How To Heal From Spiritual Trauma

Faith plays a vital role in many people's lives. Whether you were up in a religious home or in a more secular one, our stories often contain elements of faith or spirituality, even though definitions differ greatly from one family to the next. Spirituality, for some, refers to the belief that we are all interconnected and that there is an energy – some call it holy energy – that flows through all of nature. For others, faith conjures up ideas of an elderly figure in the sky who is solely responsible for creation and punishes those who resist him.

Being a part of a faith group has a lot of advantages. We are social beings by nature, and connecting with others who share our values can be beneficial. It has the potential to strengthen our social ties. We build ties with those who can aid us when we need it. Knowing that there are others who have the same perspective on life as we do can assist to legitimize our experiences. Awe and amazement, such as that which we feel when we worship God or when we follow a series of contemplative practices, have been demonstrated to contribute significantly to our general feeling of well-being.

It's crucial to understand that not every community is a healthy, safe environment. Communities like these can become repressive or harmful when they are in a bad state. A person may be subjected to detrimental guilt and shame depending on how a community interprets and practices a certain set of beliefs. People may be told that they aren't good enough as they are and must repent or face eternal damnation. According to research, if we believe in an angry and terrifying deity, we will most likely have an angry and fearful attitude toward the world. Those in power in the most unhealthy spiritual communities may even take advantage of others for their own gain, justifying their actions with belief or scripture.

Trauma is a word that isn't thrown about carelessly in the medical profession. However, when confronted with such events, we can easily become traumatized. Our bodies have evolved mechanisms that are necessary to our survival when painful or frightening conditions are extreme and out of our control. Our fight or flight reflexes are the most well-known, but that doesn't tell the whole story. We go through a series of reactions that rise in intensity without our knowledge. The first is a reaction to a social situation. We may scream or shriek in times of fear. As a first step to resolving the situation, we engage in some social engagement. If that doesn't work, our bodies begin to prepare for fighting or fleeing – you've probably heard of the famous fight or flight scenario. Our bodies release adrenaline, cortisol, and other hormones, which surge through our bodies. If we can't fight or flee the problem, we have no choice except to freeze. We frequently hear about people dissociating from reality and having an experience of viewing themselves and whatever is happening to them during this final phase. Our brains analyze information differently at each level of response. We retain memories in a way that makes it easier for us to recognize possibly similar hazards in the future. This can also indicate that the recollections are incomplete. When we think about trauma, we generally think about the specific qualities of these memories. Smells, noises, or objects that remind us of a traumatic occurrence might set off our bodies' response sequence as if we were reliving the event. Our brains have filed some part of the memory away as a threat on its own in these cases.

Threats to our bodies can take many forms. This type of survival response, as well as the potential for trauma, can be triggered by a psychological threat or a threat to our community membership, just as it can be triggered by a physical threat. Trauma is defined as the feeling of being in danger and powerless to flee.

When we have one of these experiences within a spiritual group, we call it spiritual trauma. Members of the LGBTQ community who were raised in the church are one example. They are frequently told that their sexual identity, or attraction, is improper and evil. They hear messages implying that God made a mistake when creating them. They must now displace a vital element of who they are in order to stay inside a community that has been a significant part of their existence. It can be traumatic for a person to be continuously invalidated in this way.

Another terrible but all-too-common example is when people are subjected to physical abuse that is justified by religious beliefs and biblical references. The most common form of this is a father or husband explaining his status as the head of the household and wielding power to guarantee that all other family members remain submissive to him.

These, and a slew of other situations, can be traumatic in and of themselves. Many people, however, add that their indoor space does not always feel safe. It may also be wrong for those who believe in God to dispute the correctness of what is happening if God knows their heart and intellect. Someone is always keeping an eye on you. Many persons who have experienced spiritual trauma do not understand what it means to have a safe space, even in their own minds. It can feel as if a part of you has to die in order to defend yourself as a whole when everything is based on judgment.

It may sound cliche, but healing begins with acknowledging that you have been through a traumatic event. In the end, healing is about reintegrating those internal aspects of yourself that have to be banished to keep you safe. It's about letting go of the traumatic force of the disintegrating memories. So much of your story must be demolished and rebuilt in a way that inspires life rather than fear and anxiety.

