In my last blog, I discussed the prevalence and symptoms of post-traumatic stress disorder and mentioned some of the evidence-based interventions which can be effective for treating it.
Today, I’d like to provide a more detailed overview of one of those interventions – Cognitive Processing Therapy. It’s not the only effective intervention available, nor the only one available at Better Self Psychology, but it is an effective one, and it’s my area of expertise.
What is Cognitive Processing Therapy?
You might have heard of Cognitive Behavioural Therapy and its broad principle of finding the connections between our thoughts, our feelings and our behaviours.
People who see psychologists tend to want to change their feelings. They want to feel happier, calmer or more fulfilled, and all of those are reasonable goals to have. However, feelings are the ones that are most difficult to change directly.
I’m sure most of us have felt stressed or angry at some point in our lives and had someone tell us to ‘calm down’. Maybe it was done with the best of intentions, but I bet you didn’t just snap your fingers and feel better. However, if we can over time identify and change the patterns of thoughts and behaviours that cause, exacerbate, or prolong those feelings, then we can start to see changes in the feelings themselves.
Cognitive Processing Therapy was developed from those same principles. As a result, it focuses less on the trauma than you might expect and more on how we process that trauma. What thoughts, beliefs and rules that experience has created within us and how we can effectively put those rules to the test.
What does therapy involve?
The first stage of CPT involves gaining an understanding of what post-traumatic stress disorder really is, how trauma can affect our thoughts, feelings and behaviours, and why some people seem to get ‘stuck’ in recovery.
CPT posits that one of the main ways we get stuck is through the development of ‘stuck points’ – rules or assumptions about ourselves, other people and the world in general that develop out of a traumatic experience and fundamentally affect the way we both think and function. Stuck points are often black-and-white kind of rules, with little to no middle ground.
Let’s look at an example – say I was involved in a car accident. Maybe I was following the road rules, but someone else missed a red light and slammed straight into the side of my car. I’m sure anyone would describe an experience like that as traumatic. My brain’s number one priority is always going to be keeping me safe, and so to avoid something like that happening again, it might come up with a rule to encourage me to behave a certain way.
Maybe that rule could look something like ‘I must always be on the lookout for danger’. Now there’s some merit to that rule – it’s a good idea to be aware of potential dangers, especially while doing something like driving – but it’s also very black and white and very difficult to adhere to.
We only have a finite amount of energy to give at any one moment and being constantly on guard is exhausting. My brain would have developed this rule with the best of intentions, to keep me safe, but sometimes our brains can be a bit like an overprotective friend. It tries to keep us perfectly safe even at the expense of our happiness.
While Cognitive Processing Therapy does involve looking at the trauma itself, much of it involves identifying and challenging these stuck points which can keep trauma symptoms around long after the danger has passed.
How long does it take?
Fortunately, CPT is shorter than we might think. Generally, therapy will take around 12 sessions, sometimes less, and sometimes more if our relationship with the trauma is particularly complex.
Its goal is the resolution of trauma symptoms, to the extent that we no longer meet the criteria for PTSD. Studies have shown it to be an effective treatment for most people experiencing PTSD and post-trauma symptoms, and that it provides benefits that are both meaningful and long-lasting to participants across the lifespan.
CPT is not the only gold-standard trauma therapy, and different people respond differently to different treatments. It’s important to discuss treatment options with a health professional to find a suitable approach.
However, if CPT appeals to you, I’d encourage you to link in with a qualified therapist as soon as possible and take the next step on your road to recovery.
