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July 20, 2023

Why Talk Therapy May Not Help with PTSD

Discover why talk therapy alone may not suffice for PTSD recovery and explore alternative treatments available.

Sofia Noori, MD, MPH
Why Talk Therapy May Not Help with PTSD

Talk therapy, traditionally known as psychotherapy or supportive therapy, is a cornerstone in many therapeutic settings. Typically, talk therapy involves weekly appointments with a therapist to discuss issues arising over the course of the previous week, with varying amounts of input from the therapist. However, when it comes to treating PTSD, it's not always the best option. Here's why:

It's Difficult to Speak About Traumatic Events

One of PTSD’s core symptoms is avoidance. The very nature of traumatic memories makes them difficult to access, verbalize, and confront in a traditional talk therapy setting. Without specific training in working with trauma survivors, some therapists may push survivors to share more details than is necessary to actually recover from PTSD. This can lead survivors to avoid therapy and further prolong recovery. 

Reliving Is Not The Same as Processing

Additionally, a common misconception about trauma work is that the survivor must disclose all the details about the trauma in order to recover, which researchers have found is not necessary for healing. Talk therapy runs the risk of making a patient relive their trauma without providing them the tools or coping mechanisms to process or integrate the experience in a healthy way. Many therapists are not trained to work with trauma survivors, so they can inadvertently reinforce problematic thoughts or avoidance behaviors that can prolong recovery. The value of therapy is not just in talking— it's about processing, understanding, and integrating the traumatic memories.

Trauma Rewires Your Brain

Research shows that trauma, especially chronic trauma such as child abuse or intimate partner violence, can lead to structural and functional changes in the brain. Areas of the brain like the amygdala, which is responsible for fear responses, can become hyperactive. Conversely, the prefrontal cortex, which is responsible for reasoning and decision-making, may become less active. This imbalance can make it challenging for someone with PTSD to articulate their experiences in a coherent manner, and an unstructured therapy like general talk therapy can reinforce the chaotic thinking processes seen in PTSD. 

Evidence-Based Alternatives to Talk Therapy

Given the limitations of traditional talk therapy for treating PTSD, structured therapies have been developed to treat PTSD safely and effectively. These therapies have decades of research demonstrating their effectiveness, and often lead to permanent recovery in just 10-12 sessions. 

  • Cognitive Processing Therapy (CPT) is a form of cognitive-behavioral therapy (CBT) designed specifically for PTSD. It focuses on helping patients understand how they interpret their trauma and how it affects their feelings and behavior. CPT does not require survivors to disclose all the details about their trauma in order to recover. 
  • Prolonged Exposure Therapy involves facing the traumatic memory in a safe environment, thus helping the patient process the trauma and reduce its power. It also focuses on overcoming avoidant behaviors that have become problematic in survivor’s lives. 
  • Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously undergoing bilateral stimulation (typically in the form of guided eye movements). It is generally considered a second line treatment for PTSD, but is more widely available than CPT or PE. 

Find Healing Now

While talk therapy can be incredibly healing for many conditions, PTSD often requires a specialized approach. The nature of trauma and the changes it can induce in the brain make trauma-focused therapies more effective than traditional talk therapy. With the right therapeutic approach tailored to the individual, healing and recovery from PTSD are possible.

If you, or a loved one, is suffering from PTSD and looking for trauma-specific therapy, book a free Intro Call here.