As appealing as this may appear, it can be inconvenient. Learning to see the world through a new faith lens can be frightening for many individuals, especially if they have been persuaded they must believe a specific way or face eternal punishment. This is why workplace safety is so important. It's critical to find a therapist who can assist you with holding your difficult questions and experiences in a way that helps you to grow. This person should assist you with developing techniques to control your trauma response when it arises, as well as assisting you in reprocessing the experience. It could also include assessing what it means to leave a spiritual group, and a therapist can assist you in navigating the anxiety that can come while making such a decision.

It takes time and work to heal. We may, however, recover from severe wounds, including spiritual ones. We can come to see the divine in a completely different light.

How do you overcome spiritual trauma?

Historically, there have been disagreements between scientists' and healthcare practitioners' beliefs and the general public's. According to one research (2), only 66 percent of psychologists claim to have “believe in God.” These disparities in attitude may contribute to the paucity of spirituality study. Practitioners' views and training experiences may also have an impact on whether and how spirituality is included into therapy.

Relationship of Trauma to Spirituality

Trauma appears to have both beneficial and bad consequences on people's spiritual experiences and perceptions, according to evidence (1). Depression and loneliness, for example, might cause emotions of abandonment and a loss of confidence in God. As time passes and a person moves away from the acute period of trauma healing, these consequences may shift. On the plus side, some people report increased appreciation for life, a stronger sense of connectedness to God, a stronger sense of purpose in life, and improved spiritual well-being after traumatic situations like disasters and rape. Others may experience loss of faith, decreased engagement in religious or spiritual activities, changes in belief, emotions of being abandoned or punished by God, and a loss of meaning and purpose in life as a result of trauma.

Even when trauma survivors acquire psychiatric problems like PTSD or depression, spiritual aspects are linked to beneficial results. Healthy spirituality has also been linked to fewer symptoms and clinical difficulties in specific trauma populations, according to research. Anger, rage, and a desire for vengeance in the aftermath of tragedy, for example, may be moderated by forgiveness, spiritual beliefs, or spiritual activities (5).

Spirituality has been suggested as a pathway by which survivors of traumatic events could improve their recovery trajectory.

Spirituality may improve post-traumatic outcomes by: (1) reducing behavioral risks through healthy religious lifestyles (e.g., less drinking or smoking), (2) enhancing coping skills and helpful ways of understanding trauma that result in meaning-making, and (4) physiological mechanisms such as activation of the “relaxation response” through prayer or meditation (6). The social support of a spiritual group may alleviate feelings of isolation, loneliness, and sadness associated with sorrow and loss. Being a part of a spiritual community connects survivors with caring people who may offer encouragement, emotional support, and even practical help in the shape of physical or financial assistance in times of need.

Making meaning of the trauma experience

Spiritual beliefs may have an impact on a trauma survivor's ability to make sense of their ordeal. As a result, the meaning derived can have a substantial impact on the symptoms and functioning of the survivor. Several studies have linked negative beliefs or attributions about God, such as “God has abandoned me” and “God is punishing me,” as well as being angry at God, to a variety of undesirable clinical outcomes (1). According to research, these kinds of thinking are linked to poor physical and mental health, as well as increased substance use. Negative religious coping and a lack of forgiveness were both linked to worsening PTSD and depression symptoms in a study of Veterans receiving PTSD treatment (19).

Changes in thinking, participation in meaningful activities, or rituals experienced as part of religious or spiritual activity can all help people rediscover meaning in their lives. Traumatic events, according to some academics, frequently test one's underlying beliefs about safety, self-worth, and the meaning of life (7). Traumatic occurrences may raise issues about the underlying nature of the relationship between the creator and humanity for people whose core values are spiritually based. When the innocent are subjected to severe victimization, survivors may question their faith in a loving, all-powerful God. In this way, horrific events might serve as a springboard for exploration of the various ways in which survivors interpret “faith.”

