Post-Traumatic Stress Disorder (PTSD) is a stress related disorder that develops after experiencing a potentially life threatening trauma and/or upon witnessing the sudden death of people to war, physical and sexual assault, accident, natural disaster, and crime. Extreme fight-or-flight occurs when affected persons are exposed to triggers such as flashbacks, memories, thoughts, feelings, dreams, and places or situations that are like the original trauma. Anxiety persists long after the danger has passed. In severe cases, affected persons associate those situations with danger and they are avoided at all costs.

Common symptoms include:

• hypervigilance or an intense awareness of the environment with scanning for threats
• flashbacks or a sudden and vivid memory of the traumatic event
• an exaggerated startle response
• nightmares often with themes reminiscent of the trauma
• a heightened physiological state characterized by anxiety attacks and fight-or-flight
• trouble with concentration
• extreme irritability and low frustration tolerance
• negative thoughts about self and the world
• self-blame
• lack of awareness of surroundings/time also known as dissociation
• inability to recall aspects of the traumatic experience.

PTSD is painful. Fortunately, evidenced-based treatments like Prolonged Exposure Therapy (PE) for PTSD are available. PE was developed by psychologist, Dr. Edna Foa, and her team at the University of Pennsylvania. In 2014, Frank Morelli, LMHC completed a four-day intensive to use PE with victims of trauma and traumatic experiences. PE is recognized as one of the most effective treatments for PTSD. The efficacy of PE as a cognitive behavioral therapy has been replicated worldwide in over 40 comprehensive studies.

Dr. Foa theorizes that avoidance coping is what keeps the person with PTSD symptomatic. Avoidance coping means suppressing and ignoring painful memories, thoughts, and triggers associated with the original trauma. Dr. Foa postulates that recovery occurs as the person engages in emotional processing of traumatic memories. This provides the opportunity for new learning which disconfirms maladaptive beliefs about self, the world, and the ability to cope.

PE is a structured cognitive therapy that is done one to two times per week in session with a therapist for 60 to 90 minute sessions. The therapist encourages the client to tell their story repeatedly in what is known as imaginal exposure. Imaginal exposure is using the person’s own experience with the trauma. As the person engages in storytelling, the therapist acts as a guide to assist the client in emotional processing of the experience. Homework is assigned to help the client engage the real world in what is known as in vivo exposure. Assignments are given in a hierarchical manner. The client learns to face their triggers gradually. Triggers are what precipitate anxiety.

For example, if someone were traumatized after an automobile accident in which there was loss of life, in vivo exposure could include going back to the scene of the accident, being exposed to the smell of gasoline or burning rubber, and driving in a similar vehicle. The strength of PE lies in its effectiveness in habituating clients to their triggers while simultaneously learning that thoughts and memories are not harmful. The client learns to accept their thoughts and memories.

PE can be accomplished in as little as 12 to 15 sessions. The goal is complete remission of PTSD symptoms and common comorbid conditions such as depression. The objective is for the client to return to functional living and going or being anywhere safely, as in before the occurrence of the traumatic experience.

When looking for relief from your problems choose evidence-based treatments. Evidence-based psychotherapy means the technique shows efficacy in ameliorating problematic symptoms, as demonstrated by rigorous scientific study and replication. All evidence-based therapies are peer reviewed. This means that a community of mental health professionals agree this treatment is valid and purports to do what it intends to accomplish.

I have dedicated my entire career to the practice of evidence-based treatments for OCD and anxiety. To learn more about evidence based treatments, please click here. Here’s an excellent video describing PE.