwalia

Psychopathology

Copyright © 2021, by M S Ahluwalia
Trademarks
‘Super-Notes’, ‘All About’, ‘Psychology Learners’, ‘PsyLearners’, ‘M S Ahluwalia’, ‘PsychoTech Services’, ‘Real Happiness Center’
and the msa logo, the PsyLearners logo, Star and Starji logos for Real Happiness Center logo and PsychoTech Services logo are
trademarks of M S Ahluwalia in India and other countries, and may not be used without explicit written permission.
All other trademarks are the property of their respective owners. PsychoTech Services and M S Ahluwalia, are not associated
with any product or vendor mentioned in this book.
Limit of liability/disclaimer of warranty
The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the
contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular
purpose. This book should not be used as a replacement of expert opinion. No warranty may be created or extended by sales or
promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with
the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional
assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author
shall be liable for damages arising herefrom. The fact that an organization or website is referred to in this work as a citation
and/or a potential source of further information does not mean that the author or the publisher endorses the information the
organization or website may provide or recommendations it may make. Further, readers should be aware that internet websites
listed in this work may have changed or disappeared between when this work was written and when it is read.
This document contains notes on the said subject made by the author during the course of studies or general reading. The
author hopes you will find these ‘Super-notes’ useful in the course of your learning. In case you notice any errors or have
any suggestions for the improvement of this document, please send an email to Super-Notes@PsychoTechServices.com.
For general information on our other publications or for any kind of support or further information, you may reach us at
care@PsychoTechServices.com.
3
! Disclaimer

Psychology.PsychoTechServices.com

Version 1.0
For more Super-Notes Click here!
Super-Notes
A proprietary approach developed by bringing together
the best of learning theories from Psychology, design
principles from the world of visualization, and
pedagogical methods from over a decade of training
experience, that enables you to:
Learn better, faster!

PsychoTech Services Psychology Learners 6
Meme like cards
to help you
understand and
remember
complicated
concepts.
PsyConcepts
Quotes related to
psychology,
complete with
explanations to
help understand
their real context
and meaning
PsyQuotes
Professional
checklists and
templates to
improve the look
of your work and
reduce errors
PsyTemplates
Psychology made easy and interesting…

PsychoTech Services Psychology Super-Notes Psychology Learners 7
We are here to help you…
It is in our DNA. We were born out of a
project to help students!

We are here to help you!
If you are a faculty or student of psychology, this document may be just what you need!
Universities often have a vast syllabus, and there is limited support from the faculty and
university. But, the exams are tough. Unfortunately, students often don’t get sufficient
support for their exams.
We at PsychoTech Services have launched several efforts to help psychology students – if
you haven’t visited our site yet, now might be the right time – Click Here! Look for
PsyConcepts, PsyQuotes, guidance for solving the assignments, our highly accurate ‘Exam
Question Pattern Analysis’, and PsyTemplates - to make your submissions look more
professional and high quality.
Also, remember, your exams will test both your knowledge and your ability to present the
answers well. So work on both these aspects – read this for some very useful tips on
How to Score More in your Exams!
We hope that all the resources we have created for you will help you to complete your
course requirements successfully!
Good Luck!!!
8

Let’ start…

Psychopathology >> Clinical Features of Anxiety Disorders - Post-Traumatic Stress Disorder >> Contents
Contents
1. Introduction to Anxiety Disorders
2. PTSD – Definition, Onset, & Prevalence
3. Diagnosis & Clinical Picture of PTSD in children
4. Different situations eliciting PTSD
5. Aetiology (Causes)
6. Prevention & Treatment
10

Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Introduction to Anxiety Disorders
1. Introduction to Anxiety Disorders (1/2)
11
Anxiety is normal…
• Anxiety is a common reaction to stress. It prevents
humans from being careless.
• Examples:
• Anxiety about your examination makes you study.
• Anxiety over her baby’s health makes a mother
care for her baby.
…however, in same situations anxiety can be abnormal
• If anxiety crosses a reasonable limit, it might become a disorder
• Examples:
• when one is so anxious that he/she has a breakdown in the
exam hall, forgetting everything
• when a mother is so anxious about her baby’s health, that she
spends day and night praying to God
Nature of Anxiety
Fear
• Fear is a basic emotion of human beings associated with
the perception of a real threatening situation and involves
the ‘fight or flight’ response activated by the sympathetic
nervous system.
• Example: If a street thug attacks you, you would feel intense
fear. Then, you would either run for dear life, or hit him back.
• Thus fear involves:
• cognition of the threatening object,
• subjective cognition of being in danger,
• physiological components like increased heart rate,
• behavioural components like running or hitting.
Anxiety
• Anxiety also involves subjective perception of threat,
physiological changes and some behavioural reaction.
• However, there is no immediate threat - you are
projecting the threatening situation in future and
reacting to it as if it is imminent. If you cannot go out of
your home because of apprehensions of an attack by a
hoodlum, it is anxiety.
• Anxiety serves an adaptive function - it prepares a person
for fight or flight if the danger really comes. But if the
person avoids the situation that in her perception may
cause the danger, and if such imagined situations are
unrealistic, then the effect becomes debilitating.

