Portland Trauma and PTSD Treatment

What causes PTSD?

Brian Thompson — Tue, 27 Mar 2012 22:30:18 +0000

A common question in the field is why some people develop PTSD after being traumatized and why some do not. There’s no shortage few theories that attempt to explain this. Some of these theories sound very sophisticated: they may make reference to elements of biology and neuroscience, making mention of things such as the brain, neurons, and stress hormones.

In all honesty, though, there is no unified theory that comprehensively explains what causes PTSD. All of them, at best, contain fragments of some greater truth.

Consequently, I think it’s simpler to say that: people develop PTSD when they encounter an experience that overwhelms their ability to cope. There’s a number of interacting reasons why this occurs: intensity of the experience, history, coping skills, social support, prior experience, and biology. However, no one reason predominates.

In sum, the most honest answer to what causes PTSD is, “We don’t know.” It’s a phenomenon that is not easy to predict. What’s more important is finding ways to deal with it.

What is Acceptance and Commitment Therapy?

admin — Sun, 25 Mar 2012 02:05:38 +0000

ACT (pronounced as one word, act) is a treatment in the cognitive behavioral tradition that focuses on learning to more effectively manage our distress and to move towards living a more meaningful life. In ACT, we begin at looking at ways in which how we relate to painful or uncomfortable experiences may be creating more pain for us. As human beings, we possess an incredible ability to think about all sorts of things, to reflect upon and recreate the past, or to imagine the future. This remarkable ability is a double-edged sword: we may spend a lot of time thinking about what’s wrong with us, why we think we can never be better, and what should be different about our lives or our histories. We can re-experience painful or shameful memories in any moment. In ACT, we practice contacting and moving towards what’s important to us while learning ways to deal with what gets in our way–especially uncomfortable thoughts, emotions, and bodily sensations.

ACT has a strong and growing research base. Click here for more information about Acceptance and Commitment Therapy.

What is Prolonged Exposure Therapy?

admin — Sun, 25 Mar 2012 02:03:25 +0000

Prolonged Exposure or PE is a gold-standard treatment for posttraumatic stress disorder and has an exceptional research base. It provides a way for trauma survivors to both address painful thoughts and memories associated with trauma, as well as to re-engage activities they may be avoiding because they remind them of trauma. A common metaphor for PE is that of a wound that has scabbed over but not properly healed. Through PE, we open and clean that wound, so that it may heal properly and no longer be so sensitive to the touch.

If you are interested in PE, that is something we can discuss in treatment. I can assess what you’re struggling with and get a sense of whether PE might be a good fit for you. For people who don’t feel they are ready for to directly address the trauma, there is other work that can be down that may seem less threatening.

For more on PE, check out the description at the National Center for PTSD here.

Do you conduct assessments for PTSD?

Brian Thompson — Sat, 24 Mar 2012 22:25:16 +0000

I do not conduct formal assessments for PTSD in the sense of writing a report. Any assessment of PTSD is for treatment-purposes only. Consequently, for disability claims and legal cases, you may want to look for someone who specializes in assessment, such as a neuropsychologist or forensic psychologist.

Do you recover repressed trauma memories?

Brian Thompson — Wed, 21 Mar 2012 22:32:45 +0000

No. I do not deliberately try to recover repressed memories. In fact, I would seriously question the competence and ethics of anyone who claims to do this—especially for those who claim to use hypnosis to recover memories.

Although there are a number of cases of people who have recovered previously forgotten memories of childhood abuse that have been corroborated as being true by third parties, there have been countless examples of well-intentioned therapists “uncovering” memories of abuse in clients who later learn these memories are completely false. This risk increases greatly when therapists use hypnosis. These false abuse memories have ripped families apart and have led to a number of lawsuits against therapists.

This does not mean I will not work with someone in distress who suspects they may have traumatized. However, memory is notoriously unreliable, and research has shown that it is possible to create false memories that are every bit as painful as real memories.

I have had several clients who have remembered previously forgotten memories of childhood abuse as adults, particularly sexual abuse. I have helped them work through these memories using evidenced-based treatments, especially those with posttraumatic stress disorder.

However, some people cannot remember the abuse, or they may have vague, fuzzy memories of it. This is not a problem. There is no compelling research that people must remember their abuse to heal from trauma. The bigger question is what is getting in the way now that is preventing you from living the life you want to live. These obstacles may be related to a past trauma. Or they may not.

If you suspect you may have posttraumatic stress disorder, we can evaluate the possibility in greater detail when we meet.

Links

admin — Tue, 20 Mar 2012 02:06:27 +0000

Related websites: I work at under these two clinics: Portland Psychotherapy, and the Portland Mood Disorders Clinic.

Here are some trauma/PTSD related sites for additional resources:

National Center for PTSD
Gifts from Within
Rape, Abuse, & Incest National Network
National Organization on Male Sexual Victimization
NIMH: Coping with Traumatic Events

Audio Files: I’ve helped compile a list of mindfulness and acceptance audio files for another website. I use many of these exercises in my practice. You’re welcome to check them out here.