Cognitive behavioral approaches alone seem to have limited success in treating established PTSD.
There is a level of PTSD that goes beyond apparent control by cognition.
Many clients, SO's of providers, and even some providers themselves have PTSD (Post Traumatic Stress Disorder) as a result of having been in combat in Iraq, Afghanistan, or earlier US conflicts.
I found that several vets were helped by my putting down the following thoughts in writing, so they can be reminded of them more easily. One vet has printed them and keeps them in his wallet, so that he can pull them out from time to time as needed.
Some of these ideas may also be helpful to people who have been victims of sexual assault or other forms of assault.
The idea here is to think about what happened in a way that would use clear reasoning. Reasoning clearly would mean not falling into reasoning errors that would make a person come to faulty conclusions. Here are some of the reasoning errors that would lead you to a false conclusion:
Failure to recognize that different decision-making "rules" apply when time is precious than in situations that allow more time to think about your options. Later, when you have more time, you can make the mistake of second-guessing yourself without realizing that you didn't have that time before. It doesn't make sense to second-guess yourself.
Weighing the merits of actions taken against options that only came to mind later on.
Weighing the merits of actions taken against ideal or fantasy options that did not exist. If those options didn't really exist at the time for you, there is no way you could have taken them.
Focusing only on the "good" things that might have happened if a different action had been taken. How do you know for sure that bad things would not have happened if you had taken that different action?
Tendency to overlook benefits associated with actions taken. Did anything good come out of the action taken?
Failure to compare available options in terms of their perceived probabilities of success before outcomes were known. How do you know that the other action you wish you had taken would have been successful? Are you just assuming that it would have been successful?
Ignoring the totality of forces that cause traumatic events. There are a lot of forces in play that cause events to happen the way they do, and your actions were just one piece of it, and maybe a small piece when you really think about it.
Equating a belief that you could have done something to prevent an event with a belief that you caused the event. Just because a person could have stopped something from happening doesn't mean that they made it happen. It was other things that made it happen.
Confusion between responsibility as accountability and responsibility as power to cause or control outcomes. Having been given a job or "put in charge" does not mean that one has complete control.
Tendency to conclude wrongdoing on the basis of the outcome rather than on the basis of one's intentions (before the outcome was known).
Failure to realize that strong emotional reactions are not under voluntary control (not a matter of choice or willpower).
Failure to realize that when all the available options have bad outcomes, the least bad choice is a highly moral choice.
Anyhow, these may be some things for a person to consider thinking about, so that they are reasoning clearly.
Like I said in one of my first posts, I am a 58 year old man, working toward becoming a state-licensed psychotherapist.
Never too late to start another career that gives you meaning. One of my mentors swears you can practice until you are 85, as long as you retain your cognitive abilities. I'm up for giving it a try.
Those are great! Always things to remind ourselves of when we have been through trauma of any sort! Many people have things inside them that we know nothing about and learning to think clearly inside and not blame yourself for things that have happened to you and people around you is so important to be able to live a normal life again.
Kisses,
Elina
Cognitive behavioral approaches alone seem to have limited success in treating established PTSD.
There is a level of PTSD that goes beyond apparent control by cognition.
John, and others in this field.
However, being a leader of a combat veteran support group at the Department of Veterans Affairs locally, I can assure you this is not the skill set needed for treatment of the aforementioned group.
Being a leader took me through a long journey of my own counseling for several years to get their as a group leader, which BTW is a voluntary gig. Being a combat veteran is an entirely different group than applying the mentioned treatment of the OP, sorry.
In fact, if the OP wishes to take this career path I certainly commend him, but also advise perhaps the best training could come at the hands of Phd's at a local VA clinic to find the real roads to recovery as a counselor.
And my formal training, appearances notwithstanding, is primarily in hard sciences rather than psychology/sociology/etc.
I just read a lot.
But I can't help but think, after a client read this, and you both relayed your thoughts and feelings to as such, the appointment is over.
That is, I'm assuming this was discussed at the beginning of an appointment and went on instead of actually talking about this BEFORE said appointment so that there was a mutual understanding and any misgivings or lack of performance was understood because of your theories.
Sorry, but I've seen some fucked up shit. Probably will again. But I'd be fucked if I gave you money to sit there and listen to me whine about it.
Some guys are like that. Just want someone to listen to them. But not $$$-$$$$ a date I'm not.
Your approach (as I understand it) is not appropriate to the level of agony and despair most of these men and women feel. This kind of work is best left to those who have unfortunately been through a similar situation and worked their way through it dealing with the pure emotion as it is, not overlayering it with an intellectual construct. No one can help others work through what they don't really understand yet. This is not a personal slight, just my own experience.
Your experience in working through is unique to you.
The Cognitive Behavioral approach to treating PSTD that I use is the best practices approach used at the VA. However, that does not mean that it will be helpful to all PTSD sufferers, only that it has been helpful for many.
I agree that those who have suffered PTSD themselves have an invaluable perspective.
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