Uncovering PTSD: Part 3 “I am worthy.”
June is PTSD Awareness Month. Each week this month on our blog we will explore the causes and effects of PTSD in low-income urban communities like ours, the evidence-based treatments we are using to help our client guests find healing, and the incredible strength it takes to seek healing and reconciliation. Read Part 1 and Part 2.
“I told her: each morning when you wake up, take a long, hard look at yourself in the mirror and declare, ‘I am worthy.”’ That’s Angela Williams, a therapist here at Reconciliation Services. Angela recalls working with one client who was seeking treatment for PTSD after being abused as a child:
“She was stuck. Reliving her past trauma through PTSD had completely stagnated her life and caused disruption at work. Together we had to retrain her brain to focus on the positive even though bad things had occurred in her past. Her PTSD had convinced her that she had to live a life of solitude, and she needed to learn how not to beat herself up. The trust factor was completely gone, first in herself, and especially in others.”
Through exercises like morning affirmations, Angela and her client were able to relieve her suffering and take steps toward her professional goals. It’s proven that PTSD treatment works, and that after treatment, most people feel they have a better quality of life.
Getting treatment for PTSD is important, because otherwise the condition won’t go away, and in fact, it may get worse. The symptoms of PTSD are: reliving the traumatic event, avoiding things that remind you of the event, having more negative thoughts and feelings than before the event, and feeling on edge.
Angela says her client experienced some degree of each of these symptoms. Thankfully, the team at RS have a variety of treatments at their disposal, including: narrative therapy, eye movement desensitization and reprocessing, and exposure therapy. Each of those treatments require specialty training and professional implementation.
Another technique that is more accessible to the laymen is known as Cognitive Behavioral Therapy or cognitive restructuring. CBT is a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns or treat mood disorders such as PTSD.
Dr. Robert Leahy with The American Institute for Cognitive Therapy says, “The goal of cognitive restructuring for PTSD is to return the patient to a more balanced view, in which the world is seen as safe within limits, events are seen as generally predictable and controllable, and the self is seen as competent to cope with most situations, while at the same time there is acknowledgement of the existential reality that sudden, unpredictable, and extreme negative events, including death, can and do happen.”
CBT for PTSD works to combat the distorted automatic thoughts, the maladaptive assumptions about reality, and the dysfunctional schemas (or misunderstandings about cause and effect) that hamper a person’s ability to thrive. Here are examples of each of those:
Distorted Automatic Thoughts
“What happened is my fault.”
“I should’ve been able to handle the situation.”
“I should be over this by now.”
“I am weak.”
Maladaptive Assumptions
“Because I could not control what happened, there is no point in trying to control anything.”
“Because I could be in danger at any time, I must contain control at all times.”
“I must always be on the alert.”
Dysfunctional Schemas
“The world is inherently unpredictable and dangerous.”
“Bad things can happen at any time.”
“You can’t trust anybody.”
Dr. Robert Leahy explains the three steps in cognitive behavioral therapy for PTSD:
Your therapist will teach you ways to cope with the feelings and tension that come with the memories. These include ways to relax your body and to take your mind off the pain.
Your therapist will help you face the memories. He or she will guide you in retelling the story of what happened. The more you do this, the less upsetting the memories will become, and the more you will be able to find a sense of peace.
Finally, your therapist will teach you ways to change negative thinking and handle problems in your life.
Negative thinking patterns are known as cognitive distortions. Here is a description of those which Angela shares are most prevalent for people with PTSD:
All-or-Nothing Thinking: Seeing things in terms of extremes – something is either fantastic or awful, the person believes they are either perfect or a total failure.
Overgeneralization: This sneaky distortion takes one instance or example and generalizes it to an overall pattern.
Mental Filter: This distortion focuses on a single negative piece of information and excludes all the positive ones.
Disqualifying the Positive: On the flip side, this distortion acknowledges positive experiences but rejects them instead of embracing them.
Jumping to Conclusions – Mind Reading: This distortion manifests as the inaccurate belief that we know what another person is thinking.
Jumping to Conclusions – Fortune Telling: This refers to the tendency to make conclusions and predictions based on little to no evidence and holding them as gospel truth.
Emotional Reasoning: This is the acceptance of one’s emotions as fact. “I feel it, therefore it must be true,” even though that is verifiably not true.
Should Statements: These are statements that you make to yourself about what you “should” do, what you “ought” to do, or what you “must” do.
Personalization: This is when we assign judgments of value to ourselves or to others based on one instance or experience.
Treating these negative, automatic thoughts requires differentiating between yourself and your thoughts, and creating space between your thoughts and your actions. This can mean actually taking a breath between experiencing an event and evaluating your response. To turn this positive reaction into a habit, a person can use exercises like an “Automatic Thought Record,” or “Putting Thoughts on Trial,” as detailed here.
Angela says the key to treating PTSD all comes down to helping the person regain their power, reminding them that they have control over their situation and their outcomes, and not the other way around. “When a person can say with confidence that ‘I have the ability to make my life better,’ that’s when we know that they are on the path to healing.”
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