PTSD - Post Traumatic Stress Disorder treatments available at
The Romney Centre

We work in an integrative way using Cognitive Behavioral Based Counseling, Cognitive Behavioral Based Clinical Hypnotherapy, Psychotherapy and EMDR (eye movement desensitization and reprocessing).

Our aim is not only to alleviate psychological distress and deal with the main symptomology of the disorder but to help sufferers develop appropriate coping techniques enabling them to regain control of the way they think, the way they feel and how they respond to their lives. We also have experience working with Solicitors and Insurers, providing assessment reports for compensation claims.

What is Post Traumatic Stress Disorder?
Post Traumatic Stress Disorder, or PTSD, is a psychological disorder that can occur following the experience or witnessing of potentially life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape.
People who suffer from PTSD often relive the experience through distressing dreams or nightmares and dissociative flashbacks, it is not uncommon for them to be able to recall the incident in detail, and find the effect of the memory very difficult. They believe that the event threatened death or serious injury to themselves or their companions. They report experiencing feelings of intense fear and helplessness.

Some details of the incident can be persistently re-experienced over time in the form of recurrent and intrusive distressing recollections, including images, thoughts and perceptions. Many show clear psychological distress at the exposure to internal and external cues which resembled those of accident or event.

In day to day life sufferers often develop strategies of persistent avoidance of any stimuli associated with the incident, and a numbing of general responsiveness which was not present beforehand. They can appear to take great effort to avoid thoughts, feelings and a conversation associated with the incident, and also strenuously avoids activities, places and situations that arouse recollections of it.

A markedly diminished interest of participation in significant activities can be observed. Sometimes people affected experience feelings of detachment or estrangement from others. This gives a restricted range of effect in relationships. Many also have difficulty sleeping. These symptoms can be severe enough and last long enough to significantly impair the person's daily life.

PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the person's ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting.

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Understanding PTSD
PTSD is not a new disorder. There are written accounts of similar symptoms that go back to ancient times, and there is clear documentation in the historical medical literature starting with the American Civil War, when a PTSD-like disorder was known as "Da Costa's Syndrome." There are particularly good descriptions of post traumatic stress symptoms in the medical literature on combat veterans of World War II and on Holocaust survivors.

Careful research and documentation of PTSD began in earnest in America after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% at that time and that 30% had experienced the disorder at some point since returning from Vietnam.

PTSD has subsequently been observed in all veteran populations, from many different countries that have been studied, including World War II, Korean conflict, and Persian Gulf populations, and in United Nations peacekeeping forces deployed to other war zones around the world.

PTSD is not only a problem for veterans, however. Although there are unique cultural- and gender-based aspects of the disorder, it occurs in men and women, adults and children, Western and non-Western cultural groups, and all socioeconomic strata. A study of civilians conducted in 1995 estimated that the lifetime prevalence of PTSD was 5% in men and 10% in women.

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How does PTSD develop?
Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.

The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events).

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How is PTSD assessed?
In recent years, a great deal of research has been aimed at developing and testing reliable assessment tools. It is generally thought that the best way to diagnose PTSD - or any psychiatric disorder, for that matter - is to combine findings from structured interview, questionnaires and physiological assessments. A multi-method approach especially helps address concerns that some patients might be either denying or exaggerating their symptoms.

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How common is PTSD?
An estimated 7.8 percent will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of adults aged 18 to 54 have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, potentially life threatening accidents and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, potentially life threatening accidents and childhood physical abuse.

About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. (More than half of all American male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms.") PTSD has also been detected among English veterans of the Gulf War, with some estimates running as high as 8 percent.

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Who is most likely to develop PTSD?

1. Those who report greater perceived threat or danger, suffering, upset, terror, and horror or fear
2. Those with prior vulnerability factors such as genetics, early age of onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events
3. Those who experience greater stressor magnitude and intensity, unpredictability, uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and betrayal
4. Those with a social environment that produces shame, guilt, stigmatization, or self-hatred

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What are the consequences associated with PTSD?
PTSD is associated with a number of distinctive neurobiological and physiological changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The amygdala has also been found to be involved in coordinating the body's fear response.

Psychophysiological alterations associated with PTSD include hyper-arousal of the sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities.

People with PTSD tend to have abnormal levels of key hormones involved in the body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in individuals who have both PTSD and depression.

PTSD is associated with the increased likelihood of co-occurring psychiatric disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence (27.9 percent).

PTSD also significantly impacts psychosocial functioning, independent of comorbid conditions. For instance, veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system.

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD.

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How is PTSD treated?
PTSD is treated by a variety of forms of psychotherapy. There is no definitive treatment, and no cure, but some treatments appear to be effective in dealing with the symptomoloy, especially cognitive-behavioral therapy, systematic desensitization, and EMDR ( eye movement desensitization and reprocessing) . Any of these type of Exposure therapies involves having the patient repeatedly relive the frightening experience under controlled conditions, often using relaxation of hypnosis to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Prozac and Zoloft.

At present, the psychotherapeutic cognitive-behavioral based therapies appears to be somewhat more effective than drug therapy. However, it would be premature to conclude that drug therapy is less effective overall since drug trials for PTSD are at a very early stage. A combination of psychotherapeutic and chemical interventions may be appropriate in some cases.

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