In the past year, Elle's had a surprising number of pretty serious articles on mental health. This month, writer Louisa Kamps tackles a new therapy for post-traumatic stress disorder, in which sufferers mentally relive traumatic events.
Called "prolonged exposure" therapy, it requires patients to imagine reliving their most terrifying moments — the rapes, muggings, combat scenarios, or accidents that sent them to therapy in the first place. Long used for OCD, phobias, and anxiety, exposure therapy hasn't been popular for post-traumatic stress disorder because, according to Kamps, "PTSD sufferers may be in extremis, crippled by their fear and sometimes violent." But therapist and anxiety expert Edna Foa says "that people need to viscerally learn that they can withstand what they think they can't." When they repeat their traumatic memories over and over, they can "become, if not bored by them, then at least less distressed."
Kamps quotes Kim McGillivray, who received the therapy to help her deal with dramatic memories of her abusive ex-husband. She tells the story of seeing her ex-husband after a breakthrough in therapy. He was "wearing tiny jogging shorts and tube socks pulled up snug to his knees." McGillivray says,
I had that instant flash of recognition, but in the second flash, I just thought, Dork! I was sitting there in the car, laughing, going, ‘Oh my God. Whatever is happening is working, it's taking root.' I could finally see him as other people did-as just this nerd who didn't have the right athletic equipment-instead of as the monster he was to me. After years of being told I was utterly useless, it's like I've been given another shot. And that I'm able to say all this without weeping-to view things in my past without having to be totally rolled-is testament to the process. I'm back in the human race.
The science seems to back up her experience. A small survey of 127 women who underwent prolonged exposure therapy showed that, at an average of six years post-treatment, 80% had none of the symptoms of PTSD. Other studies have found that the therapy reduces PTSD symptoms by 70%. These findings are particularly encouraging in a field where confirmation of a technique's effectiveness is uncommon — Kamps reports that there is no hard data on how well traditional psychodynamic therapy works.
These concepts — "evidence," the very idea of something "working" — are fraught in the field of psychotherapy. I've had a therapist tell me my goal shouldn't be getting rid of my anxiety, but rather gaining better insight into myself, and I'm sure I'm not alone. And while insight is indeed valuable, patients do have the right to therapy that improve their ability to live their lives. And insofar as this improvement can be measured — obviously, it's not as simple as curing strep throat — it should be.
Kamps talks to psychologist Patricia Resick, who suggests that our relatively safe modern-day lives have given us an "illusion of control" that contributes to PTSD and other mental illnesses. "When something bad happens," Resick says, "people think they must have done something wrong to deserve it." But in reality, there are plenty of things in modern life that we don't control — from our own health to, say, healthcare reform — and people are smart enough to know that. By giving them an evidence-based tool they can use, exposure therapy may give PTSD sufferers a way to control, if not their lives, at least their thoughts. Being able to do this is a big step along the way to being mentally well — and to feeling empowered again after something or someone has taken that power away.
Prolonged Exposure Therapy [Elle]