Post Traumatic Stress Disorder

A Washington Post article says that
Most PTSD Treatments Not Proven Effective

Here are a few excerpts from it:

The majority of treatments for post-traumatic stress disorder that are used to treat hundreds of thousands of veterans lack rigorous scientific evidence that they are effective, according to a report issued yesterday by a panel of the federal government's top scientists. The report by the National Academies emphasized that the therapies might not be useless. Rather, it said, the evidence is weak when it comes to drawing any kind of conclusion about most of them. The findings of the panel, widely considered the nation's most influential scientific arbiter, will have far-reaching consequences. The report comes when awareness of PTSD has risen as a result of its incidence among veterans returning from the wars in Iraq and Afghanistan.
...
"A very high percentage of people who have been diagnosed with PTSD are on medications," said Larry Scott, the founder of the advocacy group VA Watchdog dot Org, which serves as an information clearinghouse for veterans. Most of the evidence supporting the use of medications and psychological therapies for PTSD has been assembled by pharmaceutical companies that make the drugs or by researchers with conflicts of interest in the outcome of the studies, and lack independent and rigorous proof, the report said.
...
Edna B. Foa, a professor of clinical psychology in the department of psychiatry at the University of Pennsylvania, and one of the pioneers in developing exposure therapy as a PTSD treatment said the technique was based on the insight that many victims of trauma do all they can to avoid being reminded of traumatic events. A rape victim might avoid going out in the evenings, while someone injured in an auto accident might avoid getting into any kind of vehicle. Soldiers might avoid movies or TV shows about war.

Two things happen in this process, Foa said. Patients come to replace actual recollections of trauma with other perceptions -- taking on blame and guilt, for example, for being afraid. Second, by avoiding situations, patients can fail to see that much of life is not dangerous -- the movie is only fiction. Foa said she has patients recount traumatic events aloud with their eyes closed. She records the patient, and then has the patient listen to the tape repeatedly.

"People don't recover because they avoid thinking about the trauma," Foa said. "Every time the trauma comes to the mind, they push it away. They don't allow themselves to process and digest the memory, so it keeps on haunting them with nightmares, flashbacks."

Foa also has patients make lists of situations that trigger anxiety and encourages them to deliberately expose themselves to the least-frightening situation. As people realize that many situations are harmless, Foa said they replace images of self-doubt and helplessness with a more healthy outlook.