Exposure Therapy to Treat Post Traumatic Stress Disorder of Childhood Abuse - Research Paper Example

Exposure Therapy to Treat Post Traumatic Stress Disorder of Childhood Abuse" Post-traumatic stress disorder is an incapacitating psychological disorder that follows a traumatic experience, catastrophic or horrifying events. A great deal of psychotherapy is required to overcome such distress. This encompass involvements around critical incident stress consultation, psychological education, exposure therapy, desensitization of eye movement, trauma management therapy, cognitive therapy, psychodynamic and hypnosis. The present article deals with the significance of exposure therapy for PTSD that comprise unrelenting terrifying thoughts and memoirs of their torments and an individual feel sensitively anaesthetized. Exposure therapy relieves an individual to a greater extent from the psycho-social, interpersonal and professional impairments. The most methodologically strong studies manifest that psychotherapy along with exposure therapy bring rewarding outcomes (Robertson, 2004). Introduction Post traumatic stress disorder (PTSD) is related with considerable indicative morbidity. These individuals exhibit elevated levels of offensive thoughts or memoirs about the traumatic event with severe nightmarish. They do have flashbacks. Mere reminders may be perceived in the form of physical responses like amplified heart rate, profuse sweating or distress (Robertson, 2004). Individuals with terrible or appalling experience in childhood are severely affected. PTSD individuals display avoidance symptoms, they avoid socialization or visit to places that bring those harsh memories back, they feel isolated and secluded. These beliefs if not treated within time then it may become devastating and adulthood of child either becomes rebellious or behaviour may culminate into a psychotic disorders with great intensity of insecurity being seeded in every pursuit of life (Keane, 2002). It is essential to understand the psychology of PTSD individuals. Various psychological theories have been postulated claiming to be the remedy for PTSD, but the most efficient is "Exposure Therapy". It treats the individual through alteration or modification in behaviour by enabling them to overcome the disturbing thoughts or distressing incidence (Keane, 2002). Exposure therapy aims at enabling a person to diminish his/ her trepidations and apprehensions by means of eradicating avoidance behaviour. It deals with the confrontation of an individual with the same set of feelings or situations that he fears without avoiding them. This may be done by unswervingly exposing someone to a terrified entity or picture or going back in time to envisage or visualize the situation (Keane, 2002). In order to deal with terror and fretfulness, an individual learns that the anxiety, nervousness and apprehensions will reduce by itself and there is no need to avoid them, finally dropping the extent of fearful thoughts and emotions along with the perception of the situation. Exposure therapy can also be clubbed with enhancing realization skills. This enables an individual to manage and control the situation, anxiety and blow caused by the horrifying thoughts whenever they occur in mind. In exposure therapy individuals are engaged in learned behaviours, in response to the circumstances or feelings, memories and recollections that are assessed to be fearsome or apprehensive. It is observed that a rape survivor starts circumventing relations or outings, on dates for horror that she will be assaulted again (Keane, 2002). Exposure therapy enables one to identify learned avoidance as it aids in overcoming distressing incident and start acting in a manner to avoid threats and set targets to avert that harrowing experience from its reoccurrence. Countless to state this evasion has a protective motive or for a sense of security. Conversely, if this avoidance behaviour turn out to be an extreme, the eminence of life is diminished and one may recede away from near and dear ones and may feel thorny to maintain relationships both personal and professional. Additionally avoidance can potentially enhance PTSD signs and symptoms as the individual is escaping emotions and is not able to get the opening for his thoughts, perceptions, ideas and outlook and will be deprived of views that such circumstances may not be as devastating as they look. It is therefore processing of these ideas and vies is essential. The objective of exposure therapy is to minimize the individuals terror and fretfulness, with the eventual aspiration of abolishing avoidance deeds thereby escalating excellence of life. Thus, a direct active confrontation eradicates the fear and anxiety as development of ability to deal with fearful circumstances, thoughts and emotions and gradually the fear eludes. Methods suggested by the therapists to evade off these distressing situations: 1. In Vivo Exposure: It is the straight confrontation with apprehensive articles, deeds, or circumstances an individual witnesses under the supervision of a psychotherapist. For instance, a female with PTSD who gets terrified by the place where she was molested, physically abused in childhood may be accompanied by her psychotherapist to the same place could be able to confront her fears unswervingly. It is mandatory that in such cases the psychotherapist should generate trust and confidence in the lady (Rothbaum, 1999, Rothbaum, 2001). 2. Hypothetical Exposure: It is a direct confrontation with the memories of fearful thoughts. It is performed in those cases where the individual cannot be confronted or it is not secure to take the individual to the same location where incident happened. For instance, it is unsafe to take a battle experienced individual suffering with PTSD directly to the battlefield (Rothbaum, 2001). 3. Interoceptive Exposure: It is meant for the treatment of panic turmoil. Evidence suggests its success in PTSD as well. In this case the individual is directly confronted with the physiological symptoms encompassing stress, nervousness, augmented heart rate and shortness of breath. A physiotherapist in this case is required to support in a secure manner comprising hyperventilation for some time, deep breath, hold breath for few seconds and then restoration (Wald, 2007). 4. How to get an expert of Exposure Therapy: There is an increase in the number of exposure therapist due to its better results to overcome PTSD. It is evident that some therapist have started using visual reality methodology to a greater extent so that individual feel confident. In many cases individuals are diffident to endure exposure therapy as it sounds terrifying to face the same incidence. Thus, exposure therapy requires a terrific assurance, perseverance and dedication as it can be difficult at times. It is mandatory that the frequencies between the psychotherapist and individual match. Exposure therapy is measured as a behavioural healing for PTSD. It aims at conducts of individuals and engage the person in rejoinder to horrifying circumstances and memories. In order to make the exposure therapy valuable, a person must face a condition that intimately maps onto the most dreaded situation witnessed by them as a child or as an adult (Rothbaum, 1999, Rothbaum, 2001). 