Post-Traumatic Stress Disorder: Causes and Treatment

In the last issue we defined the nature of Post-Traumatic Stress Disorder (PTSD). When deciding whether this description fits your client, I emphasized two key concepts: extreme threats and intense fear.

Commonly, experts misidentify chronic exposure to stress as a precursor to PTSD. This is simply false. The predisposing event must be both dramatic and severe (e.g., violent marital disputes, armed robbery, rape, and so on). Another common mistake is to simply assume that the exposure to a life threatening event automatically exposes the individual to PTSD. Each of us responds differently. Indeed, some people may actually misperceive a threat due to ignorance or prior history and experiences. Other thrill-seeking individuals may actually enjoy being exposed to danger and may react paradoxically as if they enjoyed the experience. This is why it is essential to document PTSD by use of an assessment interview and psychological testing.

As to the treatment of PTSD, gradual exposure to the threat combined with relaxation training is the most common approach. Treatment may take place in an individual or group setting. The therapist may begin by asking the client to visualize cues relating to the event during relaxation or hypnosis. Then, the therapist may ask the client to expose himself or herself ?in vivo? or in real life to these cues. The therapist can accompany the client in achieving this goal. Progress is dependent upon the intensity of the precipitating event, length of exposure, and how long the condition has been in existence. It is important to note that an incubation phenomenon exists in some cases of PTSD. That is, the individual may not exhibit any symptoms for days or even months and then suddenly a full-blown disorder is manifested. Overall, it is wise to consult a psychologist whenever there is a question as to whether a client is suffering from PTSD.