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

Kurzfassung/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 conditions, such as Posttraumatic Stress Disorder (PTSD). But the issue is more complex than a set of undisputed signs 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, not everybody living a traumatic event develops mental health problems, some people recover all by themselves. The article posits the exteriority of trauma to a person’s self and addresses two ways how individuals try to integrate it into their lives: people 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 when the schema is changed so that new information can be incorporated. PTSD patients often change their schemas in a dysfunctional way ("over-accommodation"). König gives a case study, where she demonstrates 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.