A Novel Therapy, Using Writing, 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 therapy, in contrast with 35.6 p.c within the extended publicity group. In 2018, a examine by the identical group discovered that written publicity remedy was as efficient as cognitive processing remedy, one other first-line, or most extremely really useful, PTSD therapy.

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 therapy and is an creator of the examine. She stated sufferers have been requested 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 Nineteen Eighties, started experimenting with what he referred to as “expressive writing,” and located that individuals who repeatedly wrote about unfavorable life experiences had stronger immune methods and paid fewer visits to the physician.

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

Why It Matters

Cognitive processing remedy and extended publicity remedy, the two remedies most extremely really useful by the Departments of Veterans Affairs and Defense, have been in widespread use for the reason that Nineteen Eighties and are backed up by considerable analysis. A more recent technique, eye motion desensitization and reprocessing, is quickly rising in recognition.

But all three are time-intensive, requiring classes of 60 to 90 minutes for 3 months or extra. A lot of sufferers — a median of 20 p.c, and generally as excessive as 50 p.c, research have proven — drop out earlier than finishing a course of therapy.

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.”

What’s Next

Data on the effectiveness of written publicity remedy continues 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 therapy shouldn’t be 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 motive, 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 pointers, largely, Dr. Sloan stated, due to the small variety of revealed research inspecting it.

That is prone to change over the subsequent two years, she stated, as quite a lot of bigger trials are accomplished. Clinicians, too, are going to need to get used to the thought of utilizing writing, along with speech, to have interaction with sufferers on painful matters.

“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.”