Abstract
The aim of this paper is to study the Post Traumatic Stress Disorder (PTSD), its causes and treatment. The study relies on findings of empirical research to validate decisions and support arguments. The research has shown that the use of Cognitive Behavior Techniques is the most effective approach to cure PTSD.
Post Traumatic Stress Disorder occurs following exposure to a potentially traumatic life event and is characterized by three major cluster of symptom; re-experiencing, avoidance & numbing, and arousal (AmericanPsychiatricAssociation, 1994).
In this case a person constantly relieves the event through any of the following exposure to a situation that is similar to the event, vivid memories of the event, perceptions, and sometimes through dreams. Research has shown that majority of Americans are exposed to traumatic events at least once in their lives, but only a eventually few develop PTSD (Kessler, Sonnega, Bonet, Hughes, and Nelson, 1995).
Despite this, the prevalence of the disorder is high; at least 1 woman in 9 and 1 man in 20 suffer from PTSD in their lifetime (Kessler et al.; 1995; 2005). The disorder can result in interpersonal difficulties such as sociability, intimacy, anger, violence and substance abuse. There are four key theories in psychotherapy: behavioral theories, cognitive theories, developmental theories and personality theories which this paper will be discussing.
Treatment and Disorders
Behavioral theories
Applied behavior analysis and behavior therapy are based on the work of BF Skinner (1953) and the application of Pavlov’s theory of classical conditioning in treating anxiety by Joseph Wolfe (Wolpe and Plaud, 1997). Wolpe developed a technique for treating extreme fears by exposing patients to the stimuli that provoked it gradually until the response to fear was eliminated or reduced; this is what he referred as systematization.
According to Skinner, the expected positive or negative outcome of behavior, based on past experience will influence an individual’s behavior. Based on Skinner’s theory of behavior technique operant conditioning an individual is inclined to choose a behavior because of an expected positive outcome over the one with negative result expectations.
Behavioral therapy was popular in the 1970’s in treating PTSD; in the 80’s and 90’s behavioral therapists began focusing on the cognitive processes of patients in addition to behavioral therapy. At the time cognitive behavior therapy was used to change unhealthy behavior by replacing negative or self defeating thought patterns with positive one(Thomas, Clen and Arnold, 2010).
The use of other psychological interventions such as medication has been used alongside behavioral techniques and usually depends on the patient and the severity of the problem that is under treatment.
Cognitive theories
Cognitive theory refers to ranges of activities that occurs mentally and which are related. There are several approaches to cognitive behavior therapy.
These include Rational Emotive Behavior Therapy, Rational Living Therapy, Cognitive Therapy and Dialectic Behavior Therapy (Corsini and Wedding 2011). Thus, it teaches an individual that they can control the way they feel and act through positive thought processes.
Compared to other therapies, cognitive behavior therapy is faster due to its highly instructive nature and because of its practical approach. Patients are able to put to practice what they learn at their own time, increasing the effectiveness and speed of the healing process. As such, therapists facilitate the process of healing by giving patients relevant skills to coach themselves on their own.
Cognitive behavior therapy is an interactive and collaborative process in which the therapist teaches, listens and encourages, while the clients roles is to express his problems, challenges, improvements, then learns and follow the therapists guidelines (Corsini and Wedding 2011). It is therefore imperative that the patient and therapist maintain good open relationship for treatment to succeed.
Both behavioral traditions and cognitive traditions borrow heavily from each other’s theory and practice (Dowd, 2002) and the process of therapy for both is normally the same regardless of the specific theoretical background, as they involves finding out the variable that causes a clients problem and then systematically modifying and assessing these variables through treatment.
Cognitive and behavioral practitioners normally use a variety of similar behavioral or cognitive interventions depending on the specific client needs and diagnosis (Thomas, Clen, and Arnold 2010).
Past research findings have proven the efficacy and effectiveness of many cognitive, behavioral and cognitive-behavioral interventions for treating psychological problems such as PTSD.
Developmental Theories
Developmental theories are concerned with human growth, development and learning. Their interest is in finding out what motivates human thoughts and behavior in order to understand individuals and the society better. Developmental psychology also referred as human development studies was originally concerned with growth and development of children but later expanded to study of people during their later stages of life.
The focus of development psychology include investigation of issues such as whether children are born with some form of knowledge or whether they acquire intelligence and knowledge as they grow up.
There are various developmental theories such as Piaget’s theory of human intelligence which explains how human acquire knowledge gradually, construct it and apply it. Sigmund Freud’s theory explains how mental growth proceeds alongside sexual identity growth in adolescents. The theory of psychosocial development which was postulated by Erick Erikson outlines universal stages that a person must undergo.
