Tom Spooner: A Case Study

PTSD is not easily treated. Sometimes people can not only suffer mentally but have physical impairments from the event as well. This can make it hard for them to obtain the treatment they need. A combination of medications and psychotherapy is usually recommended and is the most effect form of treatment for PTSD. The earlier a person seeks treatment for this disorder the better the outcome will be. The medications are used to help people cope with their emotions while the psychotherapy will help

The first method of treatment is trauma-focused cognitive-behavioural therapy. In this method, a patient is gradually but carefully exposed to feelings, thoughts, and situations that trigger memories of the trauma. By identifying the thoughts that make the patient remember the traumatic event, thoughts that had been irrational or distorted are replaced with a balanced picture. Another productive method is family therapy since the family of the patient is also affected by PTSD. Family therapy is aimed at helping those close to the patient understand what he/she is going through. This understanding will help in the establishment of appropriate communication and ways of curbing problems resulting from the symptoms (Smith & Segal, 2011).

Posttraumatic stress disorder can occur after someone experiences a traumatic event. Once the mind hits the coping threshold, it is imperative to seek professional help. The VA offers evidence-based treatments, individual, group treatments, and medications. Coping mechanisms range from individual to individual, hence the need for a diverse PTSD program. Under the evidence-based treatment there are two sections: prolonged exposure therapy and cognitive processing therapy. Prolonged exposure therapy is when someone continues to talk about their fears/trauma to gain control of feelings associated with those fears. The cognitive processing therapy is to understand the feelings associated with trauma and finding a way to replace negative feelings with positive

The most common treatment options for PTSD consists of psychotherapy, medication, or a combination of both. Psychotherapy can help victims by teaching them about the trauma and its side effects, using relaxation and anger management skills. It can also assist them with identifying possible guilt and shame about the incident and helping them cope with those emotions. The most common forms of medications used to treat PTSD are Zoloft and Paxil ("NIMH » Post-Traumatic Stress Disorder (PTSD)," n.d.).

There are two common types of treatment, which include psychotherapy and medication (“PTSD: National Center for PTSD”). Cognitive behavioral therapy is known to be the most effective treatment for this disease. The treatment may include learning skills to understand how the traumatic event changed the individual's thoughts and feelings. This type of psychotherapy therapy may also include repeating of the memories and discussing the event in thorough detail until this event no longer causes the individual to feel distressed in a situation that is similar. These treatments help to change how one feels about the situation and themselves (“PTSD: National Center for PTSD”).

The first type of Treatment is called Cognitive behavioral therapy or CBT. Research says that this is the best type of treatment and counseling for anyone diagnosed with PTSD. Cognitive behavioral therapy is used to help the veteran think differently about their thoughts or feelings from the past. The main goal by the therapist is to help the veteran find out what past events or flashbacks correlate with the veteran’s thoughts that make the symptoms of PTSD occur. Many times, the veterans will blame themselves for a decision they made but the therapist will walk them through on how it was not their fault. Cognitive Behavioral therapy can last for three to six months. Although to some people it may seem that CBT might be the best type of treatment, it does not always work. One reason why it might not work is because the therapist may like the experience and education. The therapist may be qualified but sometimes, the therapist may fail at connecting with patient. The connection that is missed by some therapists and patients can simply occur by the therapist not having all the knowledge about all the situations soldiers face when they go to war. Soldiers struggle with their therapy if they feel that the therapist who is helping them does not have the knowledge about the battlefield or the difficulties of war itself. The relationship of the therapist and veteran can also play a major role on the effectiveness of the therapy. Some soldiers may struggle with feeling comfortable with their therapist because they are sensitive and emotional. Sometimes veterans struggle with this therapy if they cannot develop a relationship with their therapist. Another factor that can affect the effectiveness of CBT is the timing. Sometimes three to six months is not enough to show long term effectiveness of the therapy. Another treatment option is exposure therapy.

War veterans brought PTSD to public attention in the early nineteen eighties, with the lack of knowledge and treatment; planning and specialized mental facilities were not available. PTSD can stem from traumatic incidents, such as mugging, assault, torture, kidnapping or held captive, child abuse, automobile accidents, train crashes, plane crashes, bombings, or natural calamities such as floods or earthquake. The majority of people exposed to such events experience some symptoms of distress (sleep problems, jumpiness). Most fully, recover in a few weeks or months. Therefore, has there been enough accomplished over the past century to help treat veterans coming home with PTSD?

Many who suffer from PTSD will likely notice that they have all suffered greatly. "Staff Sgt. John Daniel Shannon, 43 came in one of those buses in November 2004 and spent several weeks in the Walter Reed's hospital. His eye and skull were shattered by an AK-47 rounds" (Priest). In other words, some of the injuries that occur are worse than other. They can also affect the victim and their family's lives. Next, families of those who have dealt with PTSD typically see the emotional trauma of combat that soldiers experience. "A 49 year old veteran explained that he suffered from paranoia in crowds. Nightmares and unrelenting flashbacks from the Iraq war. He said he needed his handgun to feel secure and worried that he would shoot somebody. For those affected, they do what they think they need to do to protect themselves and their family. Finally, because of the number of people suffering from PTSD impacts the people they are around and their relationships with them. Ted, a veteran from the Vietnam war, became increasingly withdrawn from his family and friends. He could only sleep for hour or two before the war nightmares came to him. He was desperate to get rid of the dark cloud that grew inside him. Within two years of returning from Vietnam, Ted committed suicide; a tragic end to a career officer's life that may not have occurred if he or those around him knew about PTSD" (Saperstein). Therefore, when PTSD gets ignored it can lead to losing the life of a loved one. In conclusion, veterans who suffer from PTSD struggle with finding jobs, dealing with PTSD, family, and

