Treating Post-Traumatic Stress Disorder With DBT
Posttraumatic stress disorder (PTSD) is an anxiety disorder that some individuals can develop after experiencing or witnessing a life-threatening event such as a serious accident, military combat, a natural disaster, or physical or sexual abuse.
Distressing emotions (e.g., anger, guilt, fear, shame, and helplessness) arising from these types of harrowing experiences are normal and typically dissipate after several days or weeks. For some, though, the difficult feelings caused by trauma can linger much longer and emotional distress may become even worse over time. Excessive anguish and interference with everyday functioning may occur, possibly indicating a diagnosis of PTSD.
Over 14 million people in the United States currently suffer from symptoms of PTSD which can begin soon after the trauma takes place, or may not occur until years later. Symptoms of PTSD usually include one or more of the following:
- Reliving the traumatic event. In these instances, individuals will become distressed when reminded about the experience. They might also have nightmares or flashbacks about the event or may get upset when reminded of the trauma.
- Avoidance. Individuals will shy away from discussing the traumatic event or will steer clear of people or places that remind them of the trauma. As a result, they may also lose interest in activities they once enjoyed and may isolate themselves from friends and family.
- Hypervigilance. PTSD sufferers may be irritable, quick to anger, and easily startled. Their preoccupation with staying safe may make it difficult for them to concentrate or sleep. Individuals who are chronically on guard may attempt to manage their stress by turning to drugs and alcohol as a coping mechanism.
The effects of PTSD can be debilitating and are often severe enough to dramatically impair one’s quality of life. Fortunately, certain types of treatments have been shown to be effective in helping individuals overcome the problems associated with PTSD. For many, these treatments can eventually eliminate all or most of the symptoms that make daily activities so difficult.
Dialectical Behavioral Therapy (DBT) is one of the treatment approaches that has demonstrated encouraging results for PTSD sufferers. Although originally developed as a treatment for Borderline Personality Disorder (BPD), many of the coping skills made available through DBT have also proven beneficial for people with PTSD.
Similar to those suffering from BPD, individuals with PTSD are challenged with managing their difficult emotions. They’re also likely to experience challenges with personal relationships, and they may engage in impulsive, risky or behaviors.
The similarity of the symptoms between the two diagnoses led to a logical exploration of determining whether DBT could achieve the same positive outcomes for those diagnosed with PTSD as it has for those diagnosed with BPD.
In one study focusing on a group of women experiencing PTSD from childhood sexual abuse, participants were subjected to treatment that combined elements of DBT with trauma-focused cognitive-behavioral approaches commonly used in PTSD treatments. Referred to as DBT-PTSD, the joint approach dramatically lessened the participants’ symptoms, including anxiety and depression. The women’s PTSD symptoms continued to improve over a month after initial treatment was concluded, suggesting that the skills participants learned during the study were employed post-treatment for continued recovery.
DBT-PTSD appears to be effective in reducing severe and chronic PTSD after childhood sexual abuse, even in the presence of severe co-occurring psychopathology such as BPD. In another study, on the efficacy of DBT for treating the effects of PTSD, concurrent DBT and Prolonged Exposure treatment reduced symptoms and improved overall quality of life for a veteran diagnosed with both PTSD and BPD.
Research using DBT to remediate symptoms of PTSD is in its early stages and further studies are needed. But the findings thus far are encouraging and offer a promising new direction for generating advanced methods of PTSD treatment.