I think I have PTSD: Now What?

When struggling with Post-Traumatic Stress Disorder (PTSD), life can feel scary and limiting. Intrusive symptoms of PTSD can look like being haunted by unwanted memories of the traumatic event, having intense physical sensations like heart palpitations or sweating, experiencing strong emotions of fear, anger, or shame when reminded of the trauma, and enduring flashbacks of the event. These intrusive symptoms indicate that something about the event still needs to be processed. However, these symptoms are so distressing and confusing that many people develop beliefs such as, “I’m going crazy,” and “I can’t handle this,” and start avoiding reminders of the trauma that bring up these symptoms. 

Avoidance comes in many forms; drinking to bring down distress, over-working, isolating from loved ones, you name it. Our brain is really good at finding ways to avoid pain, especially trauma-related pain. It’s human. However, avoidance prevents healing from trauma and limits our life. Folks might start over-relying on substances, they avoid the subway, they miss out on family functions or events they would normally love to attend. Loved ones may feel shut out. Many folks become depressed as their world shrinks. Unfortunately, avoidance breeds avoidance. The more we do it, the harder it is to stop avoiding and heal.

Good news: PTSD is curable. Bad news: the only way out of PTSD is through it. There are short-term, evidence-based approaches to treating PTSD, including Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). They both effectively treat PTSD by blocking avoidance and helping you confront your trauma in the presence of a safe other. Avoidance is the enemy.

Cognitive Processing Therapy (CPT) helps individuals to confront the trauma through our meaning-making system, the way we understand why the event happened to us and what this means about the world, others, and ourselves. CPT describes “stuck points,” or beliefs that we develop after trauma that prevent healing. So often, folks internalize blame and guilt for negative events, believing, “I must have done something to deserve this or it wouldn’t have happened to me.”  In CPT, folks learn to identify and challenge these stuck points, like “it was all my fault,” or “this happened to me because I was drinking.” Witnessing folks shed the overwhelming shame and guilt that so many trauma survivors struggle with is profound and leads to long-lasting shifts in esteem and confidence. 

In addition, after trauma, we can begin seeing the present world, ourselves and others through trauma-tinted glasses. We may go to extremes believing, “I can’t trust anyone,” “the world is dangerous,” or “I’m incompetent.” CPT helps folks effectively process the traumatic experience and integrate it with all their other experiences to create balanced beliefs that promote healing and recovery. Individuals learn to engage in the world in new ways, promoting a greater sense of safety, trust, power and intimacy.

Prolonged Exposure (PE) helps folks face their fears and get back on the horse after they fall down. Individuals confront their trauma memory with repeated accounts of the event both in session and out, and re-engage in meaningful activities, situations, and places they’ve been avoiding. Intimidating? Yes. Effective? Absolutely. The pride that folks experience from realizing they can do this is incredible. And the great part about exposure is that the more you do it, the easier it gets. As you intentionally remember the event in treatment, you stop re-experiencing the trauma as if it’s happening again. Life becomes more full and satisfying. You become braver. 

Across treatments, you will learn that you can handle confronting your fears and processing your trauma. Folks with PTSD are already reliving their trauma on repeat. While treatment is asking you to revisit the memory, you won’t be alone and you will be in control. Intrusive symptoms will go away if the memory is processed. Trauma so often strips folks of their power and joy. Treatment is about helping you take back your power and your narrative. It’s about pushing PTSD out of the driving seat and getting you back in there. You’re not going crazy. You can handle it. It’s tough but in the presence of a safe and trusted therapist, you’re stronger.