Simple, Effective Treatment for Post Traumatic Stress Disorder
Bob Van Oosterhout, MA, LLP, LMSW
bobvanoost@gmail.com   www.bobvanoosterhout.com 

My experience in over thirty-six years of counseling with trauma victims leads me to believe that recovery from PTSD is a simple, natural process that involves two basic components:

(1) Understanding how symptoms are formed and resolved through the interaction of thought, memory, emotion, and physical tension.

(2) Developing the skills and capacity to allow natural emotions to run their course without resistance through breath-holding and muscle tension while avoiding stimulating new emotion through thought and memory exploration.

Recovery is primarily an emotional and experiential process.  In my experience, talking about trauma is not necessary and can be counter-productive but understanding how each symptom of PTSD is generated and why the recovery process works provides the confidence and security to proceed.

Understanding Symptom Formation
Emotions are physical events. They are experienced in the musculature. Tensing muscles associated with emotional trauma temporarily diminishes the experience of these emotions. When this tension is released, emotions are re-experienced. This happens when tension builds to a point where emotions can no longer be restrained.  It can also be triggered by random events, and it occurs naturally as muscle tension is resolved over time. Talking or thinking about trauma stimulates new emotion, which when resisted, creates additional tension, which in turn draws the mind to dwell on thoughts and/or memories of trauma.  This stimulates more emotion, thus creating a self-escalating process, which tends to increase the intensity of that emotion when it “breaks through.” 

Understanding the Recovery Process
The key to recovery is to allow trauma-related emotions to run their course without resistance (each episode usually only lasts 2-3 minutes).  Labeling the emotion as “a natural response to past trauma” without further thought or discussion prevents stimulation of new emotion and the likelihood of increased tension.  Restoring and maintaining balance to the autonomic nervous and resolving patterns of tension that inhibit emotion are critical components of this process.  When balance is maintained, emotions associated with trauma tend to arise in a time and place where they can be fully experienced and released.  Once a person has allowed a deep, extremely uncomfortable emotion to run its course without resistance, he or she sees that balance is quickly restored and realizes that these experiences are brief and manageable.  The usual course of recovery involves resolving patterns of tension and re-experiencing traumatic emotions repeatedly over a number of months. In my experience, recovery has only extended past a year when there are other stressors and/or conflicts that complicate the process.

Role of Helper
In my experience, most trauma victims are able to develop the skills and understanding needed for full recovery within three to five sessions.  My role is to explain the process using simple terms and metaphors, to create an atmosphere where traumatic emotions can be experienced without resistance, to describe how to restore balance when specific patterns of tension inhibit emotion, and to teach how to redirect thinking during and after emotional experiences.

Additional Information about Components of the Recovery Process

Restoring balance to the autonomic nervous system  
This is accomplished by establishing a precise but effortless rhythmic movement of the diaphragm through relaxed breathing.  This stimulates the right vagus nerve where it passes through the esophageal hiatus, which appears to activate the parasympathetic nervous system.  The rhythm that works is three to four seconds on the inhale and three to four seconds on the exhale without pause or breath holding.  A video describing this process is available at:
http://exp.lcc.edu/users/bobv/weblog/5f6ab/Diaphragmatic_Breathing.html

Resolving physical patterns of tension that restrict emotion
This is accomplished by pointing out patterns of tension that arise when a person is resisting emotion and describing how to restore the body to a neutral position.  This is explained in more detail in videos available at http://exp.lcc.edu/users/bobv/weblog/62f79/Grounding.html  and
http://exp.lcc.edu/users/bobv/weblog/999a6/Common_Patterns_of_Tension_and_How_to_Resolve_Them.html

Create conditions where painful emotions can be experienced without resistance
Practitioners briefly experience similar emotions to those who are suffering from PTSD during the treatment process.  If the practitioner resists that emotion, the person suffering from PTSD will do the same and symptoms will persist or worsen.  To be effective, helpers must be able to fully experience painful emotions without muscle tension or breath holding. (This only lasts seconds because focus is shifted to the needs of the person in recovery.) Explaining the nature of emotion and describing them as universal human experiences facilitates acceptance.  This is explained in more detail at  http://bobvanoosterhout.com/id124.html and in a video at  http://exp.lcc.edu/users/bobv/weblog/dd6c6/Understanding_Emotion.html

Developing control over thoughts and memories
Since talking and/or thinking about past trauma stimulates new emotion, it is very important to develop the skills and awareness that allow one to experience emotion without dwelling on it.  Repeatedly labeling all such emotional experiences as “a normal response to past trauma” breaks patterns of thinking that tend to perpetuate emotional suffering.  Regular practice of techniques such as “thought focusing” and meditation are very helpful in this process.  Videos describing how and why these techniques work can be viewed at:
http://exp.lcc.edu/users/bobv/weblog/edab7/Clearing_Your_Mind.html and
http://exp.lcc.edu/users/bobv/weblog/2a3da/Meditation.html

How I Explain Recovery from PTSD to Clients:  http://bobvanoosterhout.com/id123.html

List of Hypotheses:  http://bobvanoosterhout.com/id101.html 

Video Summary: Understanding PTSD http://exp.lcc.edu/users/bobv/weblog/bd8f0/Understanding_Post_Traumatic_Stress_Disorder.html