Do I have to talk about it? Treatment for PTSD.
I practice two kinds of trauma-focused therapies. Here is a look at both of these models followed by an exploration of one of the most common fears people have about trauma work—talking about the trauma.
What is CPT?
Cognitive Processing Therapy (CPT) is a brief model of therapy that gets results. Typically lasting 12 sessions, CPT is a highly structured program to teach survivors new ways to think about and deal with their trauma. Through worksheets, readings, and homework, the therapist guides a person through a step-by-step process, building a new sense of meaning about what happened to them, all while decreasing the symptoms of the PTSD. People often report getting significant relief after 6 sessions. Most people who do all 12 sessions experience their symptoms reduce to a point where they no longer meet the technical definition of PTSD. They are—in essence—cured. And studies show that symptoms continue to decrease months after treatment because people take their skills with them when they leave.
CPT is a highly structured program for adults, to teach survivors new ways to think about and deal with their trauma.
With TF-CBT, young people discover they are more than the things that happen to them and that they have the power to handle what comes their way.
What is TF-CBT?
Trauma Focused Cognitive Behavioral Therapy (TF-CBT) is a proven method for decreasing trauma responses and symptoms for children and teens. Caregivers are an important part of this treatment. It can be mom or dad, an older sibling, a grandparent, or any trusted adult in the child’s life. There are three main phases of TF-CBT: 1) safety and stabilization in which the young person learns new skills and knowledge on how to handle the tough symptoms of trauma, 2) formal gradual exposure in which they neutralize the power of the trauma over their lives, and 3) consolidation/integration in which they imagine a future where the trauma doesn’t run their lives and they reach for growth. Through this highly structured, individually paced process, young people discover they are more than the things that happen to them and that they have the power to handle what comes their way.
Do I have to talk about my trauma? The answer: sometimes.
For people who have survived terrible events or situations, even the idea of revisiting those memories can be extremely uncomfortable. Avoiding the memories is one of the first things people try to do, and it makes sense. Who would want to go there? Unfortunately, this avoidance is what gets the trauma stuck in our lives and what leads us to all sorts of other awful symptoms. Usually, the brain tries to bring up the memories on its own, like with flashbacks or nightmares. This is the brain’s way of trying to heal itself. But when we are on our own, this process can be torture. So, we avoid. Over time, the avoidance grows. It can turn into using substances or drinking too much, working too much, or risky sexual behaviors. It might also look like staying home, isolating, or cutting off from people and things we love. So, while talking about the trauma is painful, ask yourself what not talking about it has gotten you. Please, read on to learn how a trauma-focused therapist can make therapy a safe place to do this hard work.
Avoiding the memories is one of the first things people try to do, and it makes sense. Who would want to go there?
…it turns out that your story is a very important story to tell,…
One of the hallmarks of trauma is a sense of the loss of control. A traumatic event puts us in a situation where we’re not able to help ourselves or others. The normal human reaction to being in a situation like that is to start establishing control wherever and whenever possible. It can get very uncomfortable to not know who’s around us or what’s about to happen— this is where hypervigilance comes in, being on high-alert for danger. Understandably, we also seek to control the thoughts, emotions, and physical reactions that arise when we are reminded of the terrible event. And one way we do this is to not talk about the terrible event. So it turns out that your story is a very important story to tell, and, with the right safety rails in place, it’s a powerful part of healing. Trauma-focused therapy helps people find their voice in the following ways:
It’s structured. Structure is the essence of control. You can feel safe knowing what is coming and when. You get to see the whole schedule so there are no surprises.
It’s evidenced-based. You can take comfort knowing that people who have gone through this process before and have gotten relief from PTSD. The numbers don’t lie.
It teaches you skills to handle the discomfort and fear that comes up, putting you in control of your own body and mind.
It shows that you’re not alone. When people learn that others have gone through what they have gone through, there’s an enormous sense of relief. The therapy structure shows how others have survived what you have survived.
Sometimes just talking about how the event affected you is enough to get serious relief. Your therapist can help you find the parts of your story that are the most important.
If you’ve made it this far, then you definitely have courage. Take one more step by reaching out to a trauma-focused therapist and finding out how they can walk alongside you the rest of the way. It’s easier with a buddy.