One may distinguish between adaptive
anxiety and pathological anxiety by
assessing the realistic probability of the
occurrence of the object of anxiety and
by assessing how dysfunctional it makes
the person.

Focus of this document
Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Introduction to Anxiety Disorders
1. Introduction to Anxiety Disorders (2/2)
13
Common Characteristics/Nature of Anxiety Disorders
• Cognition or subjective perception of danger – may be accompanied by
vivid, occasionally morbid, images of the difficulties encountered.
• Physiological Responses - through activation of sympathetic nervous
system. Usually includes dilated pupils, increased heart rate, trembling,
breathing discomfort, nausea etc.
• Behavioural Responses - usually a tendency to avoid the dreaded situation.
Except in PTSD and sometimes PTSD, where repetitive behaviour is observed.
Anxiety
Disorder
Anxiety Disorder is a blanket term that covers a group of disorders characterized by
irrational fear of some thing or situation. The person is usually aware of the irrationality.
1
Panic Disorder
(with or without
agoraphobia)
2
Phobic Disorders
(specific or social)
3
Generalised
Anxiety Disorder
(GAD)
4
Obsessive
Compulsive
Disorder
(OCD)
5
Post Traumatic
Stress Disorder
(PTSD)
Types of Anxiety Disorders
(DSM IV TR)

Contents
14

Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Diagnosis and Epidemiology
2. Post-Traumatic Stress Disorder
15
Post-
Traumatic
Stress
Disorder
• It is a psychiatric condition developed as an aftermath of severe trauma often involving
violence and demolition.
• It is characterised by intrusive memory of the trauma, excessive arousal, behavioural
problems and emotional difficulties.
Time of Onset of PTSD
• This is not clear, as in many cases the symptoms do not show up not
immediately after the event, but months or years later.
• There are multiple contending explanations for this:
1. The trauma victim initially erected a strong defence. But,
gradually it failed to serve its purpose and the memory of the
trauma returns with full severity.
2. The trauma caused a vulnerable personality in the victim. In
the course of life she encountered another trauma of relatively
milder nature, which served as a cue to the earlier one.
3. The delayed symptoms are not at all related to the original
trauma but are reactions to some recent life events. Since the
person has a memorably traumatic past, the symptoms are
wrongly attributed to the earlier trauma.
• Any of these may be possible. Detailed case history may solve the
dilemma in each individual case.
Epidemiology (Prevalence)
• As PTSD is the result of traumatic
events, its occurrence depends
on the number of events.
• As per estimates, about 9% of the
general population had
developed PTSD at some point in
their life.
• The occurrence of PTSD also
depends upon the nature of the
trauma and how society looks
upon it.
• Example: about 65% of rape
victims develop PTSD, while 15%
of Vietnam combat veterans
developed the symptoms.

Contents
3. Diagnosis &
Clinical Picture of PTSD in children
16

3.1. Diagnosis (1/2)
17
• As per DSM IV–TR, for diagnosing a person as suffering from PTSD, there must be a history of
exposure to severe trauma. The person may have experienced, witnessed or been confronted with an
event or events that involved actual or threatened death, serious injury or threat to integrity of self and
others. The reactions of the person would be predominantly fear, helplessness, and terror. The
victim cannot get rid of the memory of the traumatic experience.
• At least one of the following symptoms of intrusive memory is present:
• recurrent and intrusive recollection of the event, distressing dream, intense distress if any
internal or external cue symbolizes or resembles the traumatic event.
• Example: after a war, the sound of a car tyre bursting may remind the veteran of the sound of
firing and bring back the distress.
• At least three of the following behaviours must be present.
• The victim tries to get rid of the thoughts, feelings and activities related to the trauma, though
the effort is often not successful.
• She feels a kind of detachment and experiences a restricted range of emotions. Example: she
may feel that she is incapable of loving anybody. After the Second World War, many captives of
the Nazi camp had this feeling of not being able to relate to others. Many of them remained single
throughout life, and for some who married, inability to love became a problem.
• At times the memory of the victim is distorted. She cannot recall significant parts of her
experience.
• Sometimes she has a sense of foreshortened future, that is, she cannot visualize a normal
education, career or family life.

