Can you cure PTSD?

This is a question I hear from patients on a near constant basis and one I ponder on a regular basis both personally and professionally. What does it mean to cure PTSD? Does it mean you can sleep again? Does it mean you don’t remember what happened to you? Does it mean you can smile again? The notion of a “cure” for any mental health condition is still an extremely controversial topic in the field. While there are some mental health conditions we know are not “curable” by the textbook definition of a cure such as Schizophrenia, Bipolar Disorder, or Autism, that does not mean your life is over. Think about it this way. Is there a cure for Diabetes? Is there a cure for cancer? Is there a cure for a broken leg? The standard answer is “ yes,” but when you think about these conditions, the “cure” is more about treatment not necessarily just getting rid of the disorder. With cancer, you can go into remission, but that doesn’t mean it’s cured because it can come back. With diabetes, you can manage it with insulin and still live a full life. PTSD is the same way. When I think about “curing” PTSD, I think about it just like “curing” cancer; an individual goes through treatment, their symptoms subside, and they are able to function again. Does that mean it will always be like that? No, of course not, there are no guarantees with any treatment medical or psychological. But you can have your life back in a way that you likely didn’t think possible.

Now, I recognize how Pollyanna that perspective may sound to many, but from experience with my patients and copious amounts of research done my individuals far smarter than I am, it is something I wholeheartedly believe to be true. I have seen people with PTSD symptoms for decades go through treatment and come out the other side happier, healthier, calmer, more rested, and able to live again. Their trauma wasn’t gone though, trauma never goes away, it’s the symptoms that we are trying to treat. PTSD is made up of 4 symptom clusters: re-experiencing, avoidance, negative mood and thought changes, and hyperarousal. I spent a whole lot of time getting to know these symptoms in textbook form before I got to see them in the real world and let me tell you, the textbook has nothing on the real world manifestation of this life-destroying disorder. PTSD eats away at someone, it infects their entire existence, it makes them want to die, but for most, they keep on fighting. Suicidal thoughts with PTSD are so very common as is drinking, other substance abuse, sexual difficulties, medical problems, and a whole host of other life changers, but just as Princess Leia says in Rogue One, “hope” is the answer. Hope means there is at least the smallest glimmer that things will change. Never underestimate the motivating power of hope even if it’s just to prove someone wrong. PTSD can be cured, symptoms can go down, your life can be yours again. No, your trauma will never go away, but that does not mean you cannot get better.

Treatment for PTSD sucks. I’ll be the first one in the office telling you that from meeting #1. Having to uncover your deepest, darkest, more horrid experience to a near complete stranger is an experience that inherently makes your body tense and pucker with anticipation, but that’s honestly my job. It is the job of a trauma psychologist to be your go to person, the person who sits with you while you tell every gory, bloody, scary, horrifying, disgusting detail of this horrible time in your life, and who will never recoil from a single word. Treatment means uncovering the wound, cleaning out the infection, and stitching you up. It also means going through the rehabilitation and tending to the scar. See, trauma is a scar while PTSD is the hemorrhaging bullet wound. Like any wound, you have to stop the bleeding before you put it in a cast. Your life will never be the same after a trauma, that’s the very nature of trauma, but it does not mean your life ends after the trauma. Hope exists, treatment exists, you can exist again. To learn more about PTSD, treatment, or recovery from trauma, feel free to email or call my office. There is life after trauma, there is you after trauma.

Exposure Therapy 101

Anxiety is defined as “a state of intense apprehension, uncertainty, and fear resulting from the anticipation of a threatening event or situation, often to a degree that normal physical and psychological functioning is disrupted” (American Heritage Medical, 2007, p. 38). While I’m a big fan of this technical definition, I think it’s safe to say to anyone who has ever experienced anxiety is that it just SUCKS! The way your body reacts to anxiety makes you legitimately feel like you’re dying. I remember my first panic attack so clearly that if I needed to create it for any reason that would definitely not be a problem (it involved a snake and, at that time, my anxiety towards those little beasts was near paralyzing). I didn’t know what I know now about treatment for anxiety, particularly about exposure-based treatments to resolve any anxiety or trauma disorder. Each year, Anxiety Disorders impact approximately 18% of 40 million adults in the United States (NIMH, 2013).

So, what is exposure therapy? Considered the gold standard treatment for anxiety disorders, exposure-based treatments focus on change by exposing an individual to their feared objects, activities, or situations in a safe environment to help reduce fear and decrease avoidance (APA Division 12, 2013). Below are so basic examples of what type of techniques are used in exposure-based treatment.

