Can Cognitive Behavioral Therapy Heal PTSD?

Content updated from previous publish date.

After experiencing or witnessing physical, emotional, or sexual trauma, some people develop posttraumatic stress disorder (PTSD). In some cases, this potentially debilitating condition can lead to emotional distress, anxiety, trouble in relationships, and career problems. The bottom line: PTSD can ruin your life. Standard treatments for PTSD include several forms of cognitive behavioral therapy while more recent therapies include EMDR (eye movement and reprocessing desensitization). How do they work?

WHAT IS PTSD?

PTSD is a brain-based mental health condition that develops in some people who are exposed to trauma during their lifetime. Following a traumatic event, it is common for people to experience distressing symptoms, however, they usually go away with time. When symptoms continue and interfere with daily living, it may be an indicator of PTSD.

An estimated 3.5% of U.S. adults are currently living with PTSD and more than twice that number of Americans will be diagnosed with the disorder during their lifetime. PTSD tends to be seen more commonly in veterans, women, and first responders.

PTSD SYMPTOMS

Following a traumatic event, PTSD symptoms may appear quickly or may not develop until weeks, months, or even years later. This can make it challenging to connect the signs and symptoms of PTSD with a traumatic event that occurred in the past. Some of the most common PTSD symptoms include:

• Flashbacks
• Insomnia and nightmares
• Distressing memories
• Excessively thinking about the trauma
• Heightened anxiety and fearfulness
• Increased irritability and anger
• Hypervigilance
• Feeling depressed or emotionally numb
• Trouble remembering aspects of the trauma
• Avoidance of people, places, or things that are reminders of the trauma
• Feelings of guilt, shame, or self-blame about the traumatic event

PTSD IN THE BRAIN

Brain-imaging research, including a 2021 study in The American Journal of Psychiatry, shows that PTSD is a brain-based disorder. According to this study, it’s time to stop diagnosing PTSD based solely on symptom clusters and time to start including objective neurobiological data,  “which are greatly needed to improve treatment efficacy in this age of personalized medicine.”

A brain-imaging study conducted at Amen Clinics confirms that neurobiological data can be beneficial in making a PTSD diagnosis. This study compared brain blood flow patterns in people with either traumatic brain injury (TBI) or PTSD, a pair of disorders that share numerous symptoms. The study found that brain SPECT imaging was able to distinguish PTSD from TBI with 89% accuracy.

Getting an accurate diagnosis that includes neurobiological data can be so important to the healing process. Because PTSD shares so many symptoms with other brain and mental health disorders—such as TBI, anxiety, depression, and intermittent explosive disorder—it’s critical to rule out these other issues to find the most effective treatment. In other cases, it’s equally important to detect co-existing conditions.  For example, research shows that nearly 50% of people with PTSD also have depression. In these instances, you need to address both PTSD and depression to heal fully.

WHAT IS COGNITIVE BEHAVIORAL THERAPY?

Cognitive behavioral therapy (CBT) is one of the standard PTSD treatments. A common form of talk therapy, CBT usually involves changing unhealthy patterns of thinking, behavior, and feeling. With CBT for PTSD, patients are guided to healthier ways of thinking. People may also be exposed to reminders of the trauma in a controlled environment and trained to recognize triggers and develop stress-reduction techniques to induce a more relaxed state. There are several forms of CBT, including:

• Cognitive processing therapy (CPT): A form of cognitive behavioral therapy, cognitive processing therapy for PTSD helps people learn how to challenge unhelpful thoughts related to the trauma and how to develop more rational thinking. In this form of therapy, patients are often asked to write a detailed account of the traumatic event and read it aloud to the mental health professional. This helps a person stop avoiding the trauma and start exploring healthier ways to process it.
• Cognitive therapy: This is another form of CBT that involves teaching a person to interrupt negative thoughts related to the trauma. By becoming cognizant of these thoughts as they arise, you are better able to adopt techniques to restructure how you view those memories.
• Prolonged exposure: In this form of CBT, patients are gradually guided to face their memories and feelings related to the trauma. This type of therapy is specifically focused on overcoming the common PTSD symptom of avoiding anything that serves as a reminder of the trauma. It can involve imaginal (creating a mental picture) and in vivo (in real life outside of a therapist’s office) exposure. Because exposure can be anxiety-provoking, this form of therapy progresses gradually to reduce fears and anxiousness.

WHEN STANDARD PTSD TREATMENTS DON’T WORK

While CBT may help some people with PTSD, it doesn’t help everyone. For example, one study in The American Journal of Psychiatry found that most people with PTSD continue to experience symptoms following psychotherapy treatment. Another study found that as many as 50% of people with PTSD engaging in psychotherapy don’t respond to treatment or drop out of treatment before seeing positive results.

As the 2021 study mentioned above suggests, a lack of neurobiological data may contribute to the low response rates for standard PTSD treatments. When psychotherapy treatments don’t help you get the results you want, there are other options, such as EMDR.

EMDR THERAPY FOR PTSD

EMDR is a powerful psychotherapeutic technique that involves eye movements—or other alternate hemisphere actions—to remove the emotional charges associated with trauma-related memories. A systematic review in Frontiers in Psychiatry suggests that EMDR can improve PTSD diagnosis and reduce both PTSD symptoms and other trauma-related symptoms, such as depression and anxiety.

A growing body of research shows that EMDR can be beneficial in treating people with PTSD, and it can do it more quickly than other traditional forms of therapy. For example, one study found that just 3 sessions of EMDR provided relief from PTSD symptoms in 84% to 90% of people who had experienced a single traumatic event.

How does EMDR work? During EMDR sessions, you will meditate on a distressing trauma-related thought while a trained therapist directs you to track an object as it moves back and forth. Research suggests that directing your attention elsewhere while thinking about the trauma helps the brain reprocess the emotions attached to the thought.

HEALING FROM PTSD

If you, or a loved one, have PTSD, there is hope for healing. In addition to the therapies described above, simple lifestyle changes can also help. Eating a brain-healthy diet, taking supplements to fill in nutritional gaps, exercising, and getting adequate sleep can help manage PTSD symptoms.

When seeking help, look for a trained mental health professional who understands that PTSD is a brain-based disorder and who provides comprehensive therapies, such as forms of CBT and EMDR, as well as lifestyle recommendations. This is the key to finding the most effective and long-lasting solutions. With the right diagnosis and targeted treatment, you can get your life back.

PTSD, depression, anxiety, and other brain-based mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.