What is one of the most common symptoms that comes to mind when you think of Post-Traumatic Stress Disorder (PTSD)? If you thought of nightmares, you’re not wrong. In fact, up to 61% of people who have PTSD experience nightmares on a regular basis (Pigeon, Campbell, Possemato, & Ouimette, 2013).
Several years ago, I attended an all-day Zen retreat with Claude AnShin Thomas (AnShin means “peaceful mind”). After several hours of silent zazen (seated breath awareness meditation), I had the opportunity to meet with AnShin for a private interview. Although we only spoke for a brief period of time, one thing that he said really stuck with me. I can’t remember his exact words, but I remember him saying something like, “The challenge for combat Veterans like me who have had the illusion of themis (divine order, fairness, law) shattered is to learn to live with their new reality. Dying is easy. We know how to do that.”
On 5 March 2019, the US Food and Drug Administration (FDA) approved the nasal spray medication Spravato (esketamine) for treatment-resistant depression in adults. Some people are applauding this new medication as a much-needed shift from the era of antidepressants, including Prozac, Zoloft, and Paxil. “Finally, a drug that uses a different mechanism of action than these older antidepressants,” they cheer. Esketamine is a glutamate receptor modulator that is believed to help restore synaptic connections in a depressed person’s brain cells. Other critics are more skeptical, concerned it won’t be the panacea we’ve been looking for.
CDP, together with National Center for PTSD, recently completed the first of three training events in Prolonged Exposure (PE) with community providers who treat Veterans with PTSD as part of a pilot project funded by the National Center for PTSD. We interviewed Dr. Sonya Norman, director of the VA’s PTSD Consultation Program and Mr. Todd McKee, program manager, who are leading this project.
In working with Psychology Interns, Psychiatry Residents, Social Workers, and all other types of mental health providers from the most experienced to least, I’ve found that people often forget the basis of Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). CPT is a form of Cognitive Behavioral Therapy (CBT) and PE is a form of Exposure Therapy. They are not unique theories.