PTSD Treatment

It is Possible to Recover from Post Traumatic Stress Disorder

The first client I treated for PTSD was not a military veteran, although I have treated veterans and first responders over the duration of my practice.  He was an unfortunate bystander, when an out-of-control vehicle surprised him.  He had only enough time to see it bearing down on him, but not enough time to avoid its path.  Physically, he was badly injured, but the symptoms that bothered him the most were not physical.  They were  the continuously intruding mental images of the car coming at him, the intense anxiety accompanying those images, and the sleeplessness associated with his very frequent nightmares.  He was unable to discover any way to escape this continuous re-experience of trauma, except by drinking heavily.  Pain medications and antidepressants helped only very slightly.

I consulted medical colleagues in designing his treatment plan, and he made a good recovery.  Variations of this plan have enabled me to help every one of my subsequent clients, who have had these symptoms.

At the time of his injuries, PTSD was a new diagnosis, which had been introduced to the mental health professions by a recently published edition of the Diagnostic Manual,  called DSM-III.  (There have been two more editions since, and the current one is DSM-5.)  PTSD is also called Operational Stress Injury and it is a serious psychological or mental wound.  There are many informative comparisons to physical injury, and as with physical injuries, there are mild cases, and severe cases.  However, many physical injuries heal without much treatment.   Traumatic emotional injuries are seldom like this.  Left untended, they tend to get gradually worse.

Injuries such as fractures, sprains, and serious physical wounds all leave scars, so that recovery is never truly complete.  The scars remain, even when function is recovered.  Generally, old scars do not hurt, but people who have been wounded do not heal in such a way that there is no evidence of the wound.  They do not return to the people they were, before the injury.  Partially, this is because they are older than they were, before they were hurt.  If someone’s arm has been badly injured, after rehabilitation and recovery, that arm will almost certainly be more vulnerable to re-injury than the other arm, which had not been damaged.  Its function may be somewhat impaired, or it may not be as strong.  It may need to be protected from some kinds of stress.

No one finds these kinds of outcomes remarkable when physical injuries are involved, but it is often difficult to understand that when someone has had a mental or psychological injury, even after successful treatment and recovery, that person will be vulnerable to re-injury.  There will be a need for protection from re-injury.  There will be emotional scars.  One reason for this difficulty is that PTSD involves invisible injuries.  They leave invisible scars.  Even if the person’s appearance is very much the same as before the injury, that person will not feel the same.

Perhaps it would be more appropriate to compare psychological recovery from emotional trauma, with another painful psychological experience, such as grief.  When people experience profound grief over the loss of a loved one, they do not recover from their grief in such a way as to become the same person they were, before the loss.  Experiences of that kind change people profoundly, but we still speak confidently about recovery from grief.  It is accepted that there will be scars from such experiences.

I can help people recover from the kinds of experiences that cause PTSD, including techniques that will help them protect themselves from re-injury, or relapse.  I can’t return them to the people they were before those injuries, but I can help them resume competent management of their lives, and achieve a stable situation wherein they no longer have to live with constant psychological distress.  My goal for my clients is to see them into a life adjustment where their scars are not painful.  It is possible, eventually for those scars to not hurt.