Writing Therapy Shows Promise for PTSD

The two therapies have been discovered to be equally efficient, and solely 12.5 p.c of topics dropped out of the written publicity group earlier than finishing a course of remedy, in contrast with 35.6 p.c within the extended publicity group. In 2018, a examine by the identical crew discovered that written publicity remedy was as effective as cognitive processing therapy, one other first-line, or most extremely beneficial, PTSD remedy.

Writing down traumatic reminiscences could also be simpler for some individuals, in the event that they really feel disgrace or embarrassment about what occurred to them, stated Denise Sloan, a psychologist who helped develop the remedy and is an creator of the examine. She stated sufferers have been asked to put in writing by hand, which takes longer and permits them to have interaction with the reminiscence.

“It’s a slower process, that allows them to better think through ‘what happened next, and who was there, and what did they say,’ because they’re writing about it,” stated Dr. Sloan, affiliate director of the Behavioral Science Division of the National Center for PTSD. “It slows everything down, versus just saying it out loud.”

The remedy was impressed by the work of James Pennebaker, a Texas psychologist who, within the 1980s, started experimenting with what he known as “expressive writing,” and located that individuals who repeatedly wrote about destructive life experiences had stronger immune techniques and paid fewer visits to the physician.

The first study of written exposure therapy as a remedy for PTSD appeared in 2012. It works, Dr. Sloan stated, a lot the way in which different trauma-focused therapies do: by permitting the consumer to confront the traumatic reminiscence, lessening their concern and avoidance, and permitting them to establish misconceptions like self-blame.

Cognitive processing remedy and extended publicity remedy, the two treatments most extremely beneficial by the Departments of Veterans Affairs and Defense, have been in widespread use for the reason that 1980s and are backed up by considerable analysis. A more moderen methodology, eye motion desensitization and reprocessing, is quickly rising in recognition.

But all three are time-intensive, requiring classes of 60 to 90 minutes for three months or extra. A lot of sufferers — a mean of 20 p.c, and typically as high as 50 percent, research have proven — drop out earlier than finishing a course of remedy.

Written publicity remedy, Dr. Sloan stated, appears to attain related results in fewer classes.

“We have a lot of people that need mental health treatment, and we can’t accommodate the demand,” she stated. “We need to revisit what we’re doing and how much is necessary for a good outcome. Because most people can’t go to treatment for 12 to 16 sessions.”

Data on the effectiveness of written publicity remedy remains to be rising.

The research evaluating it to cognitive processing remedy and extended publicity remedy are non-inferiority trials — devised to display {that a} newer remedy just isn’t worse than a longtime one — and “not as scientifically stringent” as trials devised to find out superiority, stated Dr. Barbara Rothbaum, one of many builders of extended publicity remedy. She added that dropout charges at her clinic, at Emory University, have been round 10 p.c.

There is a cause, she stated, that discuss remedy has such a powerful file of success in treating PTSD.

“There is something inherently healing about saying out loud the worse, most scary, most embarrassing, most shameful moment of your life to another human who is trying to be helpful,” she stated. “Does it have to be that? No.”

Written publicity remedy was not endorsed as a first-line intervention by the Departments of Veterans Affairs and Defense in its most up-to-date scientific apply tips, largely, Dr. Sloan stated, due to the small variety of printed research inspecting it.

That is prone to change over the following two years, she stated, as plenty of bigger trials are accomplished. Clinicians, too, are going to should get used to the concept of utilizing writing, along with speech, to have interaction with sufferers on painful subjects.

“Some people, they feel threatened by this, because it kind of challenges the crux of what they generally do,” she stated. “It flies in the face of what they think is important in treatment.”

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