Written By Melissa Stricklin, MA, LPCC
Content advisory: This blog post does not contain any details about trauma. This blog post does contain some details of my PTSD symptoms and their impact on my life. This blog post does contain descriptions of me feeling frustrated and discouraged about mental health treatment.
Synopsis or TL;DR
In 2017, my PTSD symptoms were out of control. Desperate for relief, I decided to try Cognitive Processing Therapy (CPT). CPT (not to be confused with CBT, which is different) is a fast acting, evidence-based treatment for PTSD. After I completed 12 sessions CPT, I no longer had symptoms of PTSD.
Image description: An illustration of a person with light brown skin and long black hair walks through a grassy field at sunset. They are wearing a light blue jacket and a black skirt. They are holding some papers and there are many more pieces of paper flying all around as if blown by the wind.
I was not well...
In 2017, I was about to finish my Master’s Degree in Counseling. I had been in grad school for 6 years and I was more than ready to start my dream career. There was just one problem: my PTSD symptoms were destroying my life.
When I encountered something that reminded me of a past traumatic incident, I would become so distressed that I would cry until my eyes were as sore as my throat. This had escalated to the point that I was crying 4 to 6 hours per day.
I had hoped to work full time after I graduated from grad school, but my symptoms were so bad that I could barely work 10 hours per week. The slightest glimmer of happiness felt like it was a signal for some inevitable disappointment. My muscles were constantly tense and I felt like I had to always be on the lookout for some unnamed danger. My sleep schedule was a disaster and I was so exhausted I always felt like I had just run a marathon. I felt disconnected and lonely, even when I was spending time with close friends. During some of the most difficult months of my life, I had crying episodes daily for several weeks in a row and I had used up about a forests' worth of tissues.
My friends told me that I should consider talking to a mental health professional. My friends didn’t realize that I had been seeing a therapist almost weekly for the past 7 years. I had already tried multiple evidence-based trauma therapies. A couple of those trauma therapies had been somewhat helpful in reducing my PTSD symptoms. However, it was becoming apparent that I didn’t need something that was somewhat helpful, I needed something that was REALLY helpful.*
I learned about Cognitive Processing Therapy
During one of my graduate classes, I read a case study about a woman who had severe PTSD and was greatly helped by something called Cognitive Processing Therapy or CPT (not to be confused with CBT, which is quite different).
I read that CPT could reduce symptoms of PTSD in just 12 sessions and that clients who finish all 12 sessions of CPT can still feel the benefits 10 years later. CPT sessions consist of learning about PTSD, challenging unhelpful thoughts about the trauma, and completing assigned worksheets.
I reached out to a local therapist who was trained in CPT.
I did the worksheets
My CPT therapist was named Catherine. Catherine had blonde hair, a warm smile, and a wicker basket full of neon colored fidget toys. She showed me how to complete the CPT worksheets that had printed crookedly on crisp white paper, still warm from her copy machine.
The first worksheet Catherine showed me was called an “ABC Worksheet.” The worksheet prompted me to write a negative thought, whether that thought was a scientific fact, and write a thought that would be more helpful to focus on.
I immediately became annoyed. I had spent 7 years in therapy and felt like I had learned the basics about my mental health and wanted to move on to something more advanced. This worksheet did not feel advanced, it was easy to understand and it took me less than 5 minutes to fill it out. How could something so simple possibly help me?
I told Catherine that “These worksheets are childish and I hate this already.” Catherine was undaunted by my complaints and asked what I would do if I chose not to continue CPT. I had to admit I didn’t know what I would do if I quit CPT. I knew I needed to do something, so even though I felt cynical and discouraged, I dutifully completed the “childish” worksheets and kept coming to sessions once per week.
After 4 sessions, I didn’t feel like CPT was helping me. Because I was not getting results as quickly as I had hoped, I told my therapist that I was tempted to quit CPT almost every week. My therapist told me that she wouldn’t pressure me to continue if I didn’t want to. However, she always said “Would you be willing to keep going just one more week?” and I always came back.