3.1. Diagnosis (2/2)
18
• The PTSD victim also has at least two symptoms of excessive arousal: difficulty falling or staying
asleep, irritability, outburst of anger, problem in concentration and exaggerated startle response.
• These symptoms of trauma can be noticed in most victims immediately after the incident. Some
trauma victims grow out of these symptoms within a short period, especially if they are kept in a safe
place. On the other extreme, for some the symptoms persist for the rest of their lives.
• To be diagnosed as suffering from PTSD, one must have these symptoms for at least one month.
• Acute PTSD: If the duration of the symptoms is less than three months.
• Chronic PTSD: If the duration of the symptoms is more than three months.
• In some cases of PTSD, the clinical picture involves intense guilt and depression. Under emergency
situation, the victim may feel that she has not played her role adequately. Perhaps a moment’s
negligence has caused the loss of a loved one. This is known as the survivor’s guilt. This has been
studied extensively in connection to combat stress and natural disasters.
• Some other reactions are anger, substance abuse in the form of self medication, low output at
workplace and interpersonal problems. Many of the US Vietnam war veterans were discharged from
the army with a bad report due to complaints of anger outbursts and excessive alcohol intake. Much
later, these behaviours were interpreted as symptoms of PTSD.
• Sometimes, especially when the environment is unsupportive, extreme depression and suicidal
thoughts predominate.
• Behavioural aberrations may last a lifetime – war does not demolish only those who died, the trauma
can demolish the existence of even those who survive.

3.2. Clinical Picture of Children with PTSD
19
• Child victims of trauma express their responses in a manner different from the adults.
• They often have greater difficulty in verbally expressing their pain, especially when physical or sexual
abuse has been involved.
• PTSD, especially when it involves children, is an enormous burden on the society. Victims remain
prone to psychiatric disorders and physical health hazards for the rest of the life.
• They may develop mood disorder, other anxiety disorders like Generalised Anxiety Disorder
or Obsessive Compulsive Disorder, and Substance Abuse Disorder.
• Such children are also more likely to perform poorly in academics, career and relationships.
• They may be more prone to cardiac problems in later life.
PTSD in Children due to Riots related Trauma
• Riots are a horrible experience – for children, and adults too. Children may have been subject to
assaults themselves, or have witnessed their parents assaulted.
• They develop a numbness. The experiences are, often, beyond their understanding and they lack the
language to express it.
• Sleep disorder and nightmares are very common.
• Smaller children may lose already acquired developmental skills like speech or toilet training.
• Behavioral changes are common. Example: a happy outgoing child may become introvert, or a shy
child may become unduly aggressive.

Contents
20

Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Different situations eliciting PTSD
21
Trauma
Situations
eliciting PTSD
1
Wars and
other
military
combat
2
Natural
Disasters
3
Man-
Made
Disasters
4
Threat to
Personal
Security

4.1. Trauma due to Wars/Military Combat
• Army training prepares
soldiers to withstand the
trauma of warfare.
• However, during actual
exposure, the killings and
uncertainties may take a
different meaning.
• Particularly, when the war is
not against an equally
equipped country, but
against guerrillas and
ordinary civilians (as is often
required in case of terrorism)
moral issues often come to
the fore.
• Survival guilt is also
common in military combat.
22
Case Study
• Ram, 48, a retired soldier, was referred for psychiatric consultation with the
complaint of depression and alcoholism.
• The Incident: One night, during combat, his comrade Abhi confided to Ram
his frustration about the manner in which their duties were being allotted.
Ram comforted Abhi and went to sleep. Next day, Abhi was hit during cross-
fire and died instantly. Ram didn’t even get a chance to have a last word -
Abhi just looked at him with sorrow, probably trying to say something.
• Current Issues: The scene haunts Ram till date.
• There is survivor’s Guilt:
• He feels that he has no moral right to live, because Abhi was a better
person than him.
• He also feels that he could have taken the particular position that Abhi
had taken and got hit; it was just a matter of chance that he is surviving.
• He considers himself a useless person, suffers from low mood and self
blame, and has lost interest in everything.
• The scene of Abhi’s death and other horrors return in his nightmares.
• Ram took early retirement and started drinking a lot to deal with his
problem. It can relieve his guilt and depression only temporarily.
• His family life is now disrupted.
• He believes he is not going to live long.

