How CBT can help with different mental health problems

Trauma and Post Traumatic Stress Disorder (PTSD)

What is Trauma and PTSD.

Trauma or PTSD is a mental health condition that can develop after a person experiences or witnesses a traumatic event, such as natural disasters, accidents, combat exposure, violence, or other life-threatening situations. Many people experience temporary distress after such events, however some people develop PTSD when their symptoms persist for more than a month and significantly impair daily functioning.

Common symptoms of PTSD include:

Re-experiencing or reliving the traumatic experience- Playing the event over in a person’s mind, or experiencing memories of the event coming back unexpectedly

These can be experienced as:

Flashbacks- unwanted memories where it can feel like the trauma is happening again

Nightmares-bad dreams or memories that occur during the night

Physical reactions- such as pain, sweating, feeling sick or trembling, feeling the same sensations in the body felt at the time of the trauma

Repetitive and distressing images or sensations

Increased Arousal/Hyperarousal- High levels of anxiety and fear may exist for a long time after the traumatic experience is over

Symptoms may include:

Feeling on edge

Finding it difficult to relax

Feeling constantly aware of threats

Being jumpy and easily startled

Difficulty concentrating

Difficulties sleeping

Feeling irritable

Alongside fear and anxiety people with PSTD may experience a range of other emotions such as:

Anger, annoyance and/or irritability

Guilt and/or shame

Grief and depression

People with PTSD may engage in unhelpful patterns of behaviours such as avoidance. People may avoid anything that reminds them of the traumatic event. This could include certain situations, places or people. It could also include avoiding talking or thinking about the traumatic experience or avoiding any emotions associated with the traumatic event.

Avoidance can lead to people becoming isolated and socially withdrawn, and they may stop engaging in activities they used to enjoy. Alternatively people may try to push memories of the event out of their mind by distracting themselves with other things like work or hobbies.

People may also engage in unhealthy or self-destructive ways of coping with their emotions such as alcohol or substance misuse. People may also find themselves zoning out, disassociating or becoming emotionally numb as a way of helping them cope with distressing emotions.

People with PTSD may experience changes to their thinking following a traumatic experience. They may feel that they are different, that they can't trust people or that the world is more scary/dangerous. They may also feel like they are going crazy/mad or that they are somehow to blame for what happened.

NICE guidelines recommend 8-12 sessions.

How CBT helps

CBT helps people to address unhelpful thoughts and behaviours that stem from trauma. It helps people to process traumatic memories and reduce distressing symptoms. It helps people to understand the connections between their distressing thoughts, emotions and behaviours and break the cycle that maintains the problem.

CBT helps people to identify, challenge and modify negative thought patterns and beliefs about the trauma and how they see themselves, other people and the world following this. It helps people evaluate their thoughts and develop more balanced perspectives.

CBT helps people to address unhelpful behaviours. It helps people to gradually and safely confront trauma related memories, feelings and situations they have been avoiding. It does this through exposure and this is done in a gradual, step by step way. It also helps people to begin to re-engage in activities that they may have stopped doing since their traumatic experience.

CBT helps people to process their trauma through providing them with a safe space to talk about their traumatic experience. It helps people learn how to cope with distressing thoughts, feelings and symptoms and to develop healthier skills and strategies to manage these. This makes the memories less upsetting and helps people feel they are more manageable.

CBT helps people with PTSD to regain a sense of control over their lives leading to improved daily functioning and emotional wellbeing. It helps to diminish feelings of guilt, shame or fear associated with the trauma.. It helps people to move forward with their lives without being overwhelmed by their past.