Humanist theories
Humanist theory asserts that human are inherently created to be good natured; as such it’s focuses on understanding the deviant behavior and mental issues in people. Humanist theory applies a different concept in understanding psychology and has it major emphasis on understanding the human aspect of people.
Most psychologists believe that behavior can only be understood objectively, but the humanists disagree because they think than an individual is incapable of understanding their own behavior. Rogers for instance argues that the meaning of behavior is personal and subjective.
Breggin stated that “the empathic, humanistic psychology model may be the most powerful one of all for healing human distress” (1997). He maintained that “all psychiatric diagnoses… are better understood from a humanistic psychology paradigm than a psychiatric or pathological model” (Breggin, 1997).
Humanist theories have benefitted from the contribution of existential- phenomenological orientation to psychotherapy. Existentialism is a branch of philosophy that began with Kierkegaurd in the early 1800’s; he revolted against the thinking of his time, whose focus was on abstract reasoning and discerning the essence of things.
He developed a philosophy that emphasized on the problems of human existence such as inevitability of death, lack of freedom, alienation, meaningless and anxiety.
The two theoretical paradigms, psychological humanism and existential-phenomenological approaches, are the fundamental pillars of the humanistic movement in psychology (Halling and DearbonNill, 1995). The advantage of Existential psychotherapy is its ability to be integrated to other approaches of psychotherapy (Corsini and Wedding 2011).
Personality theories
These theories believe that in order to understand human qualities such as leadership, motivation and empathy, you must first understand human personality. Personality theories try to explain how and why people behave the way they do.
These theories try to explain how and why people behave the way they do by focusing on their thoughts structure. Carl Jung’s psychological theory on consciousness and unconsciousness is one of the most popular theories.
He defined psyche as a combination of spirit, soul and idea: he viewed psychic reality as the sum of the conscious and unconscious processes and that these processes had a strong influence on the body affecting the instincts, and determining a person’s view of outer reality.
Jung believed that the conscious and the unconscious interacted in a complex way to create images, ideas and thought, which informed action which in turn shaped personality and character. Freud analyzed the role of early childhood experiences in the formation of personality (Davis, 2008; Ellenberger, 1981).
Selection of Therapy
Past research findings support the efficacy of cognitive behavioral therapy and EMDY as the only treatments for Post Traumatic Stress Disorder (Davidson and Parker 2001; Rauch and Cahill 2003). Behavior therapists focus on using techniques such as hypnosis, learning how to relax mentally, systematization and flooding to cure phobias and manage stress (Rauch and Cahill 2003).
Anxiety management has been noted as a key psychotherapeutic treatment for patients of PTSD (Foa et al, 1999; National Institute for Clinical Excellence, 2005). Calming of extreme emotions associated with trauma has been the centre piece of almost all successful trauma treatment (Davidson, Landerman, Farfil and Clary, 2002; Foa, Keane and Friedman, 2000; Friedman, Davidson, Mellman and Southwick, 2000).
In treating PTSD using cognitive behavior technique, a therapist often depends on determining the origin or cause of the disorder and whether it is simple or complex in nature. Simple trauma is a singular event whereas complex is prolonged and repeated experience.
According to research effective treatment for PSTD such as exposure, cognitive behavior technique focus on the symptom that is related to a particular trauma and is usually adequate to address the symptoms of simple PTSD (Bradly, Greene, Rus, Dutra and Westen, 2005; Roth and Fonagy, 2005).
The role of optimism and hope in coping with the challenges of life and in curing stress and trauma has been confirmed by recent studies. Studies such as Fredrickson (2001) and Fredrickson, et al (2003) suggests that positive emotions such as joy normally leads to effective coping by broadening the list of options that a person may have to rely on when resolving their problems.
This leads to less stress and patients should be encouraged to engage in activities that stimulate positive emotions (Biglan and Craker, 1982; Zeiss, Lewinsohn and Munoz, 1979), and to reduce or eliminate totally watching, listening and reading information that produces negative emotions
References
AmericanPsychiatricAssociation. (1994). Diagnostic and Statistical Manual of Mental Disorder 4th Ed. Washington D.C: Author.
Corsini, R.J., & Wedding, D. (2011). Current Psychotherapies. Belmont, CA: Brooks/Cole.
Dowd, E.T., Clen, S. & Arnold, K.D. (2010). Professional Psychology. Research and Practice, (4)1:89-95.
Hobfill, S. Watson, P. Bell, C. Bryant, R. Brymer, M. Friedman, M. Friedman, M. Gerson, B. Jong, J. & Layne, C. (2007). Psychiatry: Interpersonal & Biological Processes. Winter; 70(4): 283-315.