Traumatic events such as accidents or abuse can happen to anyone; so what determines whether somebody goes on to develop anxiety and Post Traumatic Stress Disorder (PTSD)?
Symptoms of PTSD may develop following an incident of exposure to actual or perceived threat to the life or physical safety of the individual, their loved ones, or those around them. Traumatic events include, but are not limited to, natural disasters, exposure to combat, torture, terrorism, rape, childhood physical abuse, and childhood neglect.
Symptoms may include persistent re-experiencing the event through nightmares or flashbacks, which cause significant distress; as well as avoidance of thoughts, feelings, places, activities, or conversations related to the event, and negative changes in thoughts and mood or numbing resulting in feeling detached or a loss of interest in normal activities. Chronic difficulties sleeping or concentrating, hyper-awareness to threat, irritability or an exaggerated startle response may also be experienced by those with PTSD.
PTSD can significantly impact on not just the sufferer’s life, but on those of their family and friends. PTSD is estimated to affect 6.4% of Australians at any one time.
How does PTSD develop?
Emerging theories of the development of PTSD focus on experiential avoidance being a strong factor in the difference between whether one develops PTSD following a traumatic event or not.
Experiential avoidance can be defined as negative internal events that we are unwilling to experience and attempt to suppress through distraction, changing the thoughts or getting away from reminders. These attempts may also lead to numbing which alleviates the negative internal event, but which also stops us feeling positive emotions and experiences as well.
Thought suppression, or a deliberate attempt to not think about a topic (such as a traumatic event) has been linked with the likelihood of developing PTSD one year after a car accident. The thing with thought suppression, is that though the effort is made to not think about the event, due to the “rebound effect” we are actually more likely to think about it. If I asked you to not think about a pink elephant for one whole minute – could you do it? Give it a go, I predict it would be incredibly difficult, if not impossible!
This in essence may be the difference between whether PTSD develops after a traumatic event or not. By avoiding these internal experiences, processing of the event is impaired and the symptoms maintained over time.
Treatments available for PTSD
There are many treatments on offer for individuals suffering PTSD. Current effective treatments are:
- Cognitive Behaviour Therapy (CBT);
- Mindfulness-Based Stress Reduction (MSBR);
- Acceptance and Commitment Therapy (ACT);
- Stress Management (SM);
- Eye Movement Desensitisation and Reprocessing (EMDR).
Even with effective treatment, it is estimated that one-third of people will make a good recovery, while one-third do moderately well, and one-third minimally benefiting. This suggests that a tailored treatment plan focused on reducing experiential avoidance, may be the difference between minimal and maximum gain in PTSD treatment, and between recovery and suffering with this debilitating disorder.
Chronic cases of PTSD (three months or more) commonly co-occur with depression, anxiety, and substance abuse/addiction disorders, so early treatment is essential.
Increasing research into PTSD prevention and treatment has found traditional de-briefing methods ineffective (even harmful), with popularity growing for the use of mindfulness.
Mindfulness to Reduce Experiential Avoidance
Mindfulness is a mental training practice with roots in ancient Buddhist practices. In treatment, mindfulness is a non-judgmental awareness that emphasises paying attention with openness, flexibility and curiosity towards the external environment, as well as internal experiences like bodily sensations (eg pain or hunger), emotions and thoughts. Mindfulness has been incorporated in many different therapies such as:
- Mindfulness-Based Cognitive Therapy (MBCT);
- Dialectical Behaviour Therapy (DBT);
- Acceptance and Commitment Therapy (ACT);
- Mindfulness-Based Stress Reduction (MSBR).
As you might have guessed, mindfulness is being researched as a component of effective treatments for PTSD, as it emphasises acceptance of internal events like thoughts and flashbacks, rather than experiential avoidance. Through mindfulness, people may be able to process those reminders of the traumatic event, and reduce the associated pain and anxiety, similarly to exposure therapy for anxiety treatment.
If you are experiencing difficulties with PTSD, or are maybe just unsure and would like to discuss it further, consider booking an appointment with me, PTSD is one of my interest areas and I love helping those suffering from past trauma.
Author: Dr Rose Gillett, B Psych (Hons), D Psych (Clin), MAPS.
Rose Gillett is a clinical psychologist, working with children, adolescents, adults and couples. She is passionate about helping her clients achieve their goals, and has particular interest areas in attachment concerns in adults and young people, PTSD, and alcohol and drug addiction
To make an appointment with Clinical Psychologist Dr Rose Gillett, try Online Booking – Loganholme or call M1 Psychology (Loganholme) on (07) 3067 9129.
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