Who created Cognitive Processing Therapy (CPT)?
CPT is a cognitive therapy that was created by Dr Patricia Resick to help those who experienced traumatic events and still experience symptoms to recover. In her early career, Dr Resick worked with victims of rape and over time noticed that there was a difference in presentation of trauma symptomology depending on how the person made sense of the event. She noticed that those who allowed themselves to experience the natural emotion that follows highly stressful events were better able to process and recover, whereas those who engaged in experiential avoidance and/or integrated negative beliefs tended to have more difficulty recovering and experienced ongoing trauma symptoms. Most importantly, Dr Resick observed that avoidance perpetuates symptoms of trauma and breaking this cycle of avoidance is key to recovery. Over the past few decades, Dr Resick and her colleagues have developed the most evidence-based treatment available for treating Post Traumatic Stress Disorder including military veterans, civilians, and rape victims.
How our body responds to Trauma
Our brain has a neurobiological mechanism to keep us safe which is commonly known as the fight/flight response. When a threat to life is perceived, the older more instinctual part of our brain kicks in and the prefrontal cortex (rational thought, executive function) checks-out. Sometimes the natural emotional response to a traumatic event can be so intense that this fight/flight response is paired with a non-threatening stimulus meaning a person can have intense reactions to benign situations.
A person makes sense of their experience by integrating this new information about the traumatic event into how they already understand the world around them. If a person has had mostly positive experiences in life and been led to believe that good things happen to good people and bad things happen to bad people, a traumatic event might leave a person wondering what they did to deserve this and that they might be responsible in some way. If a person has experienced a great deal of hardship in their life, a traumatic event can reinforce the belief that they don’t deserve good things because they really are bad. Integrating an experience also influences how we expect the future to unfold. Traumatic events can lead a person to develop all-or-nothing beliefs that the world is always a dangerous place or that all people are untrustworthy. These beliefs in turn influence how a person feels about themselves, the people around them, and possibilities for the future.
Natural emotion is feeling sad when you lose a loved one or a pet dies. These emotions run a natural course and dissipate. Manufactured emotion is feeling shame because you believe a traumatic event was your fault or you deserved it. Because they are perpetuated by a belief they don’t naturally dissipate. These beliefs and the emotions they perpetuate often result in mood disorders such as depression and anxiety, and usually contribute to the cycle of avoidance that maintains trauma symptoms.
What is the purpose of Cognitive Processing Therapy (CPT)?
The purpose of CPT is to explore a person’s beliefs about the traumatic event, why it happened and what it means for the future, and to help them integrate this information in a more balanced and helpful way to improve functioning, allow them to live full lives and have healthy relationships. For example: while some people may be untrustworthy, some, or many, are trustworthy; if a person holds this belief very deeply and never trusts anyone, they never receive any information to challenge their belief and it becomes more entrenched. CPT explores how logical/rational these beliefs are to help a person see new perspectives and develop new beliefs.
What happens during Cognitive Processing Therapy?
The process of therapy is very clearly structured, with new exercises and topics introduced at each session. A standard course of treatment includes 12 sessions (minimum weekly) however this may be less or more depending on each individual’s needs and symptoms. CPT therapy is designed to help the client become their ‘own therapist’ such that ongoing weekly, monthly or fortnightly therapy over a long period of time is no longer necessary.
Sometimes it isn’t always clear to a person that what they are experiencing is linked to trauma. Often, in initial therapy sessions, it is reported as feeling ‘not good enough’, ‘worthless’ or having difficulties in relationships, particularly with emotional regulation and triggers. Symptoms of trauma tend to fall into three broad categories: Intrusive memories, hypervigilance, and avoidance. Here is a more detailed idea of what different people can experience to varying extents: re-living memories or having bad dreams about something that has happened, or feeling like it is happening again; experiencing strong emotional and even physiological reactions to reminders of a traumatic event; wanting to avoid internal (in one’s mind) and external (people, places, situations) things that remind one of what happened; having difficulty piecing together a cohesive memory of a stressful event; holding beliefs such as ‘I’m bad’, ‘there is something wrong with me’, or ‘you can’t trust people’; feeling a sense of blame or responsibility for what happened; having strong emotions such as horror or shame; difficulty feeling close to others, particularly loved ones; outbursts and irritability; risk taking behaviour; always feeling on high alert; difficulty concentrating; and difficulty sleeping.
If you’re experiencing several of these symptoms and looking to improve your quality of life and relationships, feel free to find out more at http://www.cognitiveprocessingtherapy.org.au/what-is-cpt/ or contact Bonnie Ingram Psychology to book an appointment.
