How to Treat PTSD: An Innovative New Method

You are here: Home » Blog » How to Treat PTSD: An Innovative New Method

Innovation in the treatment of post-traumatic stress disorder (PTSD)

Table of Contents

Attending the EABCT Congress

I recently had the privilege to attend the European Association for Behavioural and Cognitive Therapies (EABCT) Congress in Glasgow. This event showcases excellence in the clinical practice of Cognitive Behavioural Therapies across Europe. I attended a symposium led by the research clinicians at Kings College, London that focussed on the development of trauma treatment. One particular presentation relating to an innovation in treatment for PTSD piqued my interest.

I was excited and delighted to learn about an evolving method of how to treat PTSD that doesn’t require reliving the trauma memory as part of the therapy.

From Trauma Focussed to Trauma Informed

Many people I've worked with over the years have been reluctant to revisit the trauma they experienced in their mind's eye. This is understandable in general and, in particular, if someone is experiencing flashbacks and nightmares, they feel that they'e already reliving it, and it doesn’t help. (It does help, but it needs to be relived in a different way, to learn that we're safer than we feel.)

The people I've worked with want something that alleviates the images of the trauma, not to re-experience it. Reliving is an incredibly useful intervention, but it's somewhat intrusive. Taking out the reliving interventions makes the therapy more of a trauma informed practice (TI-CBT), rather than a trauma focussed practice (TF-CBT) and may be a new development that would help people out of their trauma responses and back into their life.

The Benefits of Reliving

Reliving has been a core component of Cognitive Behavioural Therapy (CBT) for PTSD for decades. So, it felt like a shake-up, for it to be dropped out of the therapy treatment guidance CBT for PTSD (developed by Ehlers and Clark, 2000). It is, in my opinion, a sophisticated and elegant integration of multiple psychological theories that just works like a dream. I'm pretty wedded to it, to be honest. However, there are many therapeutic techniques in the PTSD treatment model, and each have value and merit.

Some innovative clinicians at Kings College, London, have been trialing a CBT treatment for PTSD without the reliving, and the practice-based evidence is looking great. There have been promising findings.

The idea is that the therapy would be more of a light touch. There are two reasons why this may be beneficial. Firstly, it gives people the opportunity to spontaneously recover, which is a great thing. Secondly, there is no requirement to engage in an intrusive reliving session, or two.

How to Treat PTSD Without Reliving

So, what would we do, without the reliving?

There are 3 main therapeutic techniques that the Kings team have been trialing in this model of CBT:

Reclaiming life, getting out in the world and supporting people to stay connected, do the things they love and maybe try something new, too.
Visiting the site of the trauma event and seeing what’s different from the time of the trauma to how it is now.
Distinguishing between what happened at the time of the trauma and how things are different now.

Personally, I wonder if targeting rumination management work would be helpful to add to this slick treatment plan. Rumination is often a maintaining factor/behaviour in PTSD. Rumination is a process that gets a little bit stuck when we're reviewing past events to learn from them. Unfortunately, this can turn to self-criticism.

How to Treat PTSD: A Staged Approach

The clinicians at Kings hypothesised that this treatment innovation would be best delivered in the first 12 months of experiencing PTSD, and after 12 months it's likely that we'll need the full treatment plan, as devised by Ehlers and Clark.

PTSD is a problem that arises from our memory. The anxiety people experience relates to the ‘nowness’ of the trauma memory – it feels like it's happening right now; the threat is live. People are scared of something that's already happened, and scared that it might happen again, and it might. But, for the majority of people (who aren’t first responders), the probability is low. However, people can feel that the probability is very high and very present.

This is why reliving has been a great way to work, as we can put a beginning, middle and end to the trauma memory, rather than the experience of current threat dominating someone’s experience.