Guilt and moral injury

Furthermore, in some traumatic experiences, such as war, a person might be both a victim and a perpetrator of trauma. For example, while serving in a battle zone, a soldier may be exposed to the injury and death of others, be injured, and have a role in the enemy's death. Two basic parts of a person's worldview, such as patriotism and faith, might also be in conflict, leading to doubt and indecision regarding the best course of action. These encounters can sometimes result in long-term spiritual and moral dilemmas (9, 3). Loss of faith, greater shame and self-blame, and separation from others and God may be the result. Individuals may feel a gap between their childhood beliefs, their expectations of what military service would be like, and their actual wartime experiences.

Grief and bereavement

Grief and loss are difficult topics for survivors to deal with following a traumatic event. Spirituality is commonly used in American society to cope with tragic death and loss. Following the 9/11 terrorist attacks, researchers found that 90% of people used “prayer, religion, or spiritual feelings” as a coping method (17). Spirituality and grief healing for survivors of catastrophic loss appear to be linked in general, according to study (20). Spirituality, according to researchers, provides a framework through which survivors can “make sense” of their loss (14). Survivors may also benefit from the supporting interactions that spiritual communities frequently provide (10).

Learn about trauma and PTSD

It might be difficult to provide spiritual counseling after a traumatic occurrence, but pastoral workers can stay up to date on the newest research and therapies for Trauma and PTSD.

Providers who are aware about the effects of trauma can better serve those seeking help. Pastoral professionals can direct traumatized people to the following resources:

This brochure explains what is typical and what indications to look for that suggest more serious issues, such as PTSD.

Collaborate with and refer to mental health care providers

Consider directing someone under pastoral care to a mental health care professional if he or she has a history of trauma exposure and appears to be struggling. See PTSD Screening and Referral: Get Help in a Crisis for more information. Tips for Health Care Providers on how to make the survivor more likely to accept your referral.

If the victim feels suicidal, it is very critical to get help. For further information, read The Relationship Between PTSD and Suicide.

Assess spiritual beliefs and needs

Trauma survivors may benefit from adding a spiritual dimension to their healing, depending on their beliefs. Following disasters, a quick review of the impact of trauma on spirituality and the role spirituality might play in rehabilitation has been suggested (16). These questions are probably a good place to start for survivors of other types of trauma.

• Has your religion or spirituality played a role in how you've dealt with this? If so, how would you describe it?

Providers who want to analyze these issues more thoroughly can utilize a quick questionnaire developed by the National Institutes of Health to assess many domains of religion and spirituality (6).

Collaborate with and refer to pastoral care professionals

Spirituality may have an impact on a number of key PTSD symptoms. On the best methods to incorporate a survivor's spiritual beliefs and practices into treatment, mental health care practitioners may want to contact with a pastoral care specialist. You could also encourage the survivor to speak with a pastoral care provider directly.

Spirituality may have an impact on critical clinical difficulties for PTSD patients, such as:

• Isolation and withdrawal from social situations. These symptoms can be addressed immediately by defining spirituality as a connection to the divine and encouraging trauma survivors to seek out supportive, healthy communities.
• Shame and guilt. Guilt and shame are regarded as essential psychological concerns, despite not being part of the diagnostic criteria for PTSD. Spirituality can lead to self-forgiveness and a focus on self-compassion.
• Irritability and rage. Anger and persistent hostile attitudes that lead to social isolation and bad interactions with others can be addressed via forgiving beliefs and practices.
• Anxiety, hypervigilance, and physiological arousal Spiritual practices that focus inward, such as mindfulness, meditation, and prayer, may help to alleviate hyperarousal.
• Loss of interest in activities and a truncated future The rediscovery of meaning and purpose in one's life could have a significant impact on these symptoms.

Conclusions

Spirituality appears to be a resource related with resilience and rehabilitation for many trauma survivors, according to research. However, the circumstances of the trauma may cause some people to doubt essential and previously held beliefs. This might lead to spiritual difficulties or even faith loss. It's critical for helping professionals to feel at ease asking about how trauma has affected spirituality and what role spirituality plays in the recovery process after trauma.

