PTSD and Prolonged Exposure Therapy

​    By: John M. Duffey, Sr., AbD, MAcc, NCC, DMHE, CCTP, CWT, CCBT, PE, LPC 
    Post-traumatic stress disorder (PTSD) has only recently, as the history of psychology and mental health treatment and research goes, been discovered.  It is not something that has been invented but rather has been a part of human experience throughout the existence of humanity.  When we examine history, we can see many examples of the development of PTSD and its many manifestations.
     For example, the famous ROGER'S RANGERS of the American Revolutionary War has an example of rangers being exposed to combat and grueling conditions that resulted in high anxiety and hypervigilance that was noticeable and noted by commanding officers in their official and personal journals.  There are even cases of described behaviors that we would easily recognize as psychosis today.  There is a plethora of examples of PTSD developing consequential to World Wars One and Two.  The Korean and Vietnam Wars are also producers of PTSD related to combat.
     But there is more to PTSD than combat trauma.  PTSD can develop from a number of traumatic experiences ranging from childhood abuse to sexual assault to surviving a tornado.  Trauma is defined as any experience where the person is placed in immediate apprehension of receiving serious bodily injury or death. In other cases, trauma occurs when a person directly witnesses such condition happening to another person. Again, history shows many examples of PTSD development in people who have been raped, molested as children, or survived terrorist attacks.  Victims of armed robbery and physical assault are also prime candidates for the immediate or delayed onset of PTSD symptoms.  
     So, where does prolonged exposure therapy (PE) come in?  PE uses and is based in the Emotional Processing and Cognitive-Behavioral Theories.  PE allows the person to reduce the intensity of PTSD symptoms that are responses to memories or reminders of his/her traumatic experience.  Specifically, it works on separating, at least to some extent, the distressing response from the imagery of the traumatic memory.  
     It would be great to be able to honestly say that PE cures PTSD, but behavioral science is a long way from being able to boast that.  Instead, PE allows a person to experience significantly lowered distress responses to the memories of the event and to overcome their avoidance of people, places, objects, and conversations that illicit traumatic memories and their associated distress.  
     PE is a brief exposure therapy that lasts from ten to fifteen sessions and is structured-well to allow for a linear movement from beginning to end with measurable milestones to document and demonstrate progress.  It starts with education on the common responses to trauma and then transitions into imagery exposure and in-vivo exposure to the memories and the avoided reminders.  There is some homework involved in that the in-vivo, meaning, "in real-life," exposures.  
     PE was originally developed by Dr. Edna Foa, PhD, to assist women who survived rape to overcome or cope better with their symptoms of PTSD.  The efficacy studies conducted over the nearly forty years of its development show remarkable results for participating patients.  Over time, PE was also applied to PTSD related to combat and other traumas.  This includes war veterans, emergency responders, survivors of natural disasters and survivors of industrial and automobile accidents.  
     There is, at present, a significant amount of research study that reveals and supports the efficacy of PE with combat trauma-related veterans and military sexual trauma (MST) survivors.  As history and present application results show - PE is a highly effective treatment tool for PTSD.  
     Regardless of whether you have survived a single or multiple traumatic episodes in your life PE may be a fit to helping you cope better and reduce, if not eliminate, your avoidance behaviors that serve only to prolonger and worsen your symptoms and memories of event.  Ask your therapist about PE as a therapeutic approach to ending the isolation and other life-hindering problems you struggle with.  You didn't deserve what happened to you and you don't deserve the consequence of what happened to you and you can take back what has been lost and reach a level of self-empowerment to move on.