Remembering Trauma to Beat Anxiety
Reported February 28, 2007
By Lucy Williams, Ivanhoe Health Correspondent
ORLANDO, Fla. (Ivanhoe Newswire) — Posttraumatic stress disorder (PTSD) is a potentially devastating anxiety disorder caused by exposure to traumatic events like combat, rape, assault and disaster. But prolonged exposure therapy could help trauma patients overcome a painful past.
People who suffer from PTSD may re-experience traumatic events, avoid reminders of the event, feel emotionally numb, or exhibit unnecessary outbursts of anger.
Patients who recall their trauma are more likely to overcome PTSD, according to recent research. With prolonged exposure therapy, patients vividly recount a traumatic event until they can confront their past with less emotional response.
“It’s requested the patient shut his or her eyes to rule out distractions and remember the sights, the smells, the feelings, as well as possible,” Paula P. Schnurr, Ph.D., of the Department of Veterans Affairs (VA) National Center for PTSD in White River Junction, Vt., and Dartmouth Medical School in Lebanon, N.H., told Ivanhoe.
Researchers report prolonged exposure therapy is a more effective PTSD treatment than present-centered therapy. In present-centered therapy, patients and counselors discuss and review daily difficulties associated with PTSD.
“The theory is that a traumatic event, the way it’s represented in the memory, in the thoughts and the feelings, is best addressed through the techniques of exposure,” said Dr. Schnurr. “By repetitively going through the traumatic material, feeling the feelings again, thinking the thoughts again … Learning that it’s no longer as frightening as it once was and that it’s no longer dangerous.”
In a randomized controlled trial of female veterans with PTSD, participants received either prolonged exposure or present-centered therapy, delivered in weekly, 90-minute sessions for 10 weeks. Women who received prolonged exposure experienced a greater reduction of PTSD symptoms compared to women who received present-centered therapy.
By the end of the study, 41 percent of the prolonged exposure group overcame PTSD, compared to 27.8 percent of the present-centered therapy group. Patients who received prolonged exposure were two-times more likely to achieve total remission than those who received present-centered therapy.
In the United States military, women are three-times more likely than men to experience PTSD. Researchers report prolonged exposure is an effective treatment for PTSD and should be implemented in clinical settings.
“I think this has an important message for training our psychologists, psychiatrists, social workers and the people learning how to do therapy. They should be learning these techniques,” Matthew J. Friedman, M.D., Ph.D., of the Department of Veterans Affairs (VA) National Center for PTSD and Dartmouth Medical School, told Ivanhoe.
Researchers report the next step is to train medical professionals to practice these interventions broadly in health care organizations.
“Having demonstrated the efficacy of this treatment, the VA is taking the next step and is launching a major dissemination project so many practitioners can become proficient with this treatment and offer it to veterans and military personnel,” Dr. Friedman said.
SOURCE: Ivanhoe interviews with Paula P. Schnurr, Ph.D. and Matthew J. Friedman, M.D., Ph.D.; The Journal of the American Medical Association, 2007;297:820-830