There are 3-4 psychotherapies that are regarded as the gold standard treatments for resolving the symptoms related to posttraumatic stress. The ones that have the most research suggesting their effectiveness are Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT); these are described below.
Prolonged Exposure (PE) – The theory that guides PE is that traumatic events do not get processed by the mind in the same way as regular memories. Traumatic memories are supposed to teach the survivor something about the nature of survival. In order to learn the lessons that traumas teach us, once we have survived the trauma, we must make space to think about what happened, talk about it with others, and allow our emotions to play out naturally. For some, engaging with the trauma memory does not happen when it is healthiest to do so. When this process gets postponed for too long, posttraumatic stress can build up in unhealthy ways, eventually leading to posttraumatic stress disorder (PTSD). PE involves making space to 1) talk about the trauma and 2) engage in activities that have been avoided because they serve as reminders of the trauma. It is a good fit for people who learn by doing, are willing to invest substantial time to do things out of their comfort zone and prefer treatment that is direct and no-nonsense.
Cognitive Processing Therapy (CPT) – The theory that guides CPT is that traumatic events fundamentally change the way we think about and understand who we are, how people are, and how the world works. Not only are these changes to our beliefs significant, they can sometimes lead to believing that the beliefs developed through trauma should be a “new normal” for life that follows. However, in actual practice, the changed beliefs tend to focus too much on survival and not enough on thriving. (For example: “The world is not safe; I should not go out.” “If I trust people, they will hurt me.” “I am weak and incompetent; I should not take on any responsibilities.”) These types of beliefs keep us stuck in a posttraumatic loop and need to be identified, challenged and overcome. CPT is a systematic strategy for doing just that in a structured, 12-session format that involves written homework that deals with evaluating beliefs and understanding how they relate to emotions.