While exposure therapy seems scary at first glance, what we know about it is truly astonishing. Numerous research studies have revealed that positive treatment outcomes for Anxiety Disorders are maintained longer for individuals who have participated in Cognitive-Behavior Therapy and Behavior Therapy (exposure therapy; National Institute of Mental Health, 2013). But the real question people typically have is not “what is it?” but rather “how does it work?” Well, here’s how:

Over time, anxiety goes down the more frequently someone practices/engages in the activity that makes them anxious. Here are some examples of how you and your therapist can take this theory and put it into action:

While exposure therapy isn’t magic, sometimes it can feel like that. It can treat a variety of Anxiety and Trauma Disorders such as Social Anxiety, Panic Disorder, Obsessive-Compulsive Disorder, Specific Phobias, and Posttraumatic Stress Disorder (PTSD). I have seen individuals who have chronic anxiety (we’re talking 40+ years) go through exposure therapy and report no longer having anxiety, at all! I admit my bias when it comes to exposure therapy, but it truly is one of my favorite things to do in treatment because IT WORKS. Some examples of specific exposure treatments include:

If you experience anxiety, things can get better. It won’t always be pleasant and, at times, it downright hurts, but you can overcome your anxiety, you can take back your power, you can live a life without anxiety! To learn more about anxiety, trauma disorders, and treatment feel free to email me at jnspsychology@gmail.com or give me a call at 702-587-1573 to schedule an appointment.

Why go to therapy?

Seeking therapy is an individual choice and a courageous one at that! There are many reasons why someone would choose to begin therapy. Sometimes it is to focus on a long-standing issue, such as anxiety or depression. Other times it is in response to unexpected changes in life that are causing difficulties in daily functioning. Many people think therapy is “advice giving” when really it is a form of collaborative exploration where you learn techniques and tools to become your own therapist.

For many years, there have been some pretty negative messages sent about the people who see a therapist or a “shrink.” Therapy does not necessarily mean anything is “wrong” with you, it just means maybe you could use some extra support at some point in your life. Strangely enough, one of the first positive messages I saw about therapy was on an episode of Sex and the City after Carrie had a difficult break up with Mr. Big. This exchange between some of her friends really highlighted to me the function that therapy could have in someone’s life:

Carrie: Why should I pay to talk to someone when we can talk to you guys and go get a drink or whatever. I don’t need professional help I have you guys

Miranda: Yeah for about another 10 minutes and then we’re cutting you off, cold turkey

Samantha: Look, we’re just as fucked up as you are, it’s like the blind leading the blind

Miranda: Sometimes it helps to talk to someone who’s objective

*later* Stanford: How can you not have a shrink? Even the shrinks have shrinks!

Therapy is often someone’s “last ditch effort” when all other ways of feeling better have been exhausted. Other times, it’s when something bad has happened like a legal case, an ended relationship, or even a hospitalization that brings someone into the office. There is no right or wrong way to seek out therapy. The thing that is critical is finding someone who is a good match for you. Just like you are an individual so is your therapist. Your provider should make you feel comfortable, like it is ok to be yourself, and to know that they are there for you to provide the best treatment possible. Therapy is an incredibly vulnerable experience and feeling safe, secure, and supportive is pretty vital.

Therapists come in many different forms and one of the easiest ways to examine differences is in something called theoretical orientation. Every provider has an approach they typically use when working with you, their “theory of change” that provides a foundation of how they approach you. For example, my theoretical orientation is Cognitive-Behavioral, which means I believe behaviors and beliefs are directly related to presenting concerns and change comes from altering how we have been approaching things. Some of the tools and skills I use to help individuals are considered “behavioral interventions,” which essentially are concrete, tangible tools you can use in and outside of therapy.

It is my belief that therapy should not last forever, your life is so much more than that. Therapy is only a piece of your journey, not the entire quest. Beginning therapy can be incredibly scary and that’s perfectly normal and expected. Not everyone who comes to therapy really wants to be there and that’s ok too. Your therapist is there to meet you were you are and to provide you with the best care. If you do not feel like you are a good fit, let them know; your life is too important to stick with someone who isn’t a good match. For more information about therapy, Cognitive-Behavioral therapy, or any general inquires, feel free to contact me by phone at 702-587-1573 or email at jnspsychology@gmail.com.