I felt better
It seemed like it took forever before my symptoms started to improve. However, after I had completed 9 sessions over the course of 9 weeks, I very suddenly began to feel relief. By the end of the 12th session, my symptoms had improved a lot. I no longer had uncontrollable crying spells. I felt more connected to my friends and that ache of insistent loneliness in my chest started to ease. I began to relax and be present during happy moments instead of dreading their inevitable end. I no longer had to buy tissue boxes in bulk!
I will admit, I was concerned that my results might be a placebo effect. I worried that I had somehow “tricked” myself into thinking I was doing better and feared that my symptoms would suddenly return. But my symptoms didn’t return. Of course I still don’t like being reminded of past traumatic incidents, but now I am able to move past my discomfort and go about my day.
I still feel better
After I completed the 12 CPT sessions, my symptoms had reduced so much I no longer qualified for a PTSD diagnosis and I never had a problem with PTSD symptoms again. Completing CPT is the best thing I have ever done for my mental health. I am now a licensed therapist certified to provide CPT to clients who have PTSD. It feels amazing to help others who are struggling like I was struggling and I believe that my personal experience with CPT has helped me to become a better CPT therapist.
I sometimes think of Catherine, the therapist who helped me years ago. I most often think of her when I ask one of my own clients if they are willing to keep trying CPT for “just one more week.”
If you are struggling with PTSD, it is my sincere hope that you find relief from your symptoms (whether that relief comes from CPT or something completely different). I want you to know that your feelings are valid, your trauma really was that bad, and you are not alone.
If you would like to learn more about CPT for PTSD
please visit my website at: NewCanvasMentalHealth.com/CPT-for-PTSD
*There are several different evidence-based trauma therapies that can also be effective for treating PTSD. I share that CPT was the most helpful thing for my mental health in hopes that others can relate to my experience and to encourage others to try new things to improve their mental well-being.
**This blog is not intended to be a replacement for professional diagnosis, treatment, or advice. If you have questions or concerns regarding your mental health and treatment options, contact a qualified healthcare provider.**
ABOUT THE AUTHOR
Melissa Stricklin, MA, LPCC (any pronouns) is a mental health professional who specializes in helping clients with procrastination, perfectionism, and PTSD. Melissa enjoys helping people find practical ways to improve their mental health. Melissa works with individuals in Minnesota via telehealth (video) counseling. To learn more about Melissa visit NewCanvasMentalHealth.com or email Melissa@NewCanvasMH.com
NEED SUPPORT?
To contact the SAMHSA Helpline
dial 1-800-662-4357
or text 435748.
The SAMHSA Helpline is a USA based, national crisis line available 24-hours a day, 365-days per year. It provides information service (in English and Spanish) for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
References
Butollo, W., Karl, R., König, J., & Rosner, R. (2016). A randomized controlled clinical trial of dialogical exposure therapy versus Cognitive Processing Therapy for adult outpatients suffering from PTSD after type I trauma in adulthood. Psychotherapy and Psychosomatics, 85, 16-26. https://doi.org/10.1159/000440726
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-141. https://doi.org/10.1016/j.cpr.2015.10.003
Forbes, D., Lloyd, D., Nixon, R.D.V., Elliott, P., Varker, T., Perry, D., Bryant, R. A., & Creamer, M. (2012). A multisite randomized controlled effectiveness trial of Cognitive Processing Therapy for military-related posttraumatic stress disorder. Journal of Anxiety Disorders, 26(3), 442-452. https://doi.org/10.1016/j.janxdis.2012.01.006
Resick, P.A., Williams, L.F., Suvak, M.K., Monson, C.M., & Gradus, J.L. (2012). Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors. Journal of Consulting and Clinical Psychology, 80(2) 201-210. https://doi.org/10.1037/a0026602
© 2023 New Canvas Mental Health PLLC
All rights reserved
Comments