Kevlar for the Mind: PTSD therapy seeks to confront troubling memories - Off Duty, Military Health and Fitness - Navy Times

Kevlar for the Mind: PTSD therapy seeks to confront troubling memories

Q. I was recently diagnosed with post-traumatic stress disorder. My therapist wants me to start a treatment called exposure therapy. Is this the most effective treatment for PTSD?

A. Many psychological treatments are available for PTSD. Exposure therapy, one of the most common and effective ones, is a behavioral treatment that confronts a person’s maladaptive learned behaviors related to thoughts and memories of a traumatic experience that provoke anxiety.

For example, a Marine who witnessed his friend killed in combat continues to relive the incident in his thoughts and avoids talking with others about what happened.

By confronting distressing thoughts, situations and feelings associated with the traumatic event, the person’s anxiety is reduced. This is usually done in a therapist’s office with the use of imagery, or in an environment where there are items or situations that cause distress. If successful, the person no longer avoids thoughts, people or things that remind him of the event.

Exposure therapy is often combined with cognitive-behavioral therapy, which recognizes the importance of how we perceive events and the effect we believe those events have on our lives. The more commonly used cognitive-behavioral treatments for PTSD include cognitive processing therapy and prolonged exposure.

Q. I’ve been in treatment for PTSD for several months and I have seen a lot of improvement. However, I am still having frequent nightmares. Is there any treatment specifically for that?

A. Nightmares are one of the more common and distressful PTSD symptoms. The traditional view is that they will go away if the PTSD is treated effectively, but this isn’t always true; nightmares can linger well beyond other symptoms.

The good news is that researchers are studying a relatively new treatment called imagery rehearsal therapy, a brief psychological treatment that teaches patients to change their nightmares into less-distressing dreams. This is done through practicing visualization in a therapist’s office and at home. IRT has been found to be highly effective in civilian and military populations.

Another treatment for nightmares is the medication Prazosin, usually prescribed to treat people with high blood pressure. For reasons not yet fully known, it has been found to be effective for bad dreams, although the dreams tend to return after the medication is stopped.

Bret A. Moore is a board-certified clinical psychologist who served two tours in Iraq. E-mail kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only and is not intended to convey specific psychological or medical guidance. Readers should see a mental health professional or physician for mental health problems.