Post-Traumatic Stress Disorder: How DBT-Prolonged Exposure Can Help
Post-traumatic stress disorder (PTSD) is a complex mental health condition that affects millions of individuals worldwide. It creates significant challenges in daily functioning and emotional well-being. At Gladstone Psychiatry and Wellness, we specialize in providing innovative treatments for post-traumatic stress disorder that offer hope and meaningful recovery for people who are struggling with trauma-related symptoms. In our DBT program, we do this with a therapy called DBT-Prolonged Exposure (DBT-PE).
What Is Post-Traumatic Stress Disorder?
Post traumatic stress disorder is a mental health condition that can develop after a person experiences or witnesses a traumatic event. For example, a person might develop PTSD after a sexual assault or another violent crime, a car accident, a natural disaster, or witnessing the death of a loved one. PTSD is also common among military service members returning from war, first responders who are repeatedly exposed to the traumatic events of others, and victims of child or spousal abuse.
Symptoms of PTSD
Sadly, PTSD can cause a number of debilitating symptoms. These include frequent, intrusive memories of the trauma, “flashbacks” that make the person feel like they are reliving the trauma, physical symptoms like heart-pounding or sweating, or persistent and exaggerated negative beliefs about themselves and others. This latter symptom often causes victims of violence to blame themselves or loved ones for the traumatic things that happened to them. In addition, many people with post traumatic stress disorder feel constantly fearful and they are hypervigilant, or always “on guard” and waiting for something dangerous to happen. There are other symptoms as well.
Avoidance and PTSD
Most importantly, some of the defining symptoms of PTSD involve avoidance. People with PTSD often avoid thinking about their traumatic memories. So when those intrusive memories inevitably pop into their heads, they do their best to push them out. They may try not to see or hear anything that will remind them of the trauma as well. For example, a woman who was sexually assaulted by a man might avoid talking to men. A person who survived a debilitating car crash may refuse to ride in cars. We’ve treated PTSD victims who avoid many things like being alone, crowds, sharing their opinions, asking for help, wearing makeup, and more.
The reason that avoidance is such an important symptom is because it is what maintains the person’s PTSD. Here’s how that works. Let’s say a woman was sexually assaulted and developed PTSD. She now believes that any man she sees is dangerous, and if she talks to a man he is likely to attack her. Whenever she sees a man she feels intense fear, so she turns and walks the other way, reducing her fear. Now, she believes that the reason she is safe is because she avoided that man. Whereas if she had approached the man instead, she might have learned that he was safe and reduced her overall fear of men.
Introducing an Innovative Approach to Treating Post-Traumatic Stress Disorder
DBT-PE is a groundbreaking method of treating post-traumatic stress disorder by integrating two powerful therapeutic modalities: Dialectical Behavior Therapy (DBT) and Prolonged Exposure therapy.
“The combination of DBT with DBT-PE is designed to make effective PTSD treatment available to even the most high-risk and complex clients and help them get relief from trauma-related suffering,” says Melanie S. Harned, Ph.D., Associate Professor in the Department of Psychiatry and Behavioral Sciences and Adjunct Associate Professor in the Department of Psychology at the University of Washington and creator of DBT Prolonged Exposure.
Components of DBT-PE
1.It Starts With DBT Therapy.
In DBT, we treat mental health problems in stages.
- Pretreatment: The therapist helps the client get oriented to DBT therapy and asks for a one-year commitment to treatment.
- Stage one: During stage one DBT, we help the client get control over life threatening behaviors like suicide and self harm. We also treat therapy-interfering behaviors, and certain behaviors that interfere with a person’s quality of life. In addition, we teach skills to help people regulate their emotions, tolerate distress, and communicate effectively. This work is very important to helping people develop emotional stability before formally processing their trauma.
- Stage two: For people with PTSD, we conduct DBT-PE during stage two. We also work on helping people to experience their emotions without avoiding them.
- Stage three: During this stage, people can work on everyday problems in their lives and relationships.
2.Prolonged Exposure to Traumatic Memories
During DBT-PE therapy sessions, the therapist helps the client approach their traumatic memories and other trauma cues in a planned way, so that they can learn that it is safe for them to think about the trauma.
3.Exposure to Cues That Remind People of Their Trauma
In DBT-PE treatment, we assign homework that involves deliberately approaching those real-life situations that people with PTSD typically avoid because they remind them of their trauma. For example, a car crash victim might ride in a car to learn that it is safe.
4.Trauma Processing
Unlike traditional prolonged exposure therapy, DBT-PE includes a significant portion of session time that is dedicated to trauma processing. This means that after the exposure part of the session, the therapist and the client discuss the traumatic event and the client’s beliefs about it. The therapist challenges any beliefs the client has that are caused by PTSD, such as beliefs that the trauma was their fault. The goal is for the client to develop newer, healthier, reality-based ways of thinking about the trauma.
Who Benefits From DBT-PE for Post-Traumatic Stress Disorder?
DBT-PE is particularly effective for people who:
- Have PTSD
- Have experienced traumatic invalidation
- Need DBT therapy because of a problem with emotional dysregulation
- Suffer from suicidal ideation or suicide attempts
- Engage in self harm
- Have tried and failed other mental health treatments
- Engage in other impulsive, self-destructive behaviors like reckless driving, substance use, risky sex, etc.
Goals of DBT-PE
Treatment is not about eliminating traumatic memories, but transforming their emotional impact to reduce suffering and help people find their life worth living. DBT-PE efficacy studies have found promising results:
- About 70% of people who complete DBT PE experience significant improvements in their PTSD.
- Many people also experience improvements in other mental health problems such as depression, dissociation, anxiety, shame, guilt, and emotion regulation.
- Our clients who complete DBT-PE often have improvements in relationships and other activities of daily living.
- After DBT-PE, many people have increased their capacity to enjoy life by participating in enjoyable activities that they used to avoid.
Our Commitment to Post-Traumatic Stress Disorder Recovery
At Gladstone Psychiatry and Wellness, we believe that healing from post-traumatic stress disorder is possible. Our DBT-PE approach represents our commitment to providing cutting-edge, compassionate care that meets the unique needs of individuals struggling with PTSD.
All of our DBT therapists have participated in intensive training in DBT and DBT-PE. In addition, our program and several of our therapists are certified by the DBT-Linehan Board of Certification. This means that the board has determined that we are conducting DBT according to the rigorous standards set by the founder of DBT, Marsha Linehan. Our team of specialized therapists undergoes extensive training in post-traumatic stress disorder treatment, ensuring that clients receive the most advanced and effective trauma intervention available.
Taking the Next Step in PTSD Recovery
Seeking help for post-traumatic stress disorder can feel overwhelming, but you don’t have to navigate this journey alone. If traditional treatments haven’t worked for you, our specialized DBT-PE approach might offer the support and healing you’ve been seeking.
We invite you to reach out and schedule a consultation. Your story matters, and recovery from post-traumatic stress disorder is within reach.
If you would like to be seen in the DBT program at Gladstone Psychiatry and Wellness, you can complete an application and submit it to dbt@gladstonepsych.com. The application is available on our DBT program website.