Psychoanalytic approaches to treatment-resistant combat ptsd

Abstract

Although not rigorously researched as an independent treatment modality, psychoanalysis in the treatment of combat posttraumatic stress disorder (ptsd) may include evidence-based elements such as narration, cognitive restructuring, exposure, and education. For psychoanalytic treatment of ptsd, some of the healing is likely a very slow titration, in a mitigated form, with microlevels of anxiety from exposure, like behavioral treatment. In the prolonged exposure (PE) protocol, the imaginal exposure is the retelling, and this is similar to analysis. Additionally, the in vivo element comes alive in the treatment frame, in that the patient is coming to the office daily and the behavioral experiments become coming in and sitting in the waiting room. It seems to me that psychoanalysis is holistic and noninterventionist in a medical sense. It opens up the possibility of the patient using the psychological holding and containment of the treatment to heal naturally.