4.2. Trauma due to Natural Disasters
• It includes events like
earthquakes, cyclones,
tsunamis, floods, etc.
• Such situations are primarily
characterised by
helplessness as the
destructive force of nature
is beyond human control.
• However, after the initial
disaster has passed, the
role of the Govt. and rescue
operations conducted
becomes crucial.
23
Case Study
• Jai was a 10 year old child, whose father Raj was a Government employee
posted on the beautiful island where they lived.
• The Incident: One day, Jai went for a walk on the beach after his breakfast.
Suddenly he saw a big wave erupting from the sea and heard a strange
rumbling sound. He ran for his house, but never reached there; the wave was
faster. He got stuck to a tree trunk and clasped it. Later on he discovered that
his mother and sister had perished.
• After the Incident: Jai was found wandering alone amidst the debris far
from his house and taken to a rescue camp. Fortunately, Raj was away from
home and survived the disaster. Using his influence as a Government Official
Raj found his son rather quickly, and took him away from the camp.
• Issues:
• Jai did not speak at all for days, and then responded only in monosyllables.
• He developed a tic in the form of continuous eye blinking whenever
anybody talks to him.
• Even after two months he didn’t disclose how he discovered his mother and
sister to be dead, if he saw their bodies and what he did after that.
• He did not weep, but wore a strange blank look on his face and ate very
little.
• Jai could not sleep peacefully, groaning and shrieking in his sleep. But he
could not remember the dreams.

4.3. Trauma due to Man-Made Disasters
• This includes a variety of disasters
like industrial accidents (like gas
leaks) and long term impacts of
planning insensitivity (like arsenic
pollution), terrorist attacks, flood
due to opening of dam gates, etc.
• Here anger towards the
perpetrators is an essential
element.
• When a single perpetrator is
identified from a group (example:
a single terrorist who has been
caught alive while others either fled
or died) the hatred and anger is
thrust on him.
• But, often the perpetrator is not
one single person, but a govt.
policy, an industrial company or a
team of people in charge. In such
cases, the directionless nature of
anger may add to the difficulty
of the victim.
24
Case Study
• Shiv, 25, a shopkeeper, lived in a building next to a market in a congested area.
• The Incident: There was a fireworks warehouse near the market. Shiv and
other young men of the locality had tried many times to get it shifted from
that area, but couldn’t do it due to political pressure from different quarters.
One night, Shiv was awakened from sleep due to his distraught father shouting
‘Fire – Fire’. He saw smoke entering the room from all sides. He and his parents
somehow escaped, but all their belongings were burnt in the fire.
• After the Incident: The meagre compensation from the Government, received
after prolonged negotiation, was nothing compared to the loss.
• Current Issues (after a year):
• Shiv, who used to be a smart and sociable young man, is now an anxious
and moody person. He has occasional anger outbursts which can go out of
proportion. He says that the moments of his escape and the cries all around
come back to his mind repeatedly, and he cannot get rid of them.
• There are no nightmares, but his sleep is disturbed and appetite is very low.
• He cannot tolerate the sound of a number of people shouting together, even
if it is cheering in a game of cricket.
• He expresses extreme frustration with the way politicians/Govt. deal with
safety issues. He expresses extreme anger with the local MLA, who didn’t
listen to their appeals before the fire, and says the MLA should be hanged.
• He says he has become detached about most things in the world.
• He is disinterested in his business, and his father has to look after it.

