Therapeutic interventions for PTSD: How to find relief from trauma

Post-traumatic stress disorder (PTSD) is often misunderstood in popular media and society. However, the prevalence of this condition is significant, with six out of every 100 people experiencing PTSD at some point in their lives. If you've experienced any traumatic event, you may be at risk of PTSD. Understanding the symptoms of this condition and the most effective research-backed treatment options may help you decide how to move forward and reduce the adverse impacts of PTSD. 

What is post-traumatic stress disorder? 

PTSD is a complex mental illness listed under the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in the trauma and stressor-related disorders category. This condition often results from experiencing or witnessing a traumatic event or multiple repeated events. Traumatic experiences might include but are not limited to the following: 

• Physical, emotional, verbal, financial, or sexual abuse
• Neglect as a child 
• Experiencing or witnessing violence 
• War and combat-related events
• Natural disasters
• Experiencing a medical emergency or painful medical procedure 
• Being diagnosed with a terminal illness
• Financial insecurity, poverty, and houselessness
• Divorce 
• Sexual assault
• Gang violence or association
• Terrorist events
• Exposure to distressing or traumatic imagery through a film, photo, or real-life event 

Not everyone who experiences a traumatic event develops PTSD, and what is traumatic for one person might not be for another. Factors like physical and mental health, emotional sensitivity, and family life might play a part in whether someone develops PTSD. 

If you are experiencing sexual abuse or have experienced assault, note that the Rape, Abuse, and Incest National Network (RAINN) has a hotline dedicated to supporting individuals experiencing sexual assault, harassment, or intimate partner violence. You can contact them anytime by calling 800-656-HOPE (4673) or using the online chat. 

What are the primary symptoms of PTSD? 

Symptoms of PTSD can vary, but one or more symptoms must be present in each category within the DSM-5 PTSD definition for a diagnosis to be made. The categories include the following: 

• A traumatic event or stressor 
• Intrusive thoughts or memories, including reliving the event 
• Avoidance 
• Cognitive and mood symptoms
• Reactivity and arousal symptoms 

Within these categories are symptoms like the following: 

• Flashbacks (intrusive memories that cause a person to relive the event cognitively and potentially somatically) 
• Anxiety or depression 
• Hypervigilance of surroundings 
• The presence of "triggers" that can set off a traumatic memory
• Dissociation, depersonalization, or derealization 
• Rage or irritability 
• Fear of the event occurring again 
• Avoidance of people, places, objects, conversation topics, or other stimuli that remind the individual of the event 
• Frequent thoughts and feelings related to the event 

If someone has experienced more than one trauma, they may fit the criteria for complex PTSD (C-PTSD), which is not an official diagnosis in the DSM-5 but is used by some mental health professionals to describe PTSD caused by repeated and severe childhood and lifelong trauma. 

Six research-backed therapeutic interventions for PTSD

Although PTSD can cause many functional challenges, it is a treatable and manageable condition, and many people find symptom relief from psychotherapy. Below are a few of the most common treatments for PTSD as well as several modern treatments that some people may find support from. 

Before trying a therapeutic modality, contact therapists in your area or online to ask for a consultation. You can ask questions about their approach and make an informed decision based on the methods you most connect with. 

Cognitive-behavioral therapy

CBT involves talk therapy techniques like roleplay, worksheets, skills mastery, mindfulness, cognitive restructuring, and self-reflection to help clients understand their thoughts and beliefs. After identifying cognitive patterns, the therapist can lead clients toward behavioral changes to meet their treatment goals, whether those goals involve reducing symptoms or having healthier relationships. 

PTSD treatment with CBT may focus on understanding how the traumatic event changed their perception of daily life, themselves, and the people they love. Understanding these changes and noticing they are new and can be changed may benefit someone with this condition. In addition, other forms of CBT, like exposure therapy or prolonged exposure therapy, may be practiced if someone wishes to reduce the amount of anxiety they're experiencing due to their PTSD diagnosis. 

Eye movement desensitization and reprocessing therapy (EMDR) 

EMDR is a form of therapy based on the concept of bilateral brain stimulation. This type of intervention involves stimulating both sides of the brain simultaneously through light movements, finger tracking, hand buzzers, throwing a ball back and forth between two hands, or other methods developed by EMDR therapists. 

Specifically developed to treat PTSD in veterans, EMDR may be an effective modality for those looking to explore their trauma-related memories through an integrative approach. During the first few sessions, you may outline your traumatic events or discuss them briefly to let the mental health professional know what you'd like to work through. You can then work alongside them to create a treatment plan. 

Your therapist may also ask you to develop a meditation exercise you can go to during sessions if you start to feel intrusive memories or distress arising. This mentally safe space could be a beach, a comfy cabin, or another beautiful location, depending on what makes you feel safe. Your therapist can help guide you to this location after each session or when you feel physical symptoms of distress occurring, such as a racing heart or sweaty palms. 

EMDR has been found to be more effective than CBT in treating PTSD in seven out of ten studies. 

