The treatment started with psychoeducation focused on Mr. Johnson’s PTSD symptoms. This involved an explanation of cognitive processing therapy (CPT) and its efficacy in addressing PTSD. Mr. Johnson underwent a version of CPT that included crafting a trauma narrative.
Trauma Narrative and Impact Statement
CPT offers different versions, with some excluding a trauma narrative. A trauma narrative involves detailed writing about the most impactful trauma, termed the ‘index trauma.’ All CPT versions incorporate an ‘impact statement,’ wherein individuals articulate the trauma’s effects on their beliefs about the world, themselves, and others. This approach aids in understanding the patient’s pre-existing belief system and the trauma’s influence on it.
During these exercises, Mr. Johnson processed his emotions and recognized the development of unhelpful beliefs as a rationalization of his trauma.
Addressing Emotional Avoidance
A key aspect of treatment involved confronting emotional avoidance. Mr. Johnson had been avoiding not only triggers like sounds or places but also his emotional experiences. He learned to process these suppressed emotions, previously perceived as a sign of weakness. This conceptualization was crucial in understanding his emotional responses.
Challenging Beliefs
Mr. Johnson identified and challenged the idea that feeling emotions meant being weak. This belief was deeply rooted in his cultural background and military experience. He explored how his core beliefs about himself and the world were affected by the trauma. Treatment specifically focused on his belief that he was responsible for his friend’s death and his general mistrust of people and the world. Consequently, his life had become significantly constrained.