4.4. Trauma due to Severe Threat to Personal
Security and Safety (1/2)
• This includes personal accidents, rape, confinement, torture and targeted violence including
domestic violence.
• Usually the trauma consists of extreme fear, helplessness and uncertainty.
Phases in the Appraisal of Personal Trauma
25
Phase 1: Apprehension
and corresponding effort
at control
• Example: the car is
skidding, or one is being
followed by a man with
seemingly bad motive.
Phase 2: Impact
• The event itself is
happening and one is left
helpless at mercy of the
external force
Phase 3: The Post-
Traumatic Situation
• One has to take charge of
oneself again.
• This last phase may be
divided in two sub phases:
3.1. Recoil Phase
• Fear, anxiety, and maybe guilt
(in case of rape and assault
victims) predominates.
3.2. Reconstruction Phase
• Starts after initial medical
treatment.
• PTSD may be diagnosed as a
psychiatric category during this
phase.
• Depression, anxiety, intrusive
memories and all other signs
and the struggle of the person
with them start at this phase.

4.4. Trauma due to Severe Threat to Personal
Security and Safety (2/2) – Case Study
The Incident:
• About one year ago, while driving along a narrow mountain road in the evening, Mohd. felt his wheels
skid. He tried his best to stop the car, but it was a fraction too late. Before he understood anything, his
car was dangling at the side of the road.
• Mohd. does not remember when he unfastened the seat belt, or how the door opened, but the next
moment he found himself falling down besides his car, which was spinning while falling. He got stuck in
some stones and bushes, while the car fell down and burst into flames.
• Mohd. tried to free himself but he was unable to move his right hand. Now he felt the extreme pain and
he realized that he had broken his elbow. He reckons he had become unconscious for a while and then
regained consciousness. For some time he felt detached from his body.
• Then he heard another car passing by and shouted at the top of his voice. Luckily, the passengers
stopped and arranged to rescue him.
Current Issues:
• Since Mohd. understood that the accident has actually happened, he has been suffering from flashbacks.
He had recurrent nightmares of the car burning below him and often sees a body burning in it.
• He cannot concentrate in his office work, has become irritable and moody.
• He has an exaggerated startle response to any sudden visual or auditory stimulus.
• He experienced a panic attack while trying to drive a car first time after the accident. He didn’t try again.
• He also believes that death is after him and he would not have a full life.
26

Contents
27

Maladaptive
Coping
PTSD
Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Aetiology
5. PTSD – An Aetiological Model
28
Primary
Traumatic
Life Event
Multiplication
of Trauma
Excessive
Arousal
Intrusive
Memory
Disruptive
Emotion
Behavioral
Problems
Vulnerable
Personality
Related
Traumatic
Event
Related
Traumatic
Event

5. PTSD Aetiology
29
Causes of
PTSD
1
Biological Factors .
2
Psychological Factors
2.1
Psychoanalytical
Approach
2.2
Behavioural Approach
2.3
Cognitive Approach
2.4
Existential Approach
2.5
Vulnerable Personality
and Life Events
3
Socio-Cultural Factors .
1. Biological Factors
• Include temperamental factors
that may contribute to
development of vulnerable
personality. Twin studies have
shown that vulnerable
personalities may run in families.
• Besides, exposure to trauma
may activate the noradrenergic
system. As a result the
norepinephrine level is elevated.
This in turn may result in
exaggerated startle responses
and heightened emotional
arousal.

5.2. Psychological Factors (1/2)
30
• No approach has been able to adequately explain why some persons develop PTSD and others do not.
• Personality and life events play an important role.
• There is a breaking point for every individual. Some succumb to symptoms earlier and some later.
• The severity of symptoms is directly proportional to the severity of the trauma. Example:
symptoms of combat stress are directly related to number of killings.
1. Psychoanalytical Approach
• It proposes that people
consciously or unconsciously
repress the painful memories of
the traumatic event.
• PTSD is the result of the ego’s
struggle to assimilate the
experience into the pre-existing
structure of personality.
• Often PTSD symptoms represent
a maladaptive compromise of
the ego.
2. Behavioural Approach
• Learning approach assumes that
PTSD results from classical
conditioning – it is a sort of
avoidance response.
• A person who has suffered a
terrible train accident would be
afraid to board a train ever again
as the association with the scene is
terrifying.

