A few weeks ago on 60 Minutes there was a piece on new treatments for Post Traumatic Stress Disorder (PTSD). PTSD or “the invisible wound,” as it’s often referred to as, is a particularly salient issue with veterans where it is highly comorbid with substance use and depression. One of the veterans in the video said that he is one of many who initially coped with his PTSD with high amounts of alcohol. This is sadly not an uncommon phenomenon. Unfortunately though, you can try to cover the wound or fill the wound, but underneath, the wound still exists.
The two treatments discussed in this 60 Minutes piece were Prolonged Exposure Therapy and Cognitive Processing Therapy (CPT). During Prolonged Exposure Therapy, the therapist has the veteran talk about their trauma 5-6 times over and over throughout each session. The idea is to break it down and loosen its grip on the veteran’s life. For many of these veterans these images and stories have been avoided and yet have this unyielding control over their thoughts and lives. They are painful stories. It’s natural to want to avoid those painful experiences. Unfortunately though, that avoidance still often lives within us. Just because we don’t know acknowledge it, doesn’t mean it’s not there. We can pretend like we don’t have cancer, but in the end, that cancer is still festering in our bodies. Research has even shown that avoidance of thoughts actually leads to more of those thoughts, and thus, a perturbation of symptoms. For example, try as hard say as you can right now to NOT think about a pink elephant for 30 seconds. Go! Did it work? Probably not, so read on.
Cognitive Processing Therapy (CPT) is another therapy mentioned where exposure is a key piece to the therapy. They mention in the video how veterans often carry the belief that the world is a dangerous place. To help patients, they are asked to write an impact statement at the beginning of therapy to show the impact of the trauma on their lives and beliefs. Veterans read the statement to the group and talk about “how their lives are still held in the grip of war.” CPT tries to help the vet put the war in the past and re-examine who they are today.
At the beginning of my training at USC, we had Dr. Patricia Resick, who developed CPT, come and give a full day seminar on this treatment. It was a very powerful seminar and showed just how effective this treatment could be. Dr. Marsha Sargeant, one of our collaborators on this site, has also run CPT groups before. She says, “you see so much progress in psychosocial domains so quickly and the camaraderie that is so pervasive in the military can be used by the therapist as a powerful facilitator of each individual’s progress and one of the main ingredients of therapeutic success.”
As said in the video, with either of these treatments, there is no cure even though people get better. The PTSD symptoms may not go away immediately, but some of the interpersonal problems created may at least dissipate. The psychologist in the video says,
I don’t think there is a cure for what we’re talking about. We’re talking about living and putting people more in touch with their lives and emotions and good days and bad days. This isn’t cancer – we can’t go get it. We have to teach people that they can live with this and live a valued-life – a life they want.
I’m going to leave you with 2 things. One of them is a soldier’s advice for people who ask: “What do I say to someone with PTSD?” His answer is profound and applies to anyone, PTSD or not:
When he starts talking, just listen. Don’t’ judge it, just listen.
So often we go quickly into trying to fix the problem and solve the issue. But let your goal for today, the week, the month, whatever you can do, to be to just listen. A lot of times people just need to express themselves fully before they want to be helped. Validate. Empathize. Just be with the person.
The last thing I want to say is thank you to all the veterans out there. The work you do transcends politics. We honor and respect what you do and thank you for your service.
Click on link at the top for the 60 Minutes video
- Stop focusing on the problem and start focusing on the solution
- Remove your inner thorn to avoid less and accept more!
- Lessons in the art of living
- Affirm how far you’ve come!
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