PTSD: Reclaiming Control By: Robert ‘Bob’ Cuyler, PhD Psychologist and Trauma Expert
Thoughts and Emotions: The Impact of Cognitive Processing Therapy on PTSD In this month's column, I want to continue our exploration into the effective talk therapies for PTSD, a subject close to my heart and practice. We're turning our attention to a therapy that's not just close to my expertise but also recommended by the National Center for PTSD as a frontline treatment: Cognitive Processing Therapy (CPT). CPT typically unfolds over about 12 weekly sessions. Its approach is distinct, focusing less on desensitization and (Part of 2) more on2the critical connection between thoughts and feelings. A cornerstone of CPT is the act of writing about the traumatic event. This process is not just therapeutic; it also confronts the all-too-common avoidance of traumatic reminders in PTSD. Patients often write about the why and how of the trauma, examining its profound impact on their belief systems. Homework between sessions is a standard part of this therapy, reinforcing the process of engagement with difficult thoughts and feelings. In my practice, I've seen firsthand how this therapy can transform lives. Take, for example, the case of a veteran I wrote about a few months back, who was robbed at gunpoint. This event led to a cascade of maladaptive beliefs and avoidance behaviors. He thought, as a veteran, he should've been able to defend himself and saw the world as an unrelentingly dangerous place. Through CPT, we addressed each of these beliefs. He learned to distinguish between real and perceived threats, reducing his hyper-vigilance. As he confronted his avoidance, he found he could engage in life again, cautiously but not fearfully. We also worked on his self-perception, helping him realize that his reactions were natural and not a sign of weakness or a character flaw. This shift significantly reduced his sense of shame and his tendency to replay the traumatic event, making social interactions easier. Like Prolonged Exposure, CPT isn't without its challenges. It requires revisiting painful memories, 18
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thoughts, and emotions. Not all veterans are ready or alliance between the therapist and the client is crucial for success. From my experience, I urge veterans to give therapy a try, to look for a sense of connection and trust in that first meeting, and to understand that the path to healing, while difficult, is immensely rewarding. In our next installment, we'll continue our discussion on talk therapies, delving into another approach that has shown promise in the healing journey of our veterans. Stay tuned.
Cuyler is chief clinical officer of Freespira, an FDA-cleared non-medication treatment that helps people with panic and PTSD manage their symptoms by learning how to regulate their breathing. - www.freespira.com