"I try not to think about my terrible experience and put it behind me, yet nothing has been the same since."

What is PTSD?
PTSD is an anxiety disorder that sometimes develops after a person has been exposed to or witnessed a trauma (a life-threatening event or threat to his or her physical integrity). The trauma might be a rape, an automobile accident, or a natural disaster like an earthquake or fire. PTSD involves three types of symptoms that can persist for an extended period of time, even years after the trauma.

• Nightmares
• Intrusive memories, images, and emotional reactions related to the trauma
• Flashbacks or dissociative states in which memories of the trauma are so vivid and capture the person's attention so completely that the person experiences aspects of the trauma as if they were actually happening in the present;

• Difficulty falling or staying asleep
• Irritability or angry outbursts
• Hypervigilance, feeling on guard, or scanning one's environment
• Being easily startled

• Avoidance of thoughts, feelings, or conversations associated with the trauma
• Avoidance of activities, places, or people that trigger memories of the trauma
• Difficulty remembering aspects of the trauma
• Feeling detached or having less interest in other people or activities
• Experiencing restricted emotional responding or śemotional numbness”
• Feeling as if one has a limited future in terms of lifespan, career, marriage, or family life

Cognitive-behavioral model of PTSD
The cognitive-behavioral model proposes that in individuals who have PTSD, a traumatic event is recorded as fragmented, raw, and sensory-based memories associated with strong emotions, including an acute sense of danger and alarm. Initial protective responses adapted for immediate survival, such as hypervigilance and avoiding trauma-related cues persist after they are no longer adaptive. Those protective responses preserve the memories and emotions in their raw, fragmented state and prevent recovery. Trauma also has a disillusioning and powerful impact on people's view of themselves, their future, the world, and others.

Cognitive-behavior therapy for PTSD
Cognitive-behavior therapy for PTSD includes several types of interventions designed to promote "emotional processing" of the fragmented trauma memories into a coherent memory that is integrated with the person's other memories, thoughts, and beliefs and to help people reconcile the effects of the trauma on their beliefs about themselves, their future, the world, and others. Interventions include:

• Education to learn and understand the triggers for trauma reactions, memories, and emotions;
• Coping skills to better manage strong emotions (such as fear, shame, helplessness, and panic), to śground” yourself when trauma memories overtake you, to improve sleep, and to manage anger and improve interpersonal effectiveness;
• Systematic and controlled exposure to trauma-related memories and cues; through systematic and gradual exposure, people become less reactive and reclaim these areas of life;
• Cognitive strategies to understand and reconcile the effects of trauma-based beliefs (for example, śThe world is dangerous”) on beliefs about oneself, others, and the world, and on personal goals and relationships.

Additional resources

Web links:
The Anxiety Disorders Association of America
The Association for Behavioral and Cognitive Therapies
National Center for PTSD
Trauma Information Pages
Freedom from Fear

Books:
For links to purchase these books and others, please go to Self-Help Books for Adults

Matsakis, Aphrodite (1996). I can't get over it: A handbook for trauma survivors. Oakland, CA: New Harbinger Publications.

Smyth, Larry (1999). Overcoming post-traumatic stress disorder: A cognitive-behavioral exposure-based protocol for the treatment of ptsd and the other anxiety disorders. Oakland, CA: New Harbinger Publications.