Thoughts and Trauma – Theory and Treatment of Posttraumatic Stress Disorder from a Cognitive-Behavioral Therapy Perspective

Abstract

Julia König introduces the topic of trauma from the point of view of the cognitive psychologist and therapist. The term “trauma” is firmly defined by official organs, outlining a set of symptoms for Posttraumatic Stress Disorder (PTSD). But the issue is more complex than a set of undisputed symptoms and the term “trauma,” often so casually thrown into a conversation, should be used with great care. PTSD is not an exclusive reaction to a personal or collective catastrophe, and not everybody develops mental health problems after a traumatic event, some people recover all by themselves. The article posits the exteriority of trauma to a person’s self and addresses two ways individuals try to integrate it into their lives: they either strive to keep their cognitive schemas intact or they alter their schemas to comply with reality. “Assimilation” describes the cognitive process when the traumatic event is interpreted in a way that it fits into the existing schema; and “accommodation” is the process whereby the schema is changed so that new information can be incorporated. PTSD patients often change their schemas in a dysfunctional way ("over-accommodation"). König discusses a case study to demonstrate how important it is to recognize “assimilation” and “(over)-accommodation” processes in the model known as Cognitive Processing Therapy (CPT). The model aims at changing these dysfunctional beliefs. A particularly important point of discussion is brought up in the so-called “stuck-points,” problematic cognitions that hinder the processing and integration of traumatic events into a person’s life.

Keywords

• trauma
• posttraumatic stress disorder
• ptsd
• cognitive therapy
• assimilation