Cognitive Behavioral Therapy for PTSD
Cognitive behavioral therapies for PTSD are based on the idea that problems arise as a result of the way people interpret or evaluate situations, thoughts, and feelings, as well as the problematic ways these evaluations cause people to act (for example, through avoidance). Examples of cognitive behavioral therapies for PTSD include:
Acceptance and commitment therapy Behavioral activation treatment Cognitive processing therapy Exposure therapy Stress-inoculation training
Psychodynamic Psychotherapy for PTSD
Psychodynamic approaches to PTSD focus on a number of different factors that may influence or cause PTSD symptoms, such as:
Early childhood experiences (particularly our level of attachment to our parents)Current relationshipsUnconscious coping mechanisms people use to protect themselves from upsetting thoughts and feelings that are the result of experiencing a traumatic event
Unlike cognitive behavioral therapy, psychodynamic psychotherapy emphasizes the unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings, urges, and thoughts are outside of our awareness, they still influence our behavior. For example, unconscious feelings may make you avoid starting a new relationship with someone because of the potential for the relationship to bring up those painful feelings. This is an example of where thoughts and feelings connect with behavior. Just as with cognitive behavioral therapy, psychodynamic therapy also wants to bring about changes in behavior. It is just that the road it takes to get there is different.
How Psychodynamic Therapy Works
Bringing about a change in symptoms or behavior requires getting in touch with and “working through” those painful unconscious feelings. To do this, the psychodynamic therapist will assist the patient in recognizing the defense mechanisms being used, what they are being used for (to avoid painful feelings in the unconscious mind stemming from a traumatic experience), and connecting with and appropriately releasing those feelings and thoughts that were previously being avoided. For example, over several sessions, a psychodynamic therapist may notice one of the following defense mechanisms:
Disavowal: When a patient is denying the extent to which a traumatic event has impacted their life. This common defense mechanism people use to protect themselves from something that they don’t have the ability to cope with. Displacement: When a patient is expressing anger and putting blame on family members even though they haven’t done anything to deserve it. In this case, the therapist may interpret this behavior as a sign that the patient is actually upset with and blaming themselves for the traumatic event but since this anger and guilt is too difficult to cope with, it is expressed toward others.
In both of these cases, the therapist would interpret the patient’s behavior and share this interpretation with the patient.
Effectiveness of Psychodynamic Therapy
Psychodynamic psychotherapy for PTSD has not been studied as extensively as cognitive behavioral therapy for PTSD. Of the studies that have been conducted, though, it has been shown that psychodynamic psychotherapy can have a number of benefits. For example, studies of psychodynamic therapy for PTSD have shown that after therapy, people report improvement in the following:
Interpersonal relationshipsFewer feelings of hostility and inadequacyMore confidence and assertivenessReductions in PTSD symptoms and depression
Which Type of Therapy Should You Use?
The answer to this question is really based on your personal preference. Both cognitive behavioral therapy and psychodynamic psychotherapy can have benefits for someone with PTSD. Therapy is going to be the most effective if you trust the approach and have a good relationship with your therapist. So it is important to shop around and find the best fit for you. You can find PTSD treatment providers in your area through resources like UCompare HealthCare as well as the Anxiety Disorder Association of America.
