Written by: Amanda Levison, M.S., LMHC, LPC, CCBT
Imagine living with a constant stomach ache, an uneasy feeling in your gut that never seems to go away. For people living with post-traumatic stress disorder (PTSD), this is just a glimpse of what life can feel like. The symptoms of PTSD can be overwhelming, leaving individuals feeling unsafe and unable to find comfort in their bodies. But there is hope! In this article, we will explore the different therapy options available for individuals who have PTSD, providing insight into how they can manage their symptoms and find the peace they crave.Â
PTSD is a mental health condition that affects individuals who have experienced or witnessed traumatic events like war, assault, or natural disasters. It can manifest in various ways, including anxiety, depression, nightmares, and changes in mood or thinking. These symptoms can make life challenging and rob individuals of the comfort and security they once knew.Â
Fortunately, different types of therapy can help individuals manage their symptoms and improve their quality of life. Let's take a look at these various therapies and coping techniques available to you for managing post-traumatic stress disorder.Â
Cognitive Behavioral Therapy (CBT)
CBT is a powerful therapy that aims to change negative thought patterns and behaviours. Individuals can regain control over their lives by challenging and replacing negative thoughts with positive and realistic ones. Activities like reframing negative thoughts, engaging in pleasurable activities, and gradually exposing oneself to fears through exposure therapy can all effectively manage symptoms. These approaches can significantly improve an individual's overall well-being with time and practice.Â
Reframing negative thoughts
It involves identifying and replacing them with more positive or realistic ones.
One effective way to reframe negative thoughts with PTSD is to try to challenge and replace them with more positive, realistic ones. For example, if you think "I'm not safe" when you are in a safe situation, try to remind yourself that you are safe and that your current surroundings are not threatening. You can also try to focus on the present moment and engage in calming activities, like deep breathing or meditation, to help ground yourself.Â
Remember that reframing negative thoughts takes practice but can help improve your overall well-being with time and patience.
Behavioral activation
It involves identifying and engaging in activities that bring pleasure or accomplishment.
In behavioral activation (BA) with PTSD, individuals may avoid certain situations or activities that trigger symptoms, which can lead to further isolation and negative thinking. BA encourages individuals to gradually increase their activity level and engagement in enjoyable and meaningful activities. This can help break the cycle of avoidance and increase positive experiences, which can improve overall well-being. Some examples of BA activities for individuals with PTSD may include exercise, socializing with friends and family, engaging in hobbies, and volunteering. Working with a trained mental health professional is important to develop a personalized BA plan that meets your unique needs and goals.
Exposure therapyÂ
It involves gradually exposing oneself to feared situations or objects to desensitize the fear response.
CBT for PTSD may include exposure therapy, where a patient is gradually exposed to a traumatic memory, stimuli, or situation in a safe and controlled environment to help them process their fears and emotions.
Relaxation Techniques
Taking care of one's mental health also means prioritizing relaxation and learning techniques to manage stress and anxiety. Practices such as deep breathing exercises, progressive muscle relaxation, visualization, and mindfulness meditation can all help reduce anxiety and promote a sense of calmness. By incorporating these techniques into daily routines, individuals with PTSD can gain relief and a renewed sense of peace.
1. Deep breathing exercises
One deep breathing exercise that can help reduce anxiety is called "belly breathing." Here are the steps:
Find a quiet and comfortable place to sit or lie down.
Place one hand on your chest and the other on your belly.
Breathe deeply through your nose, and feel your belly pushing your hand out as you do so. Your chest should remain relatively still.
Hold your breath for a few seconds.
Slowly exhale through your mouth, feeling your belly deflate as you do so.
Repeat this process for a few minutes or until you feel more relaxed.Â
Remember to take slow, deep breaths and focus on your breath as you do so. It may also be helpful to count to four as you inhale, hold your breath for a count of four, and exhale for a count of four.
