PTSD Awareness Day: The Future of Treatment

Post-traumatic stress order affects approximately 7.7 million adults in the United States, but it is critical to remember that there are effective treatments and more are on the way. Last year in this space, Dana Alliance member Kerry Ressler said we understand the neural circuitry behind PTSD well enough that we can pinpoint where it starts. “It’s solvable,” he said.

Ressler, whose work was recently featured in an Emory Medicine article, has combatted fearful memories with drugs as well as extinction training immediately after a trauma. Alliance member Liz Phelps has worked on modifying fear-related memories through extinction training as well. Another DABI member, Jordan Grafman, who was interviewed here two years ago, recently said that “all memories are modifiable, so the lesson is to take the PTSD memory and figure out a way to modify it through new associations with positive acts.”

Take the example of a soldier who witnesses a fellow soldier killed by an IED. Let’s say the fallen soldier was an animal lover. The surviving soldier could rescue a dog from a shelter, something he hadn’t thought of doing before, thus linking the sad memory of his friend to the memory of how that led him to help an animal in need. “This association is positive and hopefully would diminish the negative associations between what he witnessed and felt,” Grafman said.

Another treatment is prolonged exposure therapy, which was discussed at a Dana-supported AAAS briefing last month:

In prolonged exposure therapy, an evidence-based treatment for PTSD, patients talk about the trauma with a therapist over several sessions until the cues no longer create fear. “We help our patients process their memories in such a way that they can reorganize it and understand that it is something that happened in the past that is not happening again, and that frees them up to go on and go forward,” [JoAnn] Difede, [director of the Program for Anxiety and Traumatic Stress Studies at Weill Cornell Medical College], said.

While observers mistakenly believe that encouraging trauma survivors to directly engage with their memories is cruel, Difede disagreed, explaining that PTSD is characterized by intrusive thoughts that force survivors to relive their trauma.  “We are not asking people to do something that their brain already isn’t doing,” she said. “In fact, we’re introducing a sense of mastery.”

–Andrew Kahn

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