References

• G. G. Ano and E. B. Vasconcelles (2005). A meta-analysis of religious coping and psychological stress adjustment. The Journal of Clinical Psychology, vol. 61, no. 4, pp. 461-480.
• H.D. Delaney, W.R. Miller, and A.M. Bisonoa (2007). A poll of clinician members of the American Psychological Association revealed that psychologists are religious and spiritual. 538-546 in Professional Psychology: Research and Practice.
• K.D. Drescher, D. W. Foy, C. Kelly, A. Leshner, K. Schutz, and B. Litz (In Press). The idea of moral harm among war veterans is investigated for its feasibility and utility. Traumatology.
• R.W. Hood, P.C. Hill, and B. Spilka (2009).
• An empirical approach to religion psychology.
• The Guilford Press, New York, NY, p. 179.
• E.L. Idler, M.A. Musick, C.G. Ellison, L.K. George, N. Krause, M.G. Ory, K.I. Pargament, L.H. Powell, L.G. Underwood, and D.R. Williams (2003).
• Conceptual foundation and findings from the 1998 national social survey on measuring numerous dimensions of religion and spirituality for health research.
• 327-365 in Research on Aging, 25(4).
• R. Janoff-Bulman, R. Janoff-Bulman, R. Janoff-Bul (1992). Shattered Assumptions: Towards a New Trauma Psychology Free Press, New York, NY.
• D. B. Larson, J. P. Swyers, and M. E. McCullough (1997). A consensus report on spirituality and health based on scientific research. National Institute for Healthcare Research, Rockville, MD.
• D. N. McIntosh, R. C. Silver, and C. B. Wortman (1993). Coping with the death of a child: The role of religion in adjusting to a terrible life event. 812-821 in Journal of Personality and Social Psychology.
• M. McCullough, K. Pargament, and C. Thoresen (2000).
• Theory, research, and application of forgiveness Guilford Press, New York.
• W. R. Miller (Ed). (1999). Resources for practitioners that want to incorporate spirituality into their treatment. American Psychological Association, Washington, D.C.
• W. R. Miller and J. E. Martin (Eds). (1988). Integrating spiritual behavioral methods to transformation with behavior therapy. Sage, Newbury Park, CA.
• C. L. Park, C. L. Park, C. L. Park, C (2005). In dealing with life stress, religion can be used as a framework for creating meaning. 707-729 in Journal of Social Issues.
• L. Powell, L. Shahabi, and C. Thoresen (2003).
• Religion and Spirituality: Physical Health Connections
• 36-52 in American Psychologist, vol. 58, no. 1.
• K.M. Trevino and K.I. Pargament (2007). Terrorism and natural disasters: religious responses. 946-947 in Southern Medical Journal, vol. 100, no. 9.
• C. E. Thoresen, C. E. Thoresen, C. E. Thores (1998). Is there a rising rebirth of spirituality, health, and science? In S. Roth-Roemer, S. K. Robinson & C. Carmin (Eds.), The increasing role of counseling psychology in health care (pp. 409-431). (pp. 409-431). Norton, New York.
• C. V. O. Witvliet, K. A. Phillips, M. E. Feldman, and J. C. Beckham (2004). Military veterans' posttraumatic mental and physical health connects with forgiveness and religious coping. 269-273 in Journal of Traumatic Stress.
• J. H. Wortman and C. L. Park (2008). An integrative assessment of religion and spirituality in the aftermath of bereavement. Death Studies, vol. 32, no. 7, pp. 703-736.

What is spiritual trauma?

Spiritual trauma is the result of a person's reaction to a belief system that dismisses and degrades them on behalf of a deity or a set of deities. More information can be found here. Christians are frequently encouraged to recruit for their religion, and losing a Christian friend or family member can be devastating.

What is Religious Trauma Syndrome?

Religious Trauma Syndrome (RTS) is a collection of symptoms that develop in the aftermath of traumatic or stressful religious experiences. While Religious Trauma Syndrome is not a recognized diagnosis in the DSM-5, it is a typical experience shared by many people who have fled cults, fundamentalist religious groups, abusive religious environments, or other difficult religious experiences. Religious Trauma Syndrome has symptoms that are similar to those of complex PTSD.