5. VRET: In this method the individual is engrossed in a computer imitated virtual atmosphere, with the help of head-mounted demonstrated apparatus or admission into computer-automated chamber where images are displayed. This milieu can be planned to facilitate the individual unswervingly meet horrifying circumstances which is otherwise insecure to stumble upon in true world. It is effective for treating anxiety disorders encompassing claustrophobia, fear of driving, acrophobia, arachnophobia and social concerns. It is found to be effective in minimizing PTSD prevalent in soldiers of wars (Krijn, 2004). Although VRET is a novel technology but it is high-priced skill. Consequently, it is not used by most of the clinicians; conversely, in anticipation of VRET it is imperative to recognize that exposure therapy (without virtual reality) stays to be highly valuable method in reducing PTSD symptoms (Krijn, 2004). 6. Social Anxiety Disorder (SAD): It deals with the treatment of fear of eating or drinking among others or when in a group. Even though cognitive-behavioural therapy (CBT) is the perfect management, exposure therapy has many paradigms where one must run through exposures in day-to-day life. To overcome this exposure therapy directs a person to dare the worries (Antony, 2008). A person must dare to eat alone and should place the order for those items that he is not comfortable eating in public. Such eating exposure is essential to overcome eating anxiety. The following hierarchy must be followed: Eating alone in the café or food court, with a choice to sit at a place from where the individual is visible to most of the occupants. Inviting friends for having food together, hosting lunch/ dinner in home or in public place like restaurants, holding a glass of water in the company meet. When in office one must have lunch in the office with colleagues, clients, partners and business associates. Attending a formal function also and having food in public, with strangers and with acquaintances will help the individual to overcome the distress related to eating (Heimberg, 2002). Exposure therapy is a methodology to overcome the situation that is responsible for induction of fear, trauma or anxiety. It is essential to understand the by avoiding situations inducing anxiety, the fear for that situation will never evade, it is essential that one must witness fear-inducing situations as often as possible, unless the fear for that situation goes off. If one finds a particular instance to evade the anxiety by exposing oneself to that particular circumstances then that should be formulated till the fear eludes. Discussion Posttraumatic stress disorder (PTSD) is introduced in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980; 2000), a substantial amount of research has been performed that enumerate the success of several cognitive–behavioral therapy (CBT) plans for the cure of chronic PTSD. Amongst these effective therapies is the exposure therapy. Regardless of all the evidence for the usefulness of exposure therapy along with CBT plans, only a limited number of psychotherapists are skilled in exposure therapy and only a limited population could draw the benefit of it. The present article highlights the importance and methodologies being adopted for the use of exposure therapy for PTSD (Beck, 2005). Exposure therapy is proposed to help the long-suffering (from childhood to adolescence) faced by the traumatized individuals. It provides substantial control over the fear and anguish. The patient may feel distressed to a greater extent but with the repeated exposures the individual will overcome the devastating trauma, and anguish which was otherwise persisting over the years and has spoiled many innocent years of childhood, teenage and now the adulthood. It is essential that exposure therapy must be performed with lot of care and safety so that there is no come-back or chances re-traumatisation of the individuals. The patient cases where shock recollections or reminders are faced only once like any kind of natural calamity, disaster, earthquakes, shocks, floods death of near and dear ones. Such situations demands a great deal of psychotherapy as exposure therapy cannot be performed in real sense. A comparative study of similar situation can be shown to the victim where the rehabilitation was done and the other individual or group is able to thrive well and has overcome such a disaster. Relaxation methodologies must be adopted so as to de-stress oneself from the hectic routine or distressing stressors. A psychotherapist works in conjunction with the victim and therefore feedback is highly imperative in such cases, it is always essential to maintain one-to-one relationship and a great transparency is important between the psychotherapist and the individual. In cases of phobias, exposure therapy must be used in juxtaposition with entertainment workouts along with metaphors. Knowledge to create a situation to keep the patient relaxed and in de-stress environment is highly essential for the success of exposure therapy. Conclusion Exposing the individual to the situation which is the cause of worry or anxiety and has induced PTSD is highly complicated and should be done with lot of care and demands a great deal of psychological depth on part of psychotherapist. As this is a coping mechanism therefore it becomes imperative that the methodology adopted for exposure therapy should match with the psychology of the patient. The prior importance from the point of view of the psychotherapist is to understand and study the psychology and the extent of trauma of the patient as this will aid in the choice of methodology to be introduced for the individual. It is crucial to realize that this knowledge will help not only the psychotherapist in treating the patient but it is also going to be an immense ease and convenience for the patient to generate interest and co-operate the psychotherapist in overcoming his worries, fear, trauma or horrifying thoughts that has created distress in the life of the patient when he/ she was a child and persisted till adolescence. It is essential that the patient must be explained the method adopted by the psychotherapist to treat the PTSD of the patient and psychotherapist must come to his/ her level of understanding for the best results. This aids in enhancing the pace of the treatment and hence the patient feels free to discuss out all his/ her worries and also the inducing factors whether in the family, among the friends, or in public. References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, (4th ed., text revision). Washington, DC: Author. Antony, M. M., Swinson, R. P. (2008). The shyness and social anxiety workbook. Oakland, CA: New Harbinger. Beck, J. G., & Coffey, S. F. (2005). Group cognitive behavioral treatment of PTSD: Treatment of motor vehicleaccident survivors. Cognitive and Behavioral Practice, 12. 267–277. Heimberg, R., Becker, R. (2002). Behavioral Group Therapy For Social Phobia: Basic Mechanisms And Clinical Strategies. New York: Guilford. 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