Posttraumatic Stress Disorders and Travel Phobia
What is PTSD (Posttraumatic Stress Disorder) ?
Posttraumatic stress disorder (PTSD) has always existed but it has only been defined medically for about 15 years. The person with PTSD must have been involved in a definite traumatic event or events, which may have included actual or threatened death or serious injury. The person involved must also have felt very powerless at the time. There must also be a number of symptoms present involving:
- Intrusive memories or "flashbacks" of the events(s)
- Recollections of the trauma or Persistent avoidance of reminders of the event(s)
- Increased arousal (being constantly on the "lookout" for danger, increased heart rate, anxiety and panic, etc.)
- Feeling emotionally numb and experiencing a loss of interest in activities or other people.
These must be present for at least one month after the
event. Clinical psychologists and other health care professionals
use well-researched and established questionnaires and an
interview to determine whether PTSD actually exists and
how severe it is.
Anyone can get PTSD and road accidents are the commonest
cause of PTSD in the UK. Other traumas may include accidents
at work, assaults, train or plane crashes, rape and sexual
abuse.
PTSD is best treated soon after the trauma before symptoms
become chronic.
Research shows that PTSD responds best to EMDR or CBT Therapy. EMDR Therapy often works faster and patients/clients prefer it above CBT. Counselling does not tend to lead to a relief of specific symptoms.
What is Travel Phobia/Anxiety ?
Travel phobia is a particular kind of anxiety which may occur after a person has been involved in a road traffic accident. The incident itself may not have been associated with significant physical damage to the person or the vehicle involved. However, the person may have perceived the incident as a potential threat to their or another person's physical integrity or life.
Individuals who suffer from phobias become tense and distressed when exposed to the situation they fear, often experiencing an overwhelming urge to escape or get away. They can also experience some unpleasant physical symptoms such as palpitations, shakiness, difficultly with breathing and anticipation that they might "lose control" or "go mad". This is commonly known as the "fight or flight" reaction which is a basic survival response triggered in the brain when there is a perception of threat or danger.
There is a general assumption that panic and anxiety are all "in the mind". Sufferers from these conditions know that their physical symptoms are very real and it often exacerbates their feelings of despondency if they come across this point of view.
There is in fact a very close relationship between "body" and "mind" in anxiety. Careful observation and research has shown that it is a perception of danger and loss of control that often unconsciously triggers the physical symptoms. Once the individual becomes aware of the symptoms, the symptoms are negatively interpreted as signs of serious ill health. This in this in turn triggers a series of adrenalin fuelled physical symptoms, causing what is termed as "the vicious cycle of anxiety and panic."
The person suffering from a travel or other phobia is likely to avoid travelling as much as possible. If they have to travel by car, they are likely to prefer being the driver of the car. They are often very poor passengers. If a person is prepared to travel by car, they will be hyper-alert, scanning the road and other drivers for potential accident causing situations. By the time the destination has been reached, they are often irritable and exhausted. Such experiences only reinforce the phobic response.
In some cases, individuals refuse to travel by car, even if this has radical consequences for their daily lives. This AVOIDANCE is one of the reasons phobias are maintained as the individual does not get exposed for long enough periods to the situation they fear: short or anxiety ridden exposures tend to reinforce the phobic response.
Despite being painful and unpleasant, phobias can be treated successfully in as few as six sessions of appropriate psychological therapy. The two main research-based treatments are EMDR (Eye Movement Desensitisation and Reprocessing) and CBT (Cognitive Behaviour Therapy). Both therapeutic approaches enable the phobic individual to develop a more adaptive view of the accident and its consequences. EMDR therapy is especially helpful in reprocessing memories and sensations which are stored in the brain in a dysfunctional form, thus enabling the person to return to previously adaptive behaviours, such as driving. In order for treatment of phobias to be successful, the phobic person has to be desensitised for the upsetting memories of the incident by exposure to painful memories, sensations and situations. Both CBT and EMDR have been shown, by extensive research, to be equally effective. EMDR however is often preferred by clients and is usually of significantly shorter duration.
"Counselling" has become an umbrella term for all psychological treatments - inaccurately so. Counselling usually consists of an opportunity to "talk through" problems and as such can be very supportive and comforting. "Counselling" is however NOT specialised or focused enough to resolve phobias and generalised anxiety. In fact, repeatedly relating the traumatic experience which precipitated the phobia without adequate therapeutic input could actually lead to re-traumatisation. In order to practice both EMDR and CBT, practitioners need specialised additional training. It is always wise to make sure that the professional tasked with treating a phobia is both experienced and sufficiently trained.
Treatment usually includes the following:
8-12 EMDR (or 10-15 CBT) 1-hour therapy sessions. These sessions include
- Learning relaxation and anxiety management strategies
- Becoming desensitised for the original accident
- Learning to cope with the upsetting thoughts and feelings connected with travelling/driving
- Practicing driving/passenger skills first in the imagination and then in reality, whilst using the learnt skills