5.2. Psychological Factors (2/2)
31
4. Existential Approach
• It suggests that exposure to trauma
disturbs the meaning of life.
• Each of us develops through our
experiences a number of expectations
about life and relationship. Example:
we expect to help a baby in distress.
• During traumatic events, however, the
exact opposite of this might happen.
Example: a mother may throw her
baby down the river to save herself.
• These experiences are difficult to
integrate once we return to safety.
• Often, it develops nihilism and
cynicism about anything good in life.
• The treatise by Viktor Frankl on
existential problems of concentration
camp survivors is a famous account
of the existential viewpoint.
5. Vulnerable personality and
life events
• are a number of risk factors in
PTSD. Example: being female,
early separation from parents,
family history of psychiatric
disorder and pre-existing Anxiety
or Mood disorders.
• Sometimes people may be
exposed to multiple traumas.
Example: during the partition of
India, many people lost their
land and migrated to a different
place. There, instead of being
provided for, they had to suffer
deprivation and humiliation.
Some also lost their close ones in
the process.
• Thus, in many situations the
traumatic events are
multiplied, enhancing the risk
of PTSD.
3. Cognitive Approach
• It assumes that the person
exposed to trauma adopts
a faulty coping mechanism.
• The coping style of the
person with PTSD is often
emotion focussed rather than
problem focussed.
• Furthermore, they often take
personal responsibility for
failures resulting in survivor
guilt.
• The information processing
of the trauma victims may
also be distorted. The person
remains extremely sensitive
to cues suggesting the event.
Intrusive memory and
thoughts cannot be
controlled and the person is
very quick to pick up certain
cues that revive the memory.

5.3. Socio-Cultural Factors
32
• It has been observed that in combat related stress, when the group
morale is strong and the combatants are committed to the job, the
PTSD symptoms are less common and less severe.
• Also, if after the traumatic event one is placed in a supportive
environment the severe symptoms can be avoided. The entire
purpose of army training is to develop a community that supports
combatant mentality and glorifies it. PTSD would be less under the
circumstances.
• In case of rape, on the other hand, society often blames the victim thus
enhancing the risk of symptoms.
• Adequate social support and cultural assimilation of the traumatic
events help the person’s struggle with the experience.

Contents
33

Psychopathology >> Clinical Features of Anxiety Disorders – Post-Traumatic Stress Disorder >> Treatment
6. PTSD Prevention
34
• If a person is going to be exposed to extreme conditions and probable traumatic experiences,
he/she may be trained as a preventive measure.
• Though reality may exceed the imagination, at least some information and anticipation of
danger might help.
• Stress inoculation training may be used for this purpose.
• However, one can not be prepared for all disasters in this way.
Phase 1: Information
• Provide information about
the kind of situation the
person is going to face, the
stresses that can occur and
how the trainees may deal
with them.
Phase 2: Self-Comforting
Statements to endure
stress
• Ask the trainees to make
self statements like ‘This
pain is not going to last for
ever, don’t panic’.
Phase 3: Practice under
Controlled Conditions
• Expose the person to
threatening situations
created for the purpose so
that the person can
practice.
Stress
Inoculation
Training
• A stage by stage preparation for an apprehended traumatic experience.
• It involves providing information and training of coping techniques and practice of these
techniques in simulated stressful conditions.
Stages of Stress Inoculation Training

6. PTSD Treatment – Short Term
35
Treatment of PTSD
(in the short term)
1
Pharmocology
2
Psychological
Approaches
• Immediately after the
trauma, often a range of
psychoactive drugs may be
used with the victims of
trauma to ease out the
terror.
• Antidepressants and
tranquilizing medicines
have some effect. Especially
SSRIs have been
particularly successful.
• Short term crisis therapy
may also be needed at
these difficult times. Here
therapists are proactively
engaged with the patients
– giving information,
supporting and clarifying
things as far as possible.

6. PTSD Treatment – Long Term (1/4)
36
• The therapist must provide ways for integrating the experiences into the daily life of the person.
• For all approaches, the key is to gradually expose the person to the memories of the trauma and to
teach her the coping skills.
• Usually after the event or series of events, the person loses trust and sense of security in the world.
Sometimes fear of losing one’s stability predominates.
• As a therapist your first task would be to educate the person about the nature and expected
symptoms of PTSD and emphasise that these can be handled.
• Early approaches to treating PTSD were developed during World War II and the US-Vietnam war:
PTSD Self-Help Groups
• In 1971, Robert Jay Lifton of Yale University worked
with Vietnam war veterans and formed a rap group.
• The rap group dealt with residual guilt and anger of
the war veterans.
• Their guilt concerned what they had to do as part of
their duty in fighting guerrilla warfare.
• They were also angry for being left in this dubious
position by their own Government.
• In the rap groups formed as self help groups the
combatants came to share their experiences with
each other and had a scope to work through the
trauma.
Narcosynthesis
• World War II combat exhausted soldiers were treated
with narcosynthesis.
• Sodium Pentathol (truth serum) was used to induce a
drowsy state.
• Then he was asked about the trauma. Often, a vivid and
horrible description – the traumatic memory -
emerged.
• After the patient woke up, the terrifying events were
discussed.
• The purpose was to make the patient believe that the
events are now past and no longer a threat, thus,
integrating the traumatic memory to the present.