Somatic experiencing therapy

Somatic experiencing therapy focuses on how trauma impacts the body. Traumatic events, especially those which occurred during childhood, have been associated with adult chronic pain, headaches, physical illness, an impaired immune system, and inflammation. Somatic experiencing therapy looks at how these symptoms can be reduced by driving awareness to the body instead of the mind. 

Clients may start identifying bodily sensations with a therapist while discussing traumatic events. Their therapist might ask them which body part they're feeling it in, what it feels like, and what emotion could be associated with it. For instance, emotions like anger can be associated with stomach pain or feelings of hotness under the skin. 

Through somatic therapy, clients can learn to identify their emotions and pinpoint where trauma is being held in their bodies. Studies have found that Somatic experiencing therapy can reduce PTSD symptoms. However, this therapeutic modality is more modern, so further studies may be needed to get a more accurate assessment of its effectiveness.  

Internal family systems therapy (IFS) 

Internal family systems therapy (IFS) is an individual therapy often used for those who have gone through childhood trauma. It uses the family systems theory to showcase how individuals function based on their place in the family system they grew up in. Adults may practice IFS by understanding how their personality has developed to cope with trauma. The IFS theory believes each person has "parts" of their personality. Each part might take on a different role, such as working, defending the family, experiencing emotions, or expressing individuality. 

When a person experiences trauma at any time in their life, the parts might shift and change to cope with the trauma. In IFS, the therapist leads discussions about the different parts of a person's personality and may ask them to investigate how these parts serve them. Many people have parts of themselves they feel ashamed about, and IFS can help them learn to accept these parts and see themselves as complete, unique individuals. 

According to research, IFS is associated with a reduction in PTSD symptom severity over time as well as a reduction in depression, dissociation, and dysregulation. At a one-month follow-up of one study, 92% of participants no longer met the criteria for PTSD. 

Cognitive-processing therapy (CPT) 

Cognitive-processing therapy (CPT) is another modality focused on treating adverse events from the past. According to the American Psychological Association (APA), CPT is delivered over 12 sessions and works on exploring and discussing unhelpful trauma-related beliefs. Through CPT, the client may become more aware of their "automatic thoughts" and start to open up more about what happened to them. 

The therapist can use several techniques, like motivational interviewing, Socratic questioning, writing exercises, roleplay, and CBT techniques to help the client start to perform self-reflection and understand their thought processes and beliefs. 

Psychodrama therapy

Psychodrama therapy is a type of group therapy focused on helping clients physically and emotionally take control of their traumatic memories by acting out conversations, events, and goals in the presence of a group. Although it may seem counterproductive to act out a traumatic event or revisit these memories, some people find it effective in reducing symptoms, as they can restructure what occurred to them in their minds and see the change visually. Results of several studies in 2022 found that psychodrama therapy was associated with 20% to 24% fewer PTSD symptoms in participants. 

Other therapeutic methods

The above methods are not the only PTSD treatments available. Clients may also find symptom relief from the following: 

• Exposure and response prevention therapy (ERP)
• Prolonged exposure therapy (PET)
• Stress inoculation training
• Emotionally focused therapy
• Attachment therapy 
• Tapping therapy
• Dialectical behavior therapy (DBT) 

Medication 

Medication can be a temporary but possible option for treating some symptoms of PTSD. Some clients may find relief from nightmares or anxiety with the help of medication. It can be essential to consult with your medical provider, like a psychiatrist or primary care physician, before starting, changing, or stopping any medication or medical treatment. 

At-home techniques for coping with PTSD symptoms 

PTSD symptoms can be challenging to address independently. Although therapy is the top treatment for PTSD, there are a few techniques you can use at home to try to reduce the impact of your symptoms outside of sessions, including the following: 

• Expressive writing, like journaling 
• Listening to music you relate to 
• Spending time with your pets or visiting an animal farm
• Spending time with horses
• Swimming
• Getting regular exercise
• Spending time in nature
• Eating healthy foods
• Practicing mindfulness 
• Listening to a guided sleep meditation 
• Spending quality time with friends and family
• Creating art 

Online therapy for PTSD

If you're experiencing symptoms of PTSD and looking for a therapeutic modality that might support you, you're not alone. Sometimes the symptoms of PTSD can make it difficult to travel to in-person appointments with a therapist. In these cases, you could benefit from online therapy sessions through a platform such as BetterHelp. 

Many of the above modalities can be delivered online, and you can search for a provider who offers a specific treatment approach. With a large database of professionals available, many of whom specialize in trauma and PTSD, you may be able to find the right match for you. Since online therapy can be conducted from home, the experience may feel safer for you, which could allow you to be more open with your therapist. 

Studies have supported the effectiveness of online models for addressing a range of mental health conditions and other concerns. One study looked at cognitive-behavioral therapy and EMDR techniques online and found that they were as effective as in-person methods for treating symptoms of PTSD. Some participants experienced a trauma-related symptom reduction of 55% after treatment. Researchers concluded that online CBT is “significantly more effective in reducing PTSD compared with waitlist controls.”