What is the most effective treatment for PTSD?
Helping clients be able to safely process the unresolved, unmetabolized trauma physiology that is dysfunctionally stored in their neural networks is the overarching goal of psychotherapy for PTSD. Once this is accomplished, the symptoms will resolve. The problem with PTSD is that clients are highly likely to become overwhelmed by their physiological responses to their memories such as flashbacks, body memories, anxiety, nightmares, etc. It’s normal to want to avoid any reminder or trigger of the original traumas, like avoiding a hot stove. Triggers can cause system overwhelm.
For a person with PTSD, their body becomes their enemy. They cannot control when and where and how they will be triggered and the trauma will be re-experienced with intrusive symptoms such as thoughts, images, body sensations, feelings, emotions, flashbacks. So, they learn to avoid any triggers they can. However, in order to heal, the traumas need to be explored and felt in real-time with a therapist and reprocessed and integrated which is how the healing takes place.
It’s very important for a client with PTSD, a condition with a primary feature of high anxiety or fear, to regain a sense of safety in their body, to go from feeling out of control to feeling in control. That means the client needs to be able to find a place in their body to “go to” that feels “okay” and strategies to be able to cope and soothe symptoms of PTSD. It’s the therapist’s job to teach the client skills to manage the intrusive symptoms of PTSD prior to utilizing one of the effective methods for processing traumatic memories.
For years, Cognitive Behavioral Therapy and Prolonged Exposure Therapy were the only treatments thought to be effective in treating PTSD. Though these modalities can be effective, there can be a risk of retraumatization with flooding and there are some clients that don’t respond well with Cognitive Behavioral Therapy.
Another option is Eye Movement Desensitization and Reprocessing or EMDR which uses bilateral stimulation to “kickstart” the process of memory integration that gets impaired in traumatic conditions when the system gets overwhelmed. The dysfunctionally stored physiology (body memories), stored with the memory of the traumatic event and the negative cognitions and emotions experienced during the trauma and as a result of the trauma will reprocess and integrate. EMDR is known to be a relatively quick therapy and can be beneficial for clients who have difficulty talking about the trauma. Talking about the traumatic incident isn’t necessary. The results can be powerful and fast.
The conundrum for the trauma therapist is that no particular mode of therapy works for every person. PTSD is complex and people respond to different types of treatments. Trauma therapists need to be well-versed in several modes of therapy especially therapies that involve focusing on how the emotions are experienced in the body such as EMDR, Sensorimotor Psychotherapy and Somatic Experiencing Psychotherapy.
About Barbara Edelman, MSW, LCSW
I am a Licensed Psychotherapist in Saint Louis, MO.
I am certified in EMDR and specialize in treating Anxiety, Depression, PTSD and Trauma in adults and adolescents and helping my clients develop a sense of peace, comfort and connection in their lives and relationships.
If you have anxiety or depression or think you may have unresolved trauma and would like to work with a Saint Louis area therapist who specializes in anxiety and trauma, please contact me for a free 15-minute phone consultation at 314-780-4906 or email me now to schedule a time.