Post-Traumatic Stress Disorder. A Guide for Primary Care Clinicians and Therapists

Preface
	History and Theory
	The Timeline of PTSD
	Social Aspects of PTSD
	PTSD Treatment—Positive Outcomes for Evidence-Based Therapies
	Complementary Therapies
	PTSD—A Guide for Primary Care Providers and Therapists
Contents
1: Shell Shock and Society
	Historic Wars
	Shell Shock
	Early Psychoanalysis
	World War II
	Vietnam and the Advent of Post-traumatic Stress Disorder
	Civilian Casualties of Trauma
	PTSD Today
	PTSD Denial
	Malingering
	Shaming
	PTSD Cures
	Clinical Approaches to PTSD
	References
2: Unzipping PTSD: Criteria and Screeners
	Diagnostic Criteria
	The Experience of Trauma
	Symptom Clusters
	Intrusion (Fig. 2.3)
	Avoidance (Fig. 2.4)
	Negative Cognition and Mood (Two Required)
	Reactivity and Altered Arousal (Two Required)
	Functional Impairment
	Comorbid Illness and Substance Abuse
	The Politics of Exclusion
	PTSD Screening Tests
	References
3: Disasters and Societal Trauma: Complex and Societal PTSD
	Natural Disasters
	Acute Stress Disorder: Grief
	Risk Factors for Developing PTSD
	Complex PTSD
	The Social Context for PTSD
	References
4: The Origins of PTSD: Psychodynamic Trauma and the Human Stress Response
	The Mind of PTSD
	The Human Stress Response
	Conclusion: PTSD – A Disorder of Mind and Body
	Appendix: Neuroanatomic Areas of the CNS Involved in the Processing of Fear
	References
5: Nightmare Science
	Nightmare Disorder
	PTSD Nightmares
	Other Frightening Dreams
		Sleep Onset Hypnagogic Hallucinations and Sleep Paralysis
	Light Sleep (Stage 2): Panic Attacks
	Deep Sleep (Stage 3): Disorders of Arousal
	Special Nightmares
	References
6: Chronic PTSD
	PTSD Over the Lifespan
	The Negative Effects of PTSD on Normal Functioning
	Social Disengagement
	Drug and Alcohol Use and Abuse
	Psychiatric Illness
	An Epidemic of Suicide
	Chronic PTSD: Treatment Issues
	References
7: Treating the Emergency: Acute Trauma
	The Acute Stress Reaction
	Crisis Intervention: Pie
	Medications in the Acute Trauma Setting
	Critical Incident Stress Debriefing (CISD)
	Psychological First Aid (PFA)
	Cognitive Behavioral Therapy
	Treating Acute Trauma: Conclusions
	Appendix: Rapid PFA
	References
8: Classic Psychotherapy for PTSD
	The Psychoanalysis of Trauma
	Freud’s Anxiety
	Freud: Trauma and Creativity
	Jung’s Nightmares
	Modern Psychotherapy
	Conclusion: Classic Psychotherapy for PTSD
	References
9: Group Therapy for PTSD
	An Overview
	Supportive Group Therapy
	Psychodynamic and Interpersonal Groups
	Cognitive Behavioral Therapies (CBT)
	Classic CBT in a Group Setting
	Prolonged Exposure in Groups
	Medication
	Group Therapies for PTSD: An Overview
	Combined Groups
	Conclusion
	References
10: Classic Cognitive Behavioral Therapy
	CBT: A Family of Interventions?
	Classic CBT: A Typical Protocol
	Using CBT to Treat Insomnia
	CBT: Problems in Application
	Treating PTSD with CBT
	Relaxation Training
	Treating PTSD with Third-Generation CBT
	Conclusion
	References
11: Prolonged Exposure Therapy
	Prolonged Exposure: The Theory
	Prolonged Exposure: The Application
	Success Rates
	Prolonged Exposure in SUD and Complex PTSD
	Prolonged Exposure: Current Recommendations
	Narrative Exposure Therapy (NET)
	Prolonged Exposure: An Overview of the Remaining Questions
	Prolonged Exposure: The Overview
	References
12: Eye Movement Desensitization and Processing (EMDR)
	Eye Movement Desensitization and Processing (EMDR)
	EMDR Protocols
	EMDR: The Evidence
	The Enigma of EMDR
	EMDR: Conclusions
	References
13: Imagery Rehearsal Therapy
	Imagery Rehearsal Therapy: The Technique
	IRT Results
	Lucid Dreaming
	IRT and Lucidity: The Taro Snake Dream
	IRT: From Prolonged Exposure (PE) Perspective
	Imagery Rehearsal Therapy: An Overview
	References
14: PTSD: The Medications
	Anti-anxiety Agents
	Antidepressants
	Antihypertensives
	Alternative PTSD Medications (Prescription)
		Antipsychotics
		Anticonvulsants
		Hypnotics
	Alternative PTSD Medications (Non-prescribed)
		Ethanol
		Cannabis
		Psychedelics
	Conclusion: Treating PTSD with Medication
	References
15: Sleep Apnea and PTSD
	The Nightmare of Sleep Apnea
	Obstructive Sleep Apnea (OSA)
	Sleep Apnea and PTSD
	Finding Sleep Apnea
	Conclusion
	References
16: Complementary Approaches to Healing PTSD: Art, Body, and Mind Awareness
	Healing PTSD
	Art Therapy
	Art Therapy as Projection
	Art Exposure Therapy
	Art and Imagery Rehearsal Therapy (IRT)
	Art Therapy for PTSD: Effectiveness
	Treating PTSD with Body Awareness
	Treating PTSD with Yoga
	Treating PTSD with Meditation
	Other Complementary Approaches to Treating PTSD
	Complementary Approaches to Treating PTSD: An Overview
	References
17: When Treatment Doesn’t Work
	Quitting Treatment
	Loss of Access to Care
	An Epidemic of Suicide and PTSD
	The Opioid Crisis
	Addressing Suicidal Ideation in the Patient with PTSD
	PTSD as a Chronic Disease
	Integrating Belief Systems
	References
18: An Evidence-Based Approach to PTSD Therapy
	Assessing Treatment Results
	Acute Trauma
	In the Month After Trauma
	One Month After Trauma [The Event Horizon of PTSD]
	Complementary PTSD Therapies
	Chronic, Complicated PTSD
	PTSD in Overview
	Reference
Index