2. Progressive muscle relaxationÂ
Progressive muscle relaxation is another technique that can help reduce anxiety. Here are the steps:
Find a quiet and comfortable place to sit or lie down.
Begin by tensing the muscles in your toes and feet as tightly as possible, and hold for a few seconds.
Release the tension and let your muscles relax completely.
Move on to the muscles in your calves and thighs, tensing them as tightly as possible, and hold for a few seconds.
Release the tension and let your muscles relax completely.
Continue moving up your body, tensing and relaxing the muscles in your abdomen, chest, back, shoulders, arms, hands, neck, and face.
As you tense each muscle group, focus on the sensations of tension and relaxation in your body.
Take slow, deep breaths throughout the exercise.
Repeat this process for a few minutes or until you feel more relaxed.
Remember to take your time with each muscle group and focus on the sensations in your body as you tense and relax your muscles. With practice, progressive muscle relaxation can become a powerful tool for reducing anxiety and stress.
3. Visualization
Visualization can be a helpful technique for managing symptoms of PTSD. Here is a visualization exercise that you can try:
Find a quiet and comfortable place to sit or lie down.
Close your eyes and take a few deep breaths to relax.
Imagine a peaceful and calming place, such as a beach, a forest, or a mountain view.
Visualize the details of this place, such as the colors, textures, and sounds.
Imagine yourself in this place, feeling safe and relaxed.
If any disturbing thoughts or memories arise, acknowledge them and let them go. Visualize them floating away like clouds in the sky.
Focus on your breathing, taking slow, deep breaths through your nose and out through your mouth.
Stay in this visualization for as long as you need to feel more relaxed and calm.Â
Remember that visualization is a skill that takes practice, but it can be a powerful tool for managing PTSD symptoms. If you find it challenging to do this exercise on your own, consider working with a therapist who specializes in trauma therapy.
4. Meditation
This involves focusing the mind on a particular object, thought, or activity to achieve a mentally clear and emotionally calm state. One example of a meditation practice that may be helpful is called "mindfulness meditation." This involves paying attention to the present moment and accepting thoughts and feelings that arise without judgment. To practice mindfulness meditation:Â
Find a quiet place to sit comfortably with your eyes closed.Â
Take deep breaths and focus on your breath, noticing the sensations in your body as you inhale and exhale.Â
When your mind wanders, gently bring your attention back to your breath. With regular practice, mindfulness meditation may help reduce symptoms of PTSD, such as anxiety, depression, and hypervigilance.
You could try practicing these techniques regularly to help reduce anxiety and stress, improve sleep, and promote a sense of calmness. It is essential to consult with a mental health professional to determine the most appropriate relaxation technique for your specific needs and to develop a comprehensive treatment plan.
Problem-Solving SkillsÂ
Sometimes, PTSD can leave individuals feeling overwhelmed and without a sense of control. That's where problem-solving skills come in. Individuals can regain a sense of empowerment and control by defining problems, brainstorming solutions, evaluating them, and implementing a plan. Problem-solving skills can be invaluable tools for managing symptoms and finding serenity in life.
This involves identifying and addressing problems and learning skills to solve them constructively, which can lead to a sense of control and empowerment. Here are some problem-solving skills that may be helpful for individuals with PTSD:
Define the problem:Â Clearly articulate the problem you are trying to solve.
Brainstorm solutions:Â Think of as many potential solutions as possible without judging or evaluating them.
Evaluate solutions:Â Consider the pros and cons of each potential solution and choose the best one.
Develop a plan:Â Create a specific plan of action to implement your chosen solution.
Implement the plan: Take action to solve the problem.
Evaluate the outcome:Â Assess the effectiveness of your plan and consider any necessary adjustments.
