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Cognitive Behavioural Therapy (CBT) Provides The Best Result For PTSD

Discussion in 'Articles' started by Anthony, Oct 12, 2010.

  1. EMDR is one of the four ONLY Tier 1 therapies for the treatment of PTSD... so yes, its just as good and effective as the other three; in actual fact, it will comprise two of the other three methods as part of the overall package delivered, as EMDR is only a substitute for the cognitive aspects, replacing Cognitive Therapy. EMDR is a cognitive therapy and even is a little exposure as well wrapped in, but internal exposure, not the full package of exposure required. Anyone practicing EMDR will also wrap more exposure and stress inoculation within the overall package, rounding it out to a normal CBT package.

    EMDR is actually a CBT therapy. If you are confused, then read this quick piece, with diagram, that explains CBT as an overall model:
    reddevil1111 likes this.
  2. Hey Anthony, what is the difference between Cognitive Behavioral Therapy (CBT) and Cognitive Processing Therapy (CPT)
  3. They are actually the same thing... CBT is the name given to an overall therapy model, it is a quick name to say that you are entering a therapy that is both cognitively processing your memories within the correct areas of the brain, and also contains a behavioural component that is realistic for you to apply within your life, done via both exposure based and technique application within situations.

    Cognitive processing therapy is just that, one part of a CBT model that is handling only the brain processing of the trauma. EMDR also does this, being it takes care of the actual processing of the trauma within the brain.

    Cognitive processing is also a form of exposure, being that you expose yourself to the trauma again in order to process, based on failure to do so is fear based. So even talking about your trauma here, is both cognitive and exposure based, because your brain is processing what you did, and receiving feedback for you to process and apply to change your mental perception of your trauma. Pretty much everything we do in life is exposure therapy... being the act of doing. So the moment you think about something, you are doing. How far doing goes, changes the term exposure therapy into more depth from just normal exposure that is collectively referred to as cognitive processing.

    Does that make sense?

    In a nutshell, you need three things to make up the overall package, being:
    1. Cognitive processing with correct feedback loop,
    2. Actually removing fear based emotion through exposure exercises, and
    3. Stress reduction / management techniques and/or exercise/s.
    All three are needed, which way you incorporate them, is unique.

    Some might have EMDR + Prolonged Exposure Therapy + Weekly massage and learning stress management. Another could have, Cognitive Trauma Processing Therapy + PE + stress management techniques, relaxation, weekly golf, exercise, etc.

    You get the idea no doubt. You can mix and match. Each complete package is called CBT, because it encompasses a cognitive processing, an exposure element and stress inoculation method/s to manage ongoing daily life.
  4. Anthony,
    In the very last sentence of your post you mention we relate best to "PE" vs. talking about our emotions. What does "PE" stand for?
  5. Prolonged Exposure.

    PTSD is primarily fear based, whether it be fear to face trauma, fear to face emotions, fear to face the world, PE is a desensitization therapy that helps you shift past the fear, which is how most function day to day... they don't have that fear that PTSD instills or envelopes us with due to isolation or other factors.

    Its then extremely effective for military, as military have already been trained to endure pain, tolerance, to push past barriers... thus most of the motivational work is already done when applying PE to military.
    JarHed likes this.
  6. Makes sense. Thanks!
  7. Where does, if at all DBT fit in Athony. It is what I was taught while in the Clinic here in Germany, mainly due to having also been diagnosed with BPD, and not just PTSD and Depression. For me its seems simliar to CBT, in that it teaches you to Learn about yourself (Actually feeling your feelings and puting them into words etc.) and surroundings (what is actually happening at a specific time, and what effect it is having on you ), so you can act upon Impulsive reactions, ie, retraining yourself, but it has to be kept updated from time to time, as we are constantly in a state of change. I had it allmost 3months solid, and have been over due a refresher, am currently waiting a reply as to when I can step up.
  8. DBT is a form of CBT, except it is tailored for people with personality disorders, as you cited BPD. Instead of jumping into trauma therapy, it can go for a year or two focused purely on emotional stabilisation and grounding techniques, stress management, etc... all before you go near trauma itself.

    Basically, when a person has a personality disorder it means their brains wiring has deviated from standard and thus more extremely measures must be taken first to get the person back on a more standard and considered "normal" view of the world, people, emotions, understanding feelings, etc.

    When you have a personality disorder, you would find it near impossible to identify emotions, to regulate them and so forth... that is what DBT focuses on as a priority.

    CBT focuses on these first as well, but its usually a short focus, one or two sessions and a person can get the gist of things to try and regulate the heightened symptoms and emotions that are coming from dredging through trauma and feelings.
  9. Thanks Anthony

    Yeah tell me about it LOL. My therapist compares me to a mine field LOL, she states "I don`t think or see the world in black and white! as would be the normal case scenario for someone from the Military. You see it in Very deep black and Very bright White" I get what she is saying.

    It has only been since I started with the DBT 2 year ago, that I have spoken to others about the Military, I still don`t go anywhere near the stuff that throws a curve ball, but learning to "Identify" and "Regulate" (as you have put it) my emotions has certainly helped in opening the doors to Therapists. before that I was just "The stroppy bastard" who didn`t talk in the group, and just got so wound up that I would take it out on myself.

    While at my therapist we take it from day to day, and generally go down the road of what ever I bring to the session with me. It started with me just being angry with the world in general, but has turned to the Military life in the last couple of months, and I am now at a point where "I" want to talk about the stuff that I saw and all, I still need to be carefull that I don`t screw myself up, but I now know throught the DBT what emotions are being aroused and can steer the session for my good. Something that was unthinkable at the begining. I want to speak to her to see if she can go down the CBT (KBT in German) road aswell.
  10. You already are from the sounds of it... DBT is CBT, just a different form. CBT is the foundation of DBT. DBT then adds additional aspects for the above mentioned focuses, which is why the name changed. You are already using CBT if having DBT, just a different approach.
  11. Aussies have a great program for PTSD in Victoria, at the Heidelberg repat hospital. I have just finish the program and I am sure that it has helped me to understand what the hell was going on with me. Also they provided tools to counter the al the issues with PTSD. DVA will pay and if you are a serving member as I am and diagnosed with PTSD they are responsable (the ADF) to provide you with the full support required.
  12. It's so interesting that someone else has been told that. My psychiatrist told me this a while ago too, but in slightly different words. He said for me there is no grey, only black or white.
  13. When I first returned from 'Nam I truly only saw things in black or white. It took me a lot a years to move away from that kind of thinking. Nothing it seems is ever completely black or white but just shades of grey. My perceptions of things have changed over the years.

    My PE therapy at the beginning of this year really helped to crystallize those ideas. Just as an aside, I think that PE was good for me in that I'm a very visually oriented person. Better at remembering a persons face than their name for instance. So talking about and visualizing my experiences was a good way to learn about them and move on.

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