Post-Traumatic Stress Disorder (PTSD) affects at least 4 in 100 people in the UK and is generally understood to be a debilitating condition that can affect your quality of life. It usually manifests after a major traumatic event, to which the person suffers symptoms such as re-experiencing traumatic memories and recurring stressful thoughts, as well as other symptoms such as social isolation, sensitivity to noise and hypervigilance. PTSD can affect anyone of any age and can be more common within some high-stress occupations such as firefighters, EMT’s or people who work in slaughterhouses.
PTSD may have been present in humanity for many years, as there are descriptions of people suffering from similar symptoms in ancient writings. The epic of Gilgamesh (dating back to 2100 B.C.E) describes the main character haunted from the trauma of the death of his closest friend. Ancient works by Hippocrates describe soldiers having frightening battle dreams. Across the world and across the ages, similar stories can be found. In modern times, PTSD was brought into light during World War I, where some soldiers who survived combat suffered from “shell shock.” A search online can reveal haunting videos taken of soldiers experiencing extreme symptoms, and documentaries on the horrors of war. Since then, a lot of attention has been put onto PTSD, what causes it, and how to treat it.
So, what can happen to someone with PTSD? Neuroscientists have examined the brains of people suffering with PTSD and found that some parts of the brain become hyperactive, and some hypoactive. The amygdala, a small, almond-shaped region of the brain is associated with fear conditioning, assessments of threats, and memory consolidation. For those with PTSD, the amygdala can become hyperactive and make people have a much more acute response to stress and the perception of threats. This can contribute to symptoms such as hypervigilance, invasive thoughts, and flashbacks. The hippocampus is also involved in memory consolidation and the release of cortisol, the stress hormone. The pre-frontal cortex, in charge of functions such as emotion regulation, attention and decision-making, can become hypoactive.
With this in mind, it is theorised that the following can happen to a person with PTSD when they encounter a stimulus associated with trauma: The amygdala becomes hypersensitive to a perceived threat, and sets off an alarm-response to danger, triggering the ‘fight-or-flight’ response. The amygdala also communicates incorrectly with the hypothalamus, which can lead to the release of cortisol into the body. The pre-frontal cortex must then assess the situation and if deemed safe, pump the brakes on the stress-response. However, as this part of the brain may be hypoactive, the calming reaction may not be effective enough at neutralising the brain’s hypersensitive reaction. Not only can this happen when facing a stimulus, but also when facing a memory. The abreaction of the amygdala can halt the process of memory consolidation, which can cause the painful memory to return again and again instead of being sorted into our long-term memories.
History lesson and theory aside, where does hypnotherapy come into this? Some therapies can become a great help to someone suffering from PSTD. If one is able to enter a state of hypnosis and examine painful memories in a calm and detached state, it may be possible to face these memories and allow the brain to consolidate them properly, potentially reducing the invasions of unprocessed trauma. Fear responses can be encouraged to lessen in severity and triggers can be managed more effectively.
There has been a lot of research on PTSD for many years, and hypnosis has been tested for its efficacy many times. Here we will have a look at some examples.
An early study by Brom et al., (1989) used hypnosis in comparison with a wait-list control group for the treatment of 52 participants of mixed gender and from both a military and civilian background in a randomised controlled trial. Measurements of their symptoms were taken before and after treatment, and then at a 3-month follow-up. The control group received treatment a month after the follow up. The researchers found a statistically significant reduction in the severity of the symptoms in the hypnotherapy group compared to the control group.
Later, in 2008, Shakibaei et al., examined the effects on both feelings of pain and the re-experiencing of trauma in 44 burn patients. This randomised controlled study worked with burn patients currently receiving treatment in hospital. The hypnosis group received five sessions of hypnotherapy in one week alongside standard care, with the control group receiving only standard care. Measurements for pain and the re-experiencing of trauma were taken at baseline, then after the 3rd and 5th sessions (or subsequent time-points for the control group). The results showed that the hypnosis group showed statistically significant reductions in the re-experiencing of their trauma, compared to the control group who did not show any improvements.
As time has passed, the number of studies examining hypnosis and how it can help with the many symptoms of PTSD grew in number, to the point where a systematic review of the literature in 2015 was deemed necessary by Rotaru & Rusu. The systematic review and meta-analysis revealed that of the studies analysed, there was a large effect in favour of hypnosis-based treatment for the improvement of symptoms of PTSD. The improvements were often stable over time, leading to long-term positive improvements maintained even a year after their hypnotherapy had concluded.
PTSD is a complex thing, with many symptoms and sources of trauma. The evidence discussed above indicates that hypnotherapy may be of great use to someone who is suffering from it, with the possibility to reduce the re-experiencing of traumatic memories, to improve sleep quality (Abramowitz et al., 2008), and to help with a number of symptoms. Not only can hypnosis be helpful in the improvement of symptoms, but the design of hypnotherapy means that each person receiving it can have their own personalised treatment and goals, working on what they find the most important to them.
In conclusion, hypnotherapy may be a helpful tool that could make a real difference to someone’s quality of life.
References
Abramowitz, E., Barak, Y., Ben-Avi, I., & Knobler, H. (2008). Hypnotherapy in the treatment of chronic combat-related PTSD patients suffering from insomnia: A randomized, zolpidem-controlled clinical trial. The International Journal of Clinical and Experimental Hypnosis, 56, 270–280. Link: https://doi.org/10.1080/00207140802039672
Brom, D., Kleber, R. J., & Defares, P. B. (1989). Brief psychotherapy for post-traumatic stress disorders.Journal of Consulting and Clinical Psychology, 57, 607–612. Link: https://doi.org/10.1037/0022-006X.57.5.607
Rotaru, T., Rusu, A., (2015). A meta-analysis for the efficacy of hypnotherapy in alleviating PTSD symptoms. International Journal of Clinical and Experimental Hypnosis, 64(1), 116-136. Link: https://doi.org/10.1080/00207144.2015.1099406
Shakibaei, F., Harandi, A., Gholamrezaei, A., Samoei, R., & Salehi, P. (2008). Hypnotherapy in management of pain and re-experiencing of trauma in burn patients. International Journal of Clinical and Experimental Hypnosis, 56, 185–197. Link: https://doi.org/10.1080/00207140701849536
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