The first treatment is psychotherapy where one is one on one talk with a psychiatrist and one can talk about one’s problems (nimh.nih.gov). Talk therapies also help people overcome PTSD by teaching about trauma and its effects, using relaxation and anger skills, and providing tips for better sleeping, eating, and exercise habits (nimh.nih.gov). Holden Caulfield uses this therapy when talking to the psychoanalyst at the end of the book. “A lot of people, especially this one psychoanalyst guy they have here, keeps asking me if I'm going apply myself when I go back to school next September” (114). There is also exposure therapy. Exposure therapy helps people face and control their fears by exposing them to the trauma in a safe way (nimh.nih.gov). Another treatment for PTSD is Cognitive restructuring. Cognitive restructuring helps people make sense of the bad memories (nimh.nih.gov). The final treatment for post-traumatic stress disorder is stress inoculation training. Stress inoculation training tries to reduce PTSD symptoms by teaching a person how to reduce anxiety (nimh.nih.gov). There is no cure for post-traumatic stress disorder but there are also medications that help such as sertraline and paroxetine which act as

For some people these therapies work their best together and for others just one does the job. The first therapy is exposure therapy, “exposure therapy asks patients to confront, in a safe way, the very situations, objects, people and memories they have attached to the trauma” (Foa 2001) This therapy helps the patient confront their fears in a healthy way, to try to slay the beast and get on with their lives. The second therapy is anxiety management. Anxiety management is five techniques taught to people that help cope with the anxiety experienced from PTSD. The five techniques are,” breathing training, relaxation, assertiveness training, positive thinking and self-talk [and] thought stopping.” These techniques help people calm down enough to cope with their fears slowly, and is usually is used with the exposure therapy process. The third therapy is cognitive therapy. Cognitive therapy is positive thinking and “helps you understand how your thoughts affect your feelings.” (Foa 2001) By using these four steps the therapy helps achieve positive feelings and thoughts. Step one, “become more aware of distressing thoughts.” Step two, “pay attention to connections between your thoughts, feelings and behaviors.” Step three, “challenge (talk back to) your negative thoughts.” Last but not least step four, “substitute positive thoughts for negative ones.”(Foa, 2001)

The two main forms of treatment are medications and psychotherapy. The medications that are used are antidepressants. Antidepressants “may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside.” The form of treatment, psychotherapy, is referred to as “talk therapy.” Psychotherapy “lasts 6-12 weeks but can last longer.”

Thomas reports being a military member who has seen combat, which means he has been exposed to the “horrors of war” in a high stressed environment. In fact he reports witnessing one of “his brother(s)” being hit by a friendly fire and dying. According to the DSM V, Thomas meets criterion A for PTSD because he had direct exposure to a traumatic event (American Psychiatric Association, 2013). As one can see and perhaps empathize with is that Thomas is not only suffering from physical pain, but he also has to carry the emotional burden of what came from witnessing the traumatic event of “his brother (’s)” death. On top of all this, if one digs a bit deeper into Thomas’s family history, one will come across a disorganized attachment within the family unit; which is another added level of stress that he has to carry around.

A frequent therapeutic option for mildly to moderately affected PTSD patients is group therapy, although empirical support for this is sparse. In such a setting, the PTSD patient can discuss traumatic memories, PTSD symptoms, and functional deficits with others who have had similar experiences. This approach has been most successful with war Veterans, rape/incest victims, and natural disaster survivors. It is important that therapeutic goals be realistic because, in some cases, PTSD is a chronic, complex (e.g., with many comorbid diagnoses and symptoms), and severely debilitating psychiatric disorder that does not always respond to current available treatments. Resick, Nishith, and Griffin (2003) have shown however, that very good outcomes

Treatment for any illness especially mental disorders can take some time to work. The case is still true with PTSD. There are many different ways to treat PTSD and it is case by case which is best for each individual. Therapy and medications have proved to be the most successful forms of treatment. In the U.S. Department of Veteran Affairs article about the different forms of treatment, it talks about the few different forms of therapy used(PTSD: National Center for PTSD). Cognitive therapy helps an individual understand that how thoughts and stressors can make your symptoms worse. Therapists that focus on this type of therapy work to learn how to point out things in externally and internally that cause triggering thoughts and how to avoid

There are many mental health professionals that can help assist those who suffer from PTSD. Isolation often occurs to patients with PTSD, the feeling that other people do not quite understand. Along with the isolation is a feeling that others have not experience it and do not know what it is about. There are pharmaceutical treatments that may be necessary in the earlier stages to help with anxiety, if a person laps into shock too long then sometimes medication is indicated. Psychotherapy is the most common recovery tool. An experienced and understanding therapist can provide being a witness, being with the patient as their reliving their trauma in the safety of a therapists office. Peoples bodies and brains are often very sensitive to being damaged. To repair the trauma patients need to relive the traumatic experience. Patients need to relive it with someone who can hear it and that will be there for them on an emotional level. The purpose of going to therapy is to keep telling the traumatic story over and over again until one day that story does not have the power that the victimizer had in creating the fear