Religious Trauma Syndrome is still in its early phases of research, but it's starting to acquire momentum as a valid diagnosis. The following are some of the most prevalent symptoms associated with Religious Trauma Syndrome.

Other PTSD symptoms include nightmares, flashbacks, dissociation, emotional problems, and so forth.

Religious Trauma Syndrome can be induced by a variety of factors in different persons. Many people get RTS as a result of growing up in a religious or faith community that is authoritarian. RTS patients may have black-and-white thinking, irrational views, difficulties trusting oneself, low self-esteem, or a sense of owing something to a group of people. In toxic religious cultures, distorted conceptions of sex, discipline, emotional management, relationships, and self-expression are common.

If you believe you are suffering from Religious Trauma Syndrome. You're not on your own. There are many people who are experiencing the same feelings as you, and there is hope for recovery. You may reclaim control over who you are and who you want to be through talk therapy and EMDR. You can begin to create the life you want to live by moving past experiences that are too painful to think about.

How do I heal from religious trauma?

Trauma is the body's reaction to something that has happened, not the event that has happened. This is why healing is easier when we go out of our heads and into our bodies. Religious trauma can be treated in a variety of ways, including:

Feel all of your emotions. “Your nervous system does not function via thinking; it functions through feelings,” says Ilene Smith, a Somatic Experience Practitioner and author of Moving Beyond Trauma. This is why we can't just imagine trauma away; we need to handle it physically as well. We may do this by first allowing ourselves to feel all of our emotions fully. This refers to the process of recognizing emotions, validating oneself, sitting with the feelings, and expressing or processing them.

Work with the body's trauma. Take note of any aches or symptoms you're experiencing in your body. Chronic weariness, back pain, worry, and a persistent sense of fight, flee, or freeze are all symptoms of trauma. Working with trauma in the body begins with monitoring what your body is feeling and where certain energy is being stored, much like completely feeling your sensations. Breathwork, meditation, dance, yoga, and other physical exercises are all effective methods for releasing trauma stored in the body.

While we all know that you can't think your way out of a bad situation, talking to a mental health counselor is always a helpful first step in the healing process. This procedure can aid in the reorganization of negative trauma-related ideas and the clarification of one's condition and experience.

DBT (dialectical behavioral therapy) is a type of treatment that focuses on recognizing one's experience, calming emotions, and teaching stress coping skills.

How does trauma affect the soul?

Trauma's Effects on the Mind, Body, and Soul, and How Movement and Meditation Can Help You Heal

Those statements still ring true today. People who have been through trauma repeatedly revisit the terrible incident or events. Long after the initial event, their mind, body, and spirit are affected. They are, in fact, afflicted with memories.

When someone experiences a traumatic event, their body becomes a crime scene. Because it does not feel safe, trauma survivors try to spend as much time as possible outside of their bodies. In addition, many people are troubled by guilt they feel now about incidents that happened in the past. They are ashamed of how they acted or did not act at the time, and they strive to numb those feelings in any manner possible. There's also a sense of loss of self. The trauma has characterized some survivors. They become whoever the abuser claims they are, or whatever society thinks they should be.

In my line of work, I've learned that before suffering can be freely addressed, it must be witnessed and validated. In his book Overcoming Trauma through Yoga: Reclaiming Your Body, David Emmerson claims that when suffering is minimized or shamed, it does not go away. It sinks into the ground. It penetrates the skin, into the body and psyche, and remains there, wreaking havoc until it is freed.

In addition, most trauma survivors are unable to explain what happened soon after the occurrence. Those feelings, thoughts, and memories are left unprocessed and are deposited in the body.

Unprocessed emotions, ideas, and memories can manifest as emotional and physical problems. Flashbacks, unexplainable wrath, unpredictable outbursts, poor impulse control, racing thoughts, melancholy, body aches, and suffering are all ways to seek validation.

While conversation therapy is an important part of the healing process, many people find it insufficient. To make the healing process more complete, we must address how trauma is stored in the body.

