Two New Treatments For PTSD

October 13, 2011
Sleeping Peacefully image

Severe life-threatening traumatic events can lead to post-traumatic stress disorder (PTSD), a syndrome that includes recurrent nightmares, vivid flashbacks, avoidant behaviors, memory deficits, feelings of detachment, excessive vigilance, and exaggerated startle responses. Medications such as antidepressants, mood stabilizers, tranquilizers, and sleeping pills can blunt the symptoms somewhat, but do not cure the illness. Psychotherapy can be effective, but only if the actual trauma is revisited, which can be too difficult for the PTSD sufferer to contemplate. Many people learn to endure PTSD, avoiding potential triggers that might remind them of their traumatic experience, trying their best to get a good night’s sleep.

Medication and Psychotherapy to Treat PTSD

Fortunately, two new treatments offer some hope for PTSD sufferers: a medication and a form of psychotherapy. Both treatments are based on the idea that recurrent nightmares are central to PTSD. Take away the nightmares and the other PTSD symptoms will go away as well.

The medication is prazosin (Minipress), an anti-hypertensive medication available for pennies in generic form. Prazosin is taken at bedtime in doses ranging from 2 to 20 mg, depending on the patient, and particularly on their having adequate blood pressure. Blood pressure needs to be regularly monitored. At an adequate dose, prazosin is capable of eliminating all nightmares including recurrent ones.

The psychotherapy is “dream revision”, also known as imagery rehearsal therapy (IRT). The treatment works best with recurrent nightmares, since its efficacy can be monitored over time. However, it can be utilized with any nightmare. The first step is to state or write down the nightmare as a text. The second step is to rescript the nightmare to give it a satisfying outcome. What is satisfying for one dreamer may not be satisfying for another, so this step needs to be carefully considered. Fortunately, one gets many chances to try again if the initial attempt proves unsuccessful. The third step is to memorize the revised version of the dream, by saying it over and over (to oneself or a friend), by writing it down and reading it over and over, or by dictating it into a recording device and listening to it over and over. The fourth step is simply to go to sleep and see what happens.

Dream Revision Takes Time

If the nightmare has been occurring every night, one may see the results right away. If it has been occurring only once a week or once a month, the results will take longer to become apparent. Eventually, one can usually find a dream revision that works. The concept that one can change an unpleasant dream can be therapeutic in and of itself. Once one has learned the dream revision technique, it can be used to deal with new traumas and new nightmares, should they occur.

I’m currently writing a book, CHANGE YOUR DREAMS, CHANGE YOUR LIFE: The Proven System for Ending Nightmares and Recovering from PTSD. The book is filled with examples of PTSD sufferers who use dream revision to get rid of nightmares and recover from PTSD.

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