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Post traumatic stress disorder (PTSD) is an extreme response to a severe stressor. Unlike other anxiety disorders, post traumatic stress disorder emerges exclusively due to exposure to a traumatic event, or string of events. The event or events must have been directly experienced or witnessed and must have involved actual or threatened death or another severe threat to a person's physical or mental well-being. The symptoms of post traumatic stress disorder are grouped into three clusters; re-experiencing, avoidance and increased arousal.
Many forms of therapy attempt to treat post traumatic stress disorder. However, it is generally agreed that the common factor in particularly successful treatments for post traumatic stress disorder is exposure. In other words, the patient must face their fears (Kring et al, 2007).
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Medication as a Treatment for Post Traumatic Stress Disorder
There are a range of medications that are used to treat anxiety disorders, including post traumatic stress disorder. Medications that reduce the symptoms of anxiety are known as anxiolytics. Benzodiazepines and anti-depressants are the most common medications used to treat post traumatic stress disorder. Clearly, the sole use of medication does not involve exposure, and cannot therefore be considered a successful treatment for post traumatic stress order on its own. However, these medications can be particularly useful when used in conjunction with therapy. Therapy that involves exposure can often lead to an increase in symptoms at first and medication can help alleviate this (Kring et al, 2007).
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Cognitive-behavioural Therapy as a Treatment for Post Traumatic Stress Disorder
Cognitive-behavioural therapy (CBT) is commonly considered to be the most successful treatment for post traumatic stress disorder, and indeed most other anxiety disorders. There are several different forms of cognitive-behavioural therapy that have been used successfully to treat PTSD. They are all based on the same theoretical principles and may be used alone or in combination with other cognitive-behavioural therapies.
Exposure therapy, which has received a wealth of empirical support, is often considered the most effective form of CBT as it places emphasis on the exposure component. Repeated exposure to stimuli associated with the traumatic event is known to decrease the associated anxiety. Exposure may mean returning to the scene of the trauma, being presented with artefacts associated with the event, or being asked to recall the event in detail.
Other forms of CBT all include an exposure component, but do not place the same emphasis on it as pure exposure therapy. Stress inoculation training for one also includes muscle relaxation training, breathing retraining, role playing and thought stopping techniques in addition to graduated in vivo (imaginal) exposure. Cognitive processing therapy, which has been found particularly successful in treating post traumatic stress disorder in those who are victims of child sexual abuse, involves patients writing a detailed account of the traumatic event(s). In order to fulfil the exposure component the patient is asked to repeatedly read it aloud, both in and out of session. In addition, the therapist studies the narrative with the patient to help identify and address errors in thinking (Foa et al, 2009).
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Creative Arts Therapies as a Treatment for Post Traumatic Stress Disorder
Creative arts therapies use a variety of creative mediums; art, music, dance, drama, and poetry to treat a range of disorders. Creative arts therapies are relatively new, having emerged in the 1940s. They were developed as a way to treat patients who were severely disturbed and could not completely benefit from talking therapies. Given their relative recency, creative arts therapies have not accumulated the amount of empirical support that CBT has. However, empirical support is growing and creative arts therapies are already considered a successful treatment for post traumatic stress disorder, among other disorders.
The success of creative arts therapies is due to the use of many of the same therapeutic elements that are used in CBT. For instance, all forms of creative arts therapy utilize exposure. Not only is the trauma imagined, but it is also represented in a physical or constructional behaviour, such as painting or a performance. This use of both in vivo (imaginal) and in vitro (external) exposure can be especially helpful in overcoming the avoidant tendencies seen in PTSD.
In addition to the components that creative art therapies share with CBT, they also feature group interaction. This component aims to improve interpersonal relationships, communication skills and work functioning, which will ultimately aid patients in smoothly resuming a normal life. Finally, creative arts therapies may be favoured by patients as they are considered less invasive, and have not received the same 'hardcore therapy' reputation that CBT has (Foa et al, 2009).
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Foa, E.B., Keane, T.M. & Friedman, M.J. (2009) Effective treatments for PTSD: practice guidelines from the international society for traumatic stress studies. New York: The Guilford Press.
Kring, A.M., Davison, G.C., Neale, J.M. & Johnson, S.L. (2007) Abnormal Psychology. USA: John Wiley & Sons.