According to Bessel VanDerKolk of Bessel VanDerKolk of Bessel VanDerKolk of Bessel VanDerKolk of Bessel Van “The Body Keeps the Score,” the body must learn that the threat has gone and that it must live in the present reality. When survivors are triggered or reminded of a terrible experience in the past, their right brain reacts as if it were happening right now. And, because their left brain is unable to interpret the event as a result of the trauma, they may be unaware of it “I am afflicted with memories.”

In my work with trauma survivors, I've discovered that yoga and meditation may help people safely process their thoughts and feelings while also moving them into a healing state.

Yoga is a sequence of bilateral integration movements using both the right and left sides of the body. Yoga movement strengthens connections between the right and left hemispheres of the brain. The brain rebuilds severed connections through bilateral integration, bringing memories to the surface of consciousness.

Yoga can assist survivors in creating a safe environment in which to process their experiences.

Meditation also aids in the rewiring and healing of the brain. We spend the majority of our time contemplating the future or reminiscing on the past. Meditation is a technique for focusing the attention on the present moment. Meditation aids in the interior focus of the mind, resulting in increased relaxation, concentration, and emotional equilibrium.

Meditation lowers stress hormones, lowers blood pressure, raises brain waves, releases dopamine, and improves focus and clarity.

Trauma-informed yoga and meditation can help survivors learn to trust and embrace their bodies by bringing them into the present moment. And it may be able to assist in the release of what has been kept and unprocessed for so long.

Jennifer Swets crafts a bridge of safety and discovery for her listeners to cross using warm honesty, compelling storytelling, and strong comedy. Jennifer is dedicated to assisting others in experiencing mental, physical, and spiritual healing. She has a passion for ministering to individuals that are frequently forgotten or undeserved. Jennifer holds a bachelor's degree in psychology as well as a master's degree in gerontology. She served as a case manager and subsequently Director of Social Services for the Illinois Department of Aging. She's also a trained yoga instructor. She empathetically shares many of the realities she's discovered on her own path to recovery as a trauma survivor. Jennifer motivates her audiences to be herself, spiritually connect, and leave profoundly altered.

What does PTSD do to the brain?

Your body responds to a threat by going into âflight or fightâ mode during a trauma. It gives you a boost of energy by releasing stress hormones like adrenaline and norepinephrine. Your heart starts to beat faster. Some of your brain's typical functions, such as filing short-term memories, are also put on hold.

Your brain becomes stuck in danger mode as a result of PTSD. It remains on high alert even when you are no longer in danger. Stress signals continue to be sent out by your body, resulting in PTSD symptoms. The amygdala, the area of the brain that deals with fear and emotion, is more active in those with PTSD, according to studies.

PTSD alters your brain over time. The part of your brain that handles memory (the hippocampus) shrinks. That is one of the reasons why professionals advise you to seek therapy as soon as possible.

Is PTSD spiritual?

Posttraumatic stress disorder (PTSD) is a serious mental illness that can occur after a person has experienced one or more traumatic experiences. Violent personal assaults, natural or man-made calamities (i.e., terrorist attacks, motor vehicle accidents, rape, physical and sexual abuse, and other crimes), or military combat are examples of experiences that can trigger PTSD. In addition to psychological numbness and interpersonal, social, educational, and vocational dysfunctions, many people with PTSD continue to experience anxiety, hypervigilance, sleep difficulties, anger, and irritability. They also recall and frequently experience terrible incidents. Various drugs and pharmacological therapies could help to alleviate these symptoms.

Hyperarousal, avoidance/numbing, and reexperiencing are the symptoms that PTSD pharmaceutical therapy aims to address. Treatment usually begins with a modest dose of one of the serotonin reuptake inhibitors (SRIs) that is gradually increased to achieve maximum efficacy. PTSD symptoms normally improve 3 to 6 weeks after reaching the optimum dose of medication. If an SRI fails to work, adding a second medicine or moving to another antidepressant, such as mirtazapine, venlafaxine, trazodone, or sedating tricyclics (TCAs), is a viable option. Mirtazapine and trazodone are sedating drugs that can be used in conjunction with SRIs to help with sleep problems and insomnia.

