Post Traumatic Stress Disorder

Post traumatic stress disorder (or PTSD for short) is the name given to the psychological and physical problems that can sometimes follow particular threatening or distressing events. These events might include:

  • a major disaster
  • war
  • rape or sexual, physical or emotional abuse
  • witnessing a violent death
  • a serious accident
  • traumatic childbirth
  • other situations in which a person was very afraid, horrified, helpless, or felt that his or her life was in danger

The trauma can be a single event or a series of events taking place over many months or even years.

Who does PTSD affect?
PTSD may affect the person directly involved in a traumatic event or situation. It may also develop in members of the emergency services or in families of those involved in a traumatic event. PTSD is quite common; up to a third of people who have experienced a traumatic event may go on to develop PTSD and it may affect about 8% of people at some point in their lives. It can develop in people of any age, including children.
What are the symptoms?
 One of the most common symptoms of PTSD is having repeated and intrusive distressing memories of the event. There may also be a feeling of reliving (or ‘re- experiencing’) the event through ‘flashbacks’ or nightmares, which can be very distressing and disorientating. There can also be physical reactions such as shaking and sweating.

Because the memory can be very intense and upsetting, some PTSD sufferers may avoid people or situations that remind them of the trauma, or try to ignore the memories and avoid talking about the event. Some people may also forget significant parts of the traumatic event. Other people will think about it constantly, which stops them coming to terms with it (they may, for instance, ask themselves why the event happened to them or how it could have been prevented).

What reactions can be caused by PTSD?

PTSD sufferers may have emotions or feelings that are difficult to deal with, such as guilt or shame, or they may feel that they do not deserve help. They may also feel anxious or irritable, and find it difficult to concentrate and sleep. For some people it can mean that doing ordinary things like going to work or school or going out with friends becomes very difficult.

It is not uncommon to have upsetting and confusing feelings and to experience very distressing symptoms in the first few weeks after a traumatic event. Sometimes these feelings pass after a few weeks or so, but if they persist for more than a month after the event, a person may have PTSD. Some people, however, may not have an immediate reaction to a distressing event and may develop PTSD months or even years after the event.

How can PTSD be treated?

The NICE (National Institute for Care Excellence) recommendations for the treatment of PTSD are:

Specialist Trauma Focussed Psychological Therapy which could be either:

EMDR  (link to www.getselfhelp.co.uk)

Or

Trauma Focussed Cognitive Behaviour Therapy (TFCBT)

In some cases medication may also be recommended in conjunction with this.

Silver Street Clinic has specialist clinicians trained in both EMDR and TFCBT with many years of experience of working with civilian, military and front line service personnel.

What is EMDR?
EMDR (Eye Movement Desensitisation and Reprocessing) is one of the 2 recommended therapies for the treatment of Post Traumatic Stress Disorder by the National Institute for Health & Clinical Excellence (NICE).

Along with this it has also been shown to be effective in the treatment of:

  • anxiety and panic attacks
  • depression
  • complicated grief
  • phobias
  • chronic pain
  • addictions
  • childhood attachment issues
  • self esteem and performance anxiety
How does EMDR work?
EMDR works on the principle that the mind can often heal itself naturally in the same way as the body does. Much of the information we take in during each day is processed whilst we are asleep but sometimes, in certain situations such as when we are under a lot of of stress or when we feel under physical or emotional threat, this information does not get processed in the normal way.

When this happens memories and feelings are stored in a different part of the memory system of the brain in a ‘raw emotional form’ and are not ‘filed away’ and put in the past. Because of this, painful or emotional feelings that relate to these memories are easily triggered by situations which remind us of what happened and evoke the same feelings, as though  it is happening all over again.

EMDR therapy helps to reprocess painful memories which have been properly stored  by recreating the natural process of REM sleep. This is done by bilaterally stimulating the brain using eye movements, sounds or pulses. The bilateral stimulation lasts for about a minute (called a ‘set’)  after which  there is a pause when the therapist asks about any experiences that have been noticed during this time. These experiences may include changes in thoughts, images, emotions and body sensations.

Repeated sets of bilateral stimulation during a therapy session updates old memories according to new perspectives and beliefs. For instance, a traumatic or distressing incident experienced as a child may have created a negative belief from a child’s perspective which can be seen very differently as an adult if the incident is reprocessed using EMDR. People report that memories feel different, that they are in the past now and that they no longer have the emotional charge they carried before.

During a session of EMDR the patient remains alert, awake and in control at all times. It is NOT like being hypnotised. It is not a talking therapy like most traditional psychological treatment and tends to be quicker than many other forms of therapy.

How long does an EMDR session take?
A normal session of EMDR processing takes between 60 and 90 minutes. It normally forms part of a longer term therapy plan but in particular cases (such as phobias) it can require as few as 4 – 6 sessions to achieve treatment goals. For more complex issues a minimum of 12 sessions would be recommended.
How much does an EMDR session cost?
After the initial assessment which is a standard fee of £75, EMDR treatment is charged at £70 per session regardless of whether it lasts 60 or 90 minutes. This can be paid either at each session or in monthly installments.

It is thought that about 80-90% of PTSD sufferers also have other problems, such as depression (which is quite common) and anxiety disorders. Some people start to use recreational drugs or alcohol as a way to cope, especially if they have had PTSD or experienced trauma for a long time.

Information taken from NICE Guidelines at www.nice.org.uk

To download a document about understanding PTSD, please click the following link: Understanding PTSD

For more information please click here

Specialist Clinicians:

Kate Tyler Helen Watson Lesley Pirie Amanda Craig Gemma Boyd Marianna Oddyseos Laura McPhilemmy Amanda Craig