“… I remember the accident just like it was yesterday… I just can’t get the images out of my head…”
Most people will go through at least one traumatic event during their lifetime with the greater part of the healing occurring within the week; sometimes this takes longer and can result in Post Traumatic Stress Disorder. So what exactly is Posttraumatic Stress Disorder (PTSD)? How can counselling therapy help in my recovery?
Posttraumatic Stress Disorder Defined
Posttraumatic Stress Disorder (PTSD) refers to a mental health condition which occurs following a traumatic or distressing event such as an assault, natural disaster, serious injury, witnessing or being involved in an accident, and also hearing about an accident that occurred for a loved one.
The diagnostic criteria within the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5), includes a history of exposure to a traumatic event and symptoms from four main symptom clusters:
- Negative changes in cognitions and mood (feeling sad or unhappy, negative thoughts),
- Changes in arousal and reactivity (easily startled, feeling tense or on edge),
- Intrusion (unwanted thoughts popping into your mind), &
- Avoidance (avoiding people and places that are reminders of the event).
The DSM-5 also examines the amount of time a person has been experiencing their symptoms, their ability to function in daily life, and whether the symptoms could be explained by substance use or a medical condition. It is important for a therapist to rule out any other causes before beginning treatment. If there is no other explanation and the symptoms have been experienced for greater than a month then it is important to speak to a therapist straight away .
What does PTSD look like & how does it affect people?
A person who is experiencing PTSD will often have the following difficulties:
- Negative thoughts and feelings
It is common for people who have PTSD to experience changes in their thoughts, feelings and behaviour. Common changes include:
- Feeling angry, guilty, flat or numb,
- Being easily startled or being constantly on the lookout for danger,
- Increased anger or irritability,
- Increased risk taking behaviour,
- Difficulty sleeping or concentrating,
- Loss of interest in day-to-day activities, &
- Feeling cut off from friends and family.
- Re-living the traumatic event
Often when a person experiences an event that is distressing for them, they will continue to think about the event and re-live the event in their mind. This can occur in a number of ways:
- Flashbacks or repetitive unwanted memories
- Nightmares, and
- Intensive physical reactions such as heart palpitations or a panic response when reminded of the event – similar physical reactions experienced at the time of the event.
As a way to manage this experience, people will often begin to avoid reminders of the event through changing their daily routines. For instance, someone with PTSD may stop spending time with friends and family, or they may stop visiting their usual coffee shop, supermarket or gym – if these people, places and routines are triggering of PTSD symptoms.
- Substance misuse
It is quite common for people who are experiencing PTSD to also start using substances as a way of coping .
Does everyone respond in the same way following a traumatic event?
Within the latest edition of the DSM, it has been recognised that children will show their distress to a traumatic event differently than adults and adolescents; there is now a sub-section titled Posttraumatic Stress Disorder for children aged 6 years and younger [1, 3, & 5].
Common behavioural changes which can be observed within children include:
- Problems with concentration,
- Changes to sleeping patterns,
- Loss of interest in games and activities which were previously enjoyed,
- Being socially withdrawn,
- Being irritable or having extreme temper tantrums, &
- Experiencing distressing memories.
What to expect during treatment for PTSD?
No one should live with ongoing PTSD symptoms and with effective therapy it is a very treatable mental health condition. If you or a loved one has experienced a traumatic event and has ongoing PTSD symptoms then it may be helpful to consider exploring your therapy options.
There are many types of therapy that can be used to assist someone who is experiencing PTSD, some examples of recommended therapies include trauma-focused cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), and narrative therapy for trauma. While each therapy style will be slightly different in duration and in the overall approach to recovery, there are similarities between each.
During therapy the client is always in control of the pace of therapy, and the therapist will work collaboratively beside the client to achieve the therapy goals and ultimately greater health and wellbeing. It is common for people to have 12 – 20 sessions of therapy, although this can be longer depending on the individual and the complexity of the trauma [3 & 4].
Often treatment will involve learning new skills and relaxation strategies for when you may be experiencing anxiety, and techniques for managing painful thoughts and memories. You may also progressively learn ways to re-integrate into activities that you once enjoyed but became too triggering for you. In time – when you are ready – therapy may involve thinking and talking about the traumatic event in a safe way, which is assisted by your therapist .
If you or a loved one has experienced a traumatic event and has ongoing PTSD symptoms then it may be helpful to consider exploring your therapy options.
 Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2012).Trauma-focused CBT for children and adolescents: Treatment applications. New York, NY: Guilford Press.
 Frueh, B. C. (2012). Assessment and treatment planning for PTSD. Hoboken, N.J: John Wiley & Sons.
 Scott, M. J., 1948, & Sembi, S. (2013;2012;). CBT for common trauma responses (Third ed.). London: SAGE.
 Shea, M. T., & Zlotnick, C. (2002). Understanding and treating PTSD: Introduction. Journal of Clinical Psychology, 58(8), 869-875.
 Phoenix Australia – www. http://phoenixaustralia.org/
 EMDR – www. http://emdraa.org/
 Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5)