Because serum TCA levels may increase when co-administered with SRIs such as fluoxetine, paroxetine, and, to a lesser extent, sertraline and citalopram, primary care physicians should always start treatment procedures with modest TCA dosages.

The monoamine oxidase inhibitor (MAOI) phenelzine can also be tried in challenging cases of pharmacologically resistant PTSD, with particular dietary and alcohol intake limitations. Patients having nightmares should receive prazosin as an adjunctive treatment. Atypical antipsychotics are only used in patients who have psychotic symptoms or to enhance the effects of antidepressants. Mood stabilizers/anticonvulsants are ineffective in treating PTSD's primary symptoms, but they can help with co-occurring bipolar illness and the accompanying symptoms of rage, impatience, impulsivity, agitation, and aggression.

In patients with co-occurring alcohol and substance misuse, benzodiazepines and sedative hypnotics should be avoided. Most people with acute PTSD should take a medication for 6 to 12 months if it is well tolerated. Patients with chronic PTSD may need to stay on pharmaceutical treatment for at least 12 months, and maybe up to 24 months, before attempting to taper off.

If PTSD symptoms reappear after stopping medication, the effective dose should be restarted and prescribed for a longer period of time. Patients with significant PTSD symptoms may likely require more time in treatment. Patients with PTSD, like those with numerous chronic medical conditions (such as diabetes and hypertension), may need to be on drugs for the rest of their lives. To achieve a satisfactory treatment outcome in some severe PTSD instances and in patients with co-occurring medical and psychiatric disorders, a combination of multiple classes of psychiatric drugs may be required.

Psychotherapy is advised for most PTSD patients unless it is contraindicated owing to significant psychiatric symptoms or cognitive impairments. For PTSD and trauma sufferers, psychotherapy is an effective therapeutic option. There are many different types of psychotherapies, but they all have one thing in common: they are all tailored to the specific concerns and needs of each individual patient, based on meticulous interview and questionnaire assessments at the start (and during) treatment. Psychotherapy aims to assist patients in coping with their trauma, adjusting to new situations, and reconnecting with family, friends, and society. Individual, group, and family therapy may be used in treatment.

• Cognitive-behavioral therapy (CBT) is a type of therapy in which you use your mind to solve problems. To treat PTSD, this style of therapy employs learning and conditioning principles and incorporates elements of both behavioral and cognitive therapy. Exposure, cognitive restructuring, and other coping techniques are all components of trauma-focused CBT that can be utilized alone or in combination. The majority of trauma-focused CBT is brief, involving 60 to 90 minute weekly sessions, while the number of sessions varies between research. CBT can be delivered in a group or individual setting.
• Prolonged exposure therapy is a type of therapy in which you are exposed to something for a long This therapy entails confronting frightening stimuli through exposure, which is based on mental images from memories or given in settings by the therapist (imaginal exposure). Exposure to the actual place or similar life events occurs in some circumstances (in vivo exposure). PTSD patients must complete two extremely tough tasks during exposure therapy: confront the memory they have been deliberately avoiding and trust the therapist to guide them through this terrifying experience. This therapy is effective in the treatment of PTSD in military veterans.
• Restructuring of the mind.5,6 This therapy tries to enable the relearning of thoughts and beliefs formed by a traumatic incident, based on the theory that the interpretation of the event, rather than the event itself, influences an individual's mood. It also aids in the recognition of dysfunctional trauma-related ideas and their correction or replacement with more adaptive and/or reasonable cognitions.

Cognitive reprocessing, for example, is founded on the idea that fear is a cognitive structure that incorporates representations of feared stimuli and feared responses, as well as the meanings connected with them. The fear memory must first be triggered in order to diminish fear. Second, in order to construct a corrected memory, fresh information must be provided that includes aspects that are incompatible with the erroneous elements in the existing fear structure.

When traumatic memories are recovered and paired with fresh information, they are changed into a new cognitive structure that is devoid of PTSD symptoms caused by traumatic cognitive distortions.

• Psