PTSD arises when an individual is involved in or witnesses/hears about a life-threatening situation e.g. car crash, sexual assault or mugging. If the symptoms remain after 4 weeks it is likely that the individual has symptoms of PTSD. If you imagine your head like a sieve that processes information (from right hemisphere to left hemisphere) a traumatic incident can be too big to pass through the sieve. So, it therefore remains unprocessed and when there are triggers, this activates distressing emotions e.g. fear, anxiety, panic. People with PTSD often relive the incident and can have intrusive thoughts/images or nightmares. This can result in sleeping difficulties, isolation and responsibility guilt. Causes of PTSD can include:
- Difficult child birth
- Car accidents
- Violent personal assaults such as sexual assaults, robbery or mugging
The first four weeks after a traumatic incident are known as acute distress disorder and if your symptoms persist after four weeks, you may have PTSD.
In CBT we do prolonged exposure/re-living to help process the traumatic incident so that it moves to the left hemisphere (stored memory). If a traumatic memory is processed, the individuals distress levels should be reduced when they think or are reminded of it. Work can also focus on discriminating between then and now when a trigger is there. Traumas also have the ability to create new ‘Core Beliefs’ and can impact how an individual feel about themselves now as a result of the incident e.g. “I am permanently damaged” or “I am weak”. Cognitive and behavioural work can help reduce the post trauma belief that an individual is experiencing.
Problems arise when an experience is inadequately processed. A particularly distressing incident may become stored in a state-specific form, meaning frozen in time in its own neural networks, unable to connect with other memory networks that hold adaptive information. When a memory is encoded in state-specific form (distressing), the original perceptions can continue to be triggered by a variety of internal and external stimuli, resulting in inappropriate emotional, cognitive and behavioural reactions, as well as overt symptoms (high anxiety, nightmares, intrusive thoughts). Dysfunctionally stored memories are understood to lay the foundation for future maladaptive responses, because perceptions of current situations are automatically linked with associated networks. The Adaptive Information Processing (AIP) model views negative behaviours and personality characteristics as the result of dysfunctionally held information. From this perspective, a negative self-belief (I am a failure) is not as the causeof present dysfunction, it is understood to be a symptom of the unprocessed earlier life experiences that contain affect and perspective.