LONGWOOD STUDENT VETERANS

The following information was found at http://ptsd.factsforhealth.org/exposure.html Take a look at the entire site! You'll be able to find information on PTSD, cognitive therapy, anxiety and the means of working on / through those issues. As always, I encourage you to contact a health provider to work with you on these issues. Exposure Therapy Exposure therapy is based on the principle that we get used to things that are just annoying and not truly dangerous. This is called habituation, and it occurs naturally in over 95% of people. For example, if you visit a friend in a large city who lives in a second-floor apartment just beside an elevated railroad, it would be very annoying every time a train screeched by, shaking the building and rattling the windows to the point that conversation became difficult. One might even say to the friend, "How do you live in this din?" The friend might answer, "What din?" If we only visit, we leave with a belief that our friend lives in an impossible situation; if we stay in the apartment for a week or two, we are no longer annoyed by passing trains and may not even be aware of them. Exposure therapy is based on the idea that this kind of habituation must occur in the person who has been traumatized if they are to overcome PTSD. Exposure therapy asks patients to confront, in a safe way, the very situations, objects, people and memories they have attached to the trauma (and are probably very consciously avoiding). Exposure therapy is the opposite of the typical, self-prescribed avoidance approach. Because while avoidance may provide temporary relief, it just doesn't last. Facing these triggers is the key to reducing the frequency and severity of PTSD symptoms. Exposure may be done in vivo (in real life) or in imagination. In vivo exposure is more effective than imaginal exposure. While anxiety or other discomfort may get worse in the first few minutes of in vivo exposure, it is important to continue exposure until the discomfort has diminished. Escaping discomfort only reinforces avoidance as a coping tactic, and produces all the limitations associated with avoidance—like avoiding safe places or situations that might be fun, beneficial or essential for a career and a full family life. It also increases the likelihood that the anxiety might spread, first to similar triggers and eventually to triggers that have little or nothing to do with the original anxiety. Examples of exposure in vivo are resuming driving after being in a traumatizing accident or returning to a now-safe site where an assault once occurred. Exposure in imagination involves the person recounting traumatic memories until they lose their sting. This can be done by saying them aloud repeatedly, writing, reading and rewriting a biography of the events or recording them on a tape and playing them over and over until they are no longer distressing. Also, from the American Psychological Association at http://www.psychologymatters.org/keane.html xposure Therapy Helps PTSD Victims Overcome Trauma's Debilitating Effects War veterans, crime victims, accident survivors and others exposed to trauma are finding help through therapy that mentally takes them back to the trauma in a controlled environment. Findings Posttraumatic stress disorder (PTSD), a debilitating disorder involving intrusive thoughts associated with traumatic events, affects millions of Americans. First known as “shell shock” and seen in WWI veterans, PTSD often involves flashbacks and nightmares following a traumatic experience, including traffic accidents. Many of these symptoms first surface many months after the trauma. In the 1980’s, Dr. Terence M. Keane and his colleagues found that exposure therapy was effective in treating the PTSD symptoms of Vietnam War veterans. Exposure therapy, previously known as imaginal flooding therapy, involves carefully exposing the patient to prolonged and repeated imagined images of the trauma until the images no longer cause severe anxiety. In Keane’s randomized clinical trial involving 24 Vietnam veterans, Keane found that exposure therapy was effective in reducing many of the veteran’s PTSD symptoms, including nightmares, flashbacks, memory and concentration problems, and irritability. Exposure therapy doesn’t just help combat veterans with PTSD. Research by Dr. Edna B. Foa and her colleagues showed that exposure therapy was effective in reducing PTSD symptoms of rape victims, including persistent fear. The improvements were seen immediately after exposure therapy, and were shown to be sustained during a three-month follow-up. Significance Many American suffer from PTSD. According to the National Institutes of Mental Health, 5.2 million Americans aged 18-54 have PTSD. These and dozens of subsequent studies have established exposure therapy as a highly effective and perhaps the most efficient treatment for PTSD. Research completed after the September 11, 2001 terrorist attacks found an increased prevalence of PTSD, especially in children living in New York City. Practical Application Exposure therapy has helped hundreds of thousands of trauma victims to work through trauma’s debilitating effects and find psychological health following war experiences, rape, accidents, and human-made and natural disasters. The Veteran's Administration (VA) operates more than 140 specialized programs for the treatment of PTSD through VA Medical Centers and Clinics, programs that include exposure therapy as part of treatment. In 2001, more than 77,300 veterans were treated for PTSD by VA specialists. Cited Research Keane, T. M. & Kaloupek, D. G. (1982). Imaginal flooding in the treatment of a posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 50, 138-140. Keane, T. M., Fairbank, J. A., Caddell, J. M., & Zimering, R. T. (1989). Implosive (flooding) therapy reduced symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245-260. Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). The treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive-behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715-723. Foa, E. B., Meadows, E. A. (1997). Psychosocial treatments for posttraumatic stress disorder: A critical review. Annual Review of Psychology, 48, 449-480. Additional Sources National Institute of Mental Health. Reliving Trauma, Post-traumatic Stress Disorder. Available at: http://www.nimh.nih.gov/publicat/reliving.cfm Department of Veterans Affairs. Fact Sheet: VA programs for veterans with Post-Traumatic Stress Disorder (PTSD). Available at: http://www.va.gov/pressrel/ptsd402.htm American Psychological Association, October 20, 2003 For more on Health, click here. Glossary of Psychological Terms