37
Treatment of PTSD
1
Psychoanalytical
Approach
2
Trauma-Focused
CBT
3
EMDR
4
Existential
Approach
5
Family Therapy
1. Psychoanalytical Approach
• The persons have to re-live the
trauma.
• Focus is on the interaction between
pre-trauma personality disposition
and the nature of the event.
• Following the usual technique of
psychoanalytically oriented therapy,
the emphasis is on analysing
defences and transference.
• Con: Controlled studies examining
efficacy of this approach are not
available.
5. Family Therapy
• Often essential for dealing with PTSD.
• Trauma disrupts the entire system of relationships,
bringing in another dimension for treatment.
• The family of the victim also needs to integrate the
aftermath of trauma.
• They often need guidance and help.
• Also, PTSD of the victim is well controlled if put within
a supportive environment.
• By working with the entire family, the therapist may
be able to help each member and also help each to
help the other.

38
3. EMDR
(Eye Movement Desensitisation and Reprocessing)
• This is a technique used for disaster victims.
• It was developed by Francine Shapiro in 1987.
• It may be conceptualised as an off-shoot of
cognitive behavioural therapy.
• Here you utilise the eye movements, hand taps
or sounds, which are essentially different
forms of rhythmic, left-right stimulation.
• Premise:
• It is based on the premise that sometimes the
traumatic memories are ‘stuck’ in the brain
in such a way that talking cannot neutralise
them.
• It is believed that bilateral stimulation may
unfreeze the brain’s information processing
system, and the unpleasant memories can get
integrated into a cohesive memory and be
processed.
2. Trauma-Focused Cognitive-Behavioural Therapy
This is one of the most widely used techniques.
Step 3:
The therapist can slowly induce her to replace the
erroneous thoughts with more reality oriented ones.
Step 2:
The erroneous irrational thoughts about the traumatic
event need to be analysed and understood by the
person.
Step 1: The victim is encouraged to gradually expose
herself to those thoughts, feelings, and situations that
are associated with the trauma and those that she has
carefully tried to avoid so long. The core beliefs and
automatic thoughts are also explored.

39
5. Existential approach (Logotherapy)
• It is also known as logotherapy, the word ‘logos’ implying
meaning.
• This approach was suggested by Viktor Frankl.
• Frankl proposed that the trauma of subhuman treatment can
only be neutralised by integrating it into a broader framework
of existential meaning.
• The task of the therapist is to identify the paradoxical
intentions (such as compulsive rituals) or dereflections
(exaggerated involvement with and watching over self) and make
the person see a broader perspective.
• Often Socratic dialogue is used for this purpose.
• It includes a conversation between the therapist and the
client to raise into consciousness the possibility of looking
for meaning in one’s life.

Do you have any questions,
or suggestions?
Message us on Facebook:
facebook.com/PsychologyLearners

Version 1.0
We have curated a list of movies directly
and indirectly related to psychology.
Click here to access now!
Do you know watching movies
is probably the best way of
learning about something?

Version 1.0
We have a collection of reviews, previews, and
legally free e-books for you.
Are you looking for books to help
you apply the concepts of
Psychology in real life?

PsychoTech Services Psychology Learners 45
Meme like cards
to help you
understand and
remember
complicated
concepts.
PsyConcepts
Quotes related to
psychology,
complete with
explanations to
help understand
their real context
and meaning
PsyQuotes
Professional
checklists and
templates to
improve the look
of your work and
reduce errors
PsyTemplates
Psychology made easy and interesting…

Version 1.0
Helping IGNOU students since 2014!
IGNOU MAPC Corner

www.RealHappinessCenter.com
The
Real Happiness
Center

www.PsychoTechServices.com
Services

PTSD Notes: Causes, Symptoms, Treatment

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

Similaire à PTSD Notes: Causes, Symptoms, Treatment

Similaire à PTSD Notes: Causes, Symptoms, Treatment (20)

Plus de PsychoTech Services

Plus de PsychoTech Services (16)

Dernier

Dernier (20)

PTSD Notes: Causes, Symptoms, Treatment