I came across a question today regarding the treatment of PTSD, someone else then gave a long winded response regarding the treatment modalities for PTSD and concluded that there is no end to severe PTSD. In short the advocacy for CBT and EMDR was simply an advocacy for treatments that temporarily help relieve symptoms.
Sufferers of PTSD to include severe cases of PTSD can experience full recovery. It all boils down to what you believe. A common example given for the cause of PTSD is war. A veteran who suffers from PTSD as a result of combat makes sense. War is bad, war is bad because engaging in hostilities against other human beings resulting in the killing of those human beings is detrimental for the mind. Human beings are inherently good, this is why we function the best when we feel good, and we feel really good when we are helpful towards other people. Furthermore, people who experience good feelings from committing any form of harm towards other people are seen as mentally ill, with labels of sociopaths and psychopaths assigned to their character.
So you take a good person, introduce said person to propaganda about how awful another group of people are, train them for combat and then send them into combat. After everything has been said and done, they come to realize that they are not at peace with their actions. Those who are more astute realize that the people they fought against are also people like themselves who were fed similar propaganda against themselves and trained to engage in combat for what they believe was a good and greater cause. To make things even more complicated, most veterans who suffer from PTSD, will encounter people who strongly believe in combat against other groups of people and will praise them for their past actions. This creates a dissonance, where they receive significant acceptance and recognition for actions they have come to disagree with, which also contributes to their illness, and potential rejection if they voice their disagreement for their previous actions.
PTSD can be cured, it is a duel process of utilizing EMDR to engage both hemispheres in getting past the difficult feelings associated with the trauma and using CBT to address detrimental beliefs and practice new and healthier beliefs.
Consider another example, let’s a say you have two men who experience extreme physical assaults and both men develop PTSD. Of the two men, the one the most least likely to fully recover from the incident is the man with rigid beliefs associated with the assault he experienced. For example, if the idea of being assaulted signifies a blow to his manhood, and he continues to hold unto these beliefs throughout treatment, the best EMDR will do for him is to temporary alleviate his symptoms before his next meltdown. He will then experience a meltdown every time he reminded about being humiliated. Such meltdowns can easily be triggered by consumption of media or association with people who voice reminders of his rigid beliefs he still holds unto.
While if the other man is more flexible with his beliefs associated with the physical assault, he is most likely to experience a full recovery. This is because after he has learned to move past his difficult feelings related to his ordeal, he is least likely to be triggered into an emotional meltdown. He is least likely to be triggered because it would be relatively easy for him to abandon any beliefs and values that prevent him from accepting the true nature of his ordeal.
Ugochukwu is a psychotherapist and owner of Road 2 Resolutions PLLC
During our first five years of life, our right hemisphere develops a narrative in accordance to what we have experienced in our immediate environment so far. This means that if our experiences so far have involved safety, compassion and affection, we develop core beliefs to reflect these narratives. If our experiences so far have evolved a scarcity of affection and compassion and a lack of safety, we develop core beliefs which prepare us to survive in a rough world. This is because on a primitive level we are hard wired to survive at all costs. An example of an unsafe environment would include physical abuse in which a person’s existence is threatened, or humiliation as a result of being on the receiving end of chronic emotional abuse. When these incidences occur during a person’s early life experience, it will most likely lead to the development of core beliefs which reside in his subconsciousness, beliefs which are geared towards protecting him from similar incidences in the future, and beliefs which habitually influence his decision making.
For example, when a child is habitually physically or emotionally abused, the child grows up to develop a sub conscious belief in which his safety and/standing with the community or any community is always at risk of being compromised. These beliefs leads to feelings of hyper arousal, where the person is subconsciously constantly on the look out of trouble, as a result everything he does will be limited by his threatening beliefs.
I once had a client who was struggling with his studies, he was a freshman at the University of Arizona and he was on the verge of dropping out of school. The primary reason for his failing grades was that he was simply not doing the work. My client would later reveal his struggle with a learning disability and the habitual shaming language he received from his parents at home in regards to their fears that he would amount to nothing. During our course of treatment, we determined that at his core, he believed himself to be worthless, and lived in fear of being discovered by others, so throughout his life, he would perform the bare minimum and avoid engaging in challenging work in the presence of others, least he was “discovered”.
Consider another story, of a client raised by a single mother, he shared that she was emotionally abusive towards him and some of her male partners were just as abusive. As a teenager, when my client finally demanded to be informed about whom his father was, his mother sent him to go live with his father for the summer. His father whom he had not had contact with since his second birthday, was now married with three children. My client reported that both his father and step mother where physically abusive towards him, and that he and his siblings struggled to get along. It was at this time he fell into a deep depression as he had always romanticized reuniting with his father and being rescued from his mother.
Fast forward to his mid thirties, where he experiences high stress and conflict in his relationships with others. He feels bullied by the mother of his child, he feels bullied by his supervisor at work and by another co worker. His response to these incidents of bullying is to become extra accommodating to the people he is experiencing conflicts with. The typical response to his accommodating behavior is that the bullying he is receiving from others becomes worse, leading him to experience bouts of panic attacks as a result of his feelings of being emotionally stuck.
Treatment for both clients were successful in which they were both able to develop new narratives to begin the process of replacing their core beliefs. These were accomplished through the process and combination of cognitive behavioral therapy and eye movement desensitization reprocessing. My first client transitioned from an academic probation status, to thriving in his studies during his second year at the University, while my second client reported how his practice of assertiveness had led to favorably changes in his relationships with others.
Our core beliefs resides in our subconsciousness and were formed during our early life experiences to meet the demands of our immediate and respective environments. However, given that change is constant, in the event we find ourselves in a new environment or competence enough to put ourselves in a new environment, it is important to know that we are fully capable of change.
We are the authors of our future.
Ugo is a psychotherapist and life coach.