Dr. Kate Thacher

Dr. Kate Thacher, a licensed psychologist with expertise in trauma-related work at Union Square Practice, gives an overview of PTSD, discusses common misconceptions, and provides information about the treatment options for PTSD that are available at Union Square Practice.

What is Posttraumatic Stress Disorder, and what does “trauma” mean in this context?

Posttraumatic Stress Disorder, or PTSD, describes the experience of persistent symptoms that can affect a person after the experience of a traumatic event. While the term trauma seems to have become part of our vernacular when describing experiences of even minor stressors in our everyday lives, in the context of PTSD, trauma has a very different meaning.  With respect to PTSD, an event is considered traumatic in nature when it involves actual or threatened death, serious injury, or a threat to one’s physical integrity (e.g. sexual assault). Examples of such traumatic events may include physical assaults, sexual assaults, combat, serious accidents, domestic violence, terrorist attacks, and even natural disasters like earthquakes, floods, hurricanes, and so on.  

What are the “symptoms” of PTSD?

Perhaps we should back up and look at what these “symptoms” actually are. It is important to remember that the experience of some symptoms does not necessarily indicate the presence of PTSD.  The symptoms can and should really only be assessed by a qualified mental health professional, in part due to an array of nuances in the criteria one needs to meet for this diagnosis.

Why do only some people develop PTSD?  Are people who have PTSD just “weaker” than others? Can a person just “toughen up” in order to manage symptoms following the experience of a traumatic event?

According to The National Center for PTSD, whether a person will develop PTSD depends on a variety factors: the intensity and duration of the traumatic event, whether there was an actual injury or death that resulted, one’s proximity to the event, the person’s sense of control during the event, the intensity of a person’s emotional reaction at the time or shortly after, and the quality of support a person receives following the event.

However, despite the abundance of research indicating the role such factors may play, there really is no clear, definite answer as to who will or will not develop PTSD.

How does Union Square Practice treat PTSD?

The psychologists at Union Square Practice who have expertise in the assessment and treatment of PTSD (Drs. Kate Thacher and Julia Vigna Bosson) are trained and skilled in using a number of effective treatments that can be used to target symptoms of PTSD. We want to do what works and will move you toward a place of recovery in the most effective manner possible.

Some of the treatment approaches used at Union Square Practice for the treatment of PTSD include Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), Skills Training in Affective and Interpersonal Relationships/Narrative Story Telling (STAIR/NST) and Eye Movement Desensitization and Reprocessing (EMDR) .  For those not quite ready to engage in a treatment approach that involves an exposure to the traumatic event(s), which the individual has likely avoided, we work with them using Cognitive Behavioral Therapy (CBT). This approach builds a person’s ability to better cope with distress. Sometimes treatment will then involve one of the evidence-based approaches with an exposure component, but this is not always necessary.

What is “exposure,” and why is it used in treatment?

To explain how exposure works in treatment, it may be helpful to understand how our brains process and store memories of events that are traumatic in nature. The following analogy is adapted from Foa, Hembree, and Rothbaum (2007) and is useful in better understanding how exposure can actually help in the treatment of PTSD:

Think of your brain as if it were a filing cabinet, with neatly labeled and organized folders that contain all the memories and events in your life. You have folders for all the experiences you generally have in life. For instance, you might have a “Grocery Shopping” folder, a “Birthdays” folder, a “Work” folder, and so on.  Each experience we have on a day-to-day basis is neatly filed away in its proper place in these folders.

Because traumatic events are so far outside one’s day-to-day experience, our brains do not have a file folder already labeled and ready to store the memory as neatly as those from our day-to-day lives. As a result, when someone experiences a traumatic event, the brain doesn’t know where to file the experience. The pages are shoved into the cabinet haphazardly, and the door is slammed shut as quickly as possible. From time to time, the pages begin to slip out, in the form of symptoms such as intrusive memories or nightmares. The automatic reaction is often to quickly stuff the pages (memories) back into the cabinet and slam the file drawer shut again and again and again. These pages, however, are slipping out for a reason—it’s your brain’s way of reminding you that there is still an experience that needs to be processed and organized.

Exposure treatment allows for the emotional processing of a traumatic event. With the guidance and support of our trauma experts at your side every step of the way, you can learn to regain control over these memories. You can take the trauma pages out and look through them when you wish, and then you can place them back in their own neatly labeled folders, close the drawer of the file cabinet, and return to living your life.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5^th ed.).

Arlington, VA: American Psychiatric Publishing.

Foa, E.B., Hembree, E.A., & Rothbaum, B.O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences. New York: Oxford University Press.