By developing and utilizing problem-solving skills, individuals with PTSD may feel more equipped to manage their symptoms and improve their overall well-being.Â
It's important to note that CBT is tailored to the individual and their specific needs, so the techniques used may vary from person to person. CBT for PTSD usually involves several steps, including education about the disorder, identifying the triggers of PTSD symptoms, learning relaxation techniques, and gradually approaching traumatic memories in a safe and supportive environment. The goal of CBT is to help individuals with PTSD develop coping skills and strategies to manage their symptoms and improve their quality of life. It is important to seek out professional support through expert individual therapists who have experience treating PTSD with CBT.
EMDR, PE, and MBSR
Apart from CBT, other therapeutic options for individuals with PTSD include Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy (PE), and Mindfulness-Based Stress Reduction (MBSR). EMDR helps individuals process traumatic memories, PE helps confront fears through gradual exposure, and MBSR teaches mindfulness and stress reduction techniques. When guided by qualified therapists, these approaches have shown promise in alleviating symptoms and helping individuals find healing.Â
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a type of therapy that uses eye movements or other forms of rhythmic stimuli to help individuals process traumatic memories, thoughts, and emotions. EMDR aims to help individuals reprocess traumatic memories and reduce their emotional intensity and negative beliefs associated with the event. In EMDR, you'll pay attention to the "back-and-forth" movement or sound as you recall the traumatic experience until there is a shift in how you re-experience that memory as more information is processed. During a session, you will do the following:
Be educated on emotional and physical reactions to traumaÂ
Discuss readiness with a clinician to refocus on past trauma
Learn new coping skills
Identify the target (upsetting memory, including any negative thoughts, feelings, and bodily sensations related to the memory)
Hold that memory while also paying attention to the back-and-forth movement or sound (i.e., flashing light, moving finger, beeping tone) until the distress is reduced (roughly 30 seconds at a time)
Discuss the exercise with the clinician about what that experience was like and focus on the positive relief and feelings associated with that experience.
Evaluation at the end of treatment assesses symptom progress and future sessions if needed.
Although EMDR is not a cure-all for PTSD, it has been found useful and practical as a treatment option. If you are interested in EMDR, find a licensed therapist trained in this technique.
Prolonged Exposure Therapy (PE)
PE is a type of therapy that helps individuals confront their traumatic memories and experiences in a safe and controlled environment. It involves gradual exposure to the memories, thoughts, feelings, and situations that cause fear and anxiety to help individuals process and overcome their symptoms. Often, people with PTSD tend to avoid anything that reminds them of their trauma. However, avoidance can lead to more serious issues down the road. PE works by helping you gradually face your fears, talk about the details of the traumatic event, and confront safe spaces that you avoided to regain control of your life. How PE works is:
First, be provided with an overview of treatment by the provider while learning about the past traumatic experience.
Learn and utilize deep breathing exercises to manage anxiety symptoms
Second, develop a list of people, places, and things that you've avoided to be used step-by-step practicing in-vivo exposure
The following Sessions will include gradual confrontation of the avoided situations. Therefore, in time, you become more comfortable and less fearful.
Discussion and imaginal exposure also guide the sessions to process emotions and other details related to the trauma.
Mindfulness-Based Stress Reduction (MBSR)
MBSR is a therapy that helps individuals learn to be more present at the moment and recognize and manage their thoughts and emotions. MBSR may include meditation, breathing exercises, and other relaxation techniques to help individuals manage their stress and anxiety. Here are some examples of how MBSR might be used in treating PTSD:Â
Mindful breathing involves focusing on your breath and observing your thoughts and feelings without judgment. This can help individuals become more aware of their thoughts and emotions and learn to accept them without trying to change or control them.
A body scan involves focusing on different body parts and observing sensations or feelings without judgment. This can help individuals become more aware of their physical sensations and learn to accept them without changing or controlling them.
Mindful movement involves practicing gentle movements, such as yoga or tai chi, and focusing on your body and breath. This can help individuals become more aware of their physical sensations and learn to accept them without changing or controlling them.
 Loving-kindness meditation involves directing positive thoughts and feelings towards yourself and others. This can help individuals develop a more positive and compassionate attitude towards themselves and others.
MBSR can be helpful for individuals with PTSD because it can help them learn to manage their symptoms and improve their quality of life. Working with a trained mental health professional is important to develop a personalized MBSR plan that meets your unique needs and goals.
Group Therapy
Group therapy for PTSD can be a helpful treatment option for individuals who have experienced traumatic events. In group therapy, individuals can connect with others who have had similar experiences and share their feelings and thoughts in a supportive environment. Group therapy for PTSD may involve different types of therapy, such as cognitive-behavioral therapy (CBT) or exposure therapy, as mentioned before.
In group CBT for PTSD, individuals may work together to identify and challenge negative thought patterns and behaviors that contribute to their symptoms. They may also learn coping skills and relaxation techniques to manage their symptoms.
In exposure therapy groups, individuals may work together to gradually confront their fears and anxieties in a safe and supportive environment. This can be especially helpful for individuals who have avoided certain situations or activities due to their PTSD symptoms.
In addition to individual therapy, group therapy, such as our mental health support groups, can be incredibly beneficial for individuals with PTSD. It provides a safe space for individuals to connect with others who have shared similar experiences, offering support, understanding, and a sense of community. Group therapy also allows learning from others and gaining different perspectives on managing symptoms. It can be a valuable complement to individual therapy and help individuals navigate their healing journey.Â
Neurofeedback
Neurofeedback is biofeedback for the brain. It exercises and helps "strengthen" the brain, calms it, and improves its stability. Using computerized feedback, the brain learns to increase certain brain waves that are helpful for improved function. The brain can decrease excessive fast or slow brain waves that interfere with good function. Over time, the result is a healthier and better-regulated brain, and the new brain behavior is "learned."Â Â
So, how does Neurofeedback work?
First, a particular EEG monitor (amplifier) and software are set up with a computer.
Electrodes are placed on the scalp to record the client's brainwave activity.Â
The client is then given visual and/or auditory feedback -such as with a specially designed computer game or movie.Â
As specific frequencies increase or decrease, the trainee gets increased or decreased feedback, including auditory, visual, and tactile (i.e., beeps, games, or screen alterations).
How can Neurofeedback help alleviate symptoms related to PTSD? A life-threatening traumatizing event or a sequence of such events can evoke our core emergency response system. One aspect of that response system is strengthening our memory for such events. Our brain records the traumatic event, but what is remembered is our experience of the event, and that experience also includes our response to the crisis. So, the body and mind remember a unitary experience that merges the external sensory inputs with the internal reactions. In subsequent recall of the event, this unitary experience re-emerges with the exalted sensation of panic, fear, etc. To understand more about how the brain processes and can be assisted in healing from such experiences, consider exploring the benefits of neurofeedback therapy, a technique that may offer significant help in managing these profound responses.
Neurofeedback can alleviate many symptoms caused by PTSD. The focus of the therapy is to allow the person the possibility of recalling the traumatic event without reliving the experience. Calming the physiology and taming the fear response is the first step. The original memory is being reprogrammed in a process reminiscent of physical therapy. It is a matter of reaching balance and strength for your brain to accomplish self-regulation and help you gain control of your mind and body. The result is that the traumatic memory assumes its rightful place as a biographical, historical memory like all the others. The person can function normally in this respect from that time forward.Â
Neurofeedback is a gradual process. One round of sessions is 20 sessions, at least twice a week. Then, the clinician will reevaluate you and assess your progress and where to proceed. Therefore, you must be aware that you may be committing to this therapeutic option for many months.Â
Living with PTSD can feel like an endless struggle, but therapy offers a path toward healing and comfort. By exploring different therapeutic options like CBT, relaxation techniques, EMDR, PE, MBSR, and group therapy, individuals can relieve their symptoms, regain control over their lives, and ultimately rediscover peace and comfort. Remember, healing takes time, and finding the right therapist for your needs is crucial. Embrace the journey towards a better quality of life, and never hesitate to seek the support you deserve.