Post-Traumatic Stress Disorder

Dr Jelena Goranovic

ptsd trauma therapy

PTSD refers to a number of symptoms which an individual may start experiencing following a serious life-threatening event (e.g. accident, heart attack, rape, etc.) although even non-life-threatening but extremely disturbing experiences (e.g. abuse, childbirth, etc.) may also result in PTSD. The symptoms include flashbacks, panic attacks and anxiety, nightmares, and other potentially debilitating symptoms.

PTSD is not simply a normal response to a major stressful event, but represents an abnormal or disordered reaction which appears to be mediated by specific neurochemical and neuroanatomical dysfunctions. If untreated, the symptoms of PTSD can last for years, causing severe distress and disruption to the person’s life.

The neurobiological mechanisms of PTSD are still unclear as is the fact that some people develop it whereas others do not, even if they had experienced the same traumatic event. One of the main disturbances that are noticeable in the brains of PTSD sufferers are increased activation of the amygdala (the ‘panic button’ of the brain, involved in the processing of emotional stimuli and the perception of threat which triggers the fight-or-flight response) and reduced volume and impaired function of the hippocampus (the brain area involved in memory formation). This disruption in the amygdala-hippocampus circuit (the ‘emotional memory system’ of the brain) is responsible for the insufficient processing of traumatic events, resulting in traumatic memories that are different from other kinds of memories and significantly more vivid. Such memories are very long-lasting, they are easily triggered and their highly emotional quality can make them difficult to translate into words.

rapid eye movement induction REM therapyPTSD is still a fairly new diagnostic category and while different drug treatments have been explored (antidepressants being the most popular choice), by far the most effective treatment is the Eye-Movement Desensitisation and Reprocessing (EMDR) technique. EMDR involves simulating the rapid eye movements (REM) which characteristically occur during the phase of sleep when we have dreams - it is during this phase that the amygdala-hippocampus circuit actively reprocesses all emotional information that has accumulated during the day. Although the client is fully awake during this intervention, simulating the eye movements seems to achieve the same effect as the REM sleep, facilitating the desensitisation of the amygdala by allowing the adaptive processing and integration of the traumatic memories.

EMDR is most commonly used in a psychotherapeutic or counselling contexts, usually alongside the cognitive behavioural therapy (CBT). EMDR-derived approaches, the REM Induction Therapy (REMit) and Wingwave Coaching, are also useful therapeutic options for PTSD sufferers. REMit is a novel neuropsychological method which combines awake REM simulation with neurolinguistic programming (NLP) and hypnosis. The advantage of this therapeutic method over standard EMDR-containing therapies is that REMit can be completely content-free so the client is not required to describe any details of the traumatic incident to the therapist. Another approach which is not related to EMDR but also shows some very promising results in the treatment of PTSD is the Emotional Freedom Technique (EFT).

Published by Hove StressBusters
July 2012