I keep hearing that I need cognitive behavioral therapy—talk therapy— to treat my symptoms of PTSD like hyper-arousal, depression, avoiding life, and being irritable all the time with my friends and family. Frankly, I don’t want to talk to someone for weeks and months. My wife keeps pressuring me, but the thought of therapy makes me feel weaker than I already am. Why do I feel this way? I’m not sure what to do. Dr. Klassen answers your questions about mental health treatment.
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Hi, I’m Dr. Brian Klassen, I’m a psychologist, and here’s our question: “I keep hearing that I really need cognitive behavioral therapy to treat PTSD. There is hyper-arousal, avoiding life, depression, being irritable all the time with my family. But I don’t want to have to go to talk to someone for weeks and months and years. If I knew that I could go for maybe a couple sessions and be done with it, I might consider it. My wife is pressuring me, but I don’t want my life to be all about therapy. It makes me feel weaker than I already am. What do you recommend?”
I want to thank you a lot for asking this question because I think it illustrates really well the kinds of dilemmas that a lot of service members and veterans feel about seeking mental health treatment. You know, on the one hand, it sounds like there is recognition that, you know, you’re struggling, that there’s some things going on that could improve with treatment. But on the other hand, it’s like “what is the cost of treatment in terms of the hassle, the time, and you know most importantly, the stigma. And so, I want to maybe first respond by saying I’m not sure that therapy makes you weaker. Right? And I sort of think about therapy, when it’s done well, almost as a sort of personal trainer kind of relationship. Right? And that you’re coming into a gym, you have this certain thing you want to work you, whether it’s like “I want to build up to run a marathon or I want to build up my bench press or squat to a certain level – that I, as a personal trainer, or a therapist in this case, would kind of assess you and kind of your strengths and weaknesses and that we would kind of target specific areas to help you reach your goal. And so that’s kind of how I think about the therapy relationship – is that you know it’s really meant to kind of improve performance, improve well-being, rather than having this kind of focus on pathology and brokenness and “here’s all the things that are wrong with you.” And I think therapy, when it’s done well, it’s you know, kind of more health and well-being oriented.
The other part of the question that I wanted to address, is that, you know, and I think this is a very kind of common and very valid concern, is that how long is this going to take? How much of my life is going to be eaten up with therapy? I think the answer is very – it’s a very good answer, it’s a very optimistic answer. I think even within a couple sessions you could start to feel some relief. Just in terms of – you’ll understand yourself better, you’ll understand your symptoms better, and if the therapy is done well, you’ll have a good idea of what needs to happen in order to experience some relief. That can happen within a few short sessions or a few short weeks.
The final thing I’ll say about this question is that therapy works best when it’s a collaborative partnership. And so, when you’re interviewing potential therapists to work with, I would absolutely lead with what your concerns are about entering treatment and what your goals are for the treatment. I think even saying something as forward as “I want to feel better in as little time as possible”, will help you best evaluate therapist fit. You will find that there are many therapists out there who absolutely are a good fit for these goals, whether it’s their style of training or the methods they use, that could have you feeling better within a few sessions; that your sort of distress and symptoms are better understandable, they’re demystified, and that you also have some concrete strategies and tools for how better to manage your symptoms going forward. I think this can happen in as little as few sessions – with the right approach. And thank you for the question.
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Brian Klassen, Ph.D., is the Clinical Director for The Road Home Program: The National Center of Excellence for Veterans and Their Families at Rush University in Chicago, Illinois. Brian spent his formative years training at the Jesse Brown VA Medical Center, completing rotations in chronic pain management, residential substance use disorder treatment, and PTSD. Brian has special expertise in providing front-line treatments for PTSD, including Prolonged Exposure and Cognitive Processing Therapy.