Counseling for PTSD

Topic Overview

When you have post-traumatic stress disorder (PTSD), dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But talking with a therapist can help you get better.

Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be an effective type of counseling for PTSD. In CBT, a therapist helps you deal with your feelings about the past. You'll have weekly hour-long visits for a few weeks or months or as long as it takes for you to feel better. CBT may help you have fewer PTSD symptoms over time.

Eye movement desensitization and reprocessing (EMDR) may also be an effective treatment.

What is cognitive therapy?

After a traumatic event, you might blame yourself for things you couldn't have changed. For example, a soldier may feel guilty about decisions he or she had to make during war. Cognitive therapy, a type of CBT, helps you understand that the traumatic event you lived through was not your fault.

In cognitive therapy, your therapist helps you understand and change how you think about your trauma and its aftermath. Your goal is to understand how certain thoughts about your trauma cause you stress and make your symptoms worse.

You will learn to identify thoughts about the world and yourself that are making you feel afraid or upset. With the help of your therapist, you will learn to replace these thoughts with more accurate and less distressing thoughts. You also learn ways to cope with feelings such as anger, guilt, and fear.

What is exposure therapy?

In exposure therapy, your goal is to have less fear about your memories. It is based on the idea that people learn to fear thoughts, feelings, and situations that remind them of a past traumatic event.

By talking about your trauma repeatedly with a therapist, you'll learn to get control of your thoughts and feelings about the trauma. This is because each time you talk about the past, you become less scared and sensitive to the memories. This may be hard at first. It might seem strange to think about stressful things on purpose.

But you'll feel less overwhelmed over time. With the help of your therapist, you can change how you react to the stressful memories. Talking in a place where you feel secure makes this easier.

You also may practice different ways to relax when you're having a stressful memory. Breathing exercises are sometimes used for this.

What is EMDR?

Eye movement desensitization and reprocessing (EMDR) is another therapy for PTSD. Like other kinds of counseling, it can help change how you react to memories of your trauma.

While talking about your memories, you'll focus on stimuli like eye movements, hand taps, and sounds. For example, your therapist will move his or her hand near your face, and you'll follow this movement with your eyes. You'll also learn skills to help you relax and handle emotional distress.

Doctors think that focusing on hand movements or sounds while you talk about the traumatic event may help change how you react to memories of your trauma over time. But, experts are still learning how EMDR works. EDMR may help you have fewer PTSD symptoms. But research also suggests that the eye movements are not a necessary part of the treatment.

EMDR may not be available at all clinics or hospitals.

For more information, see the topic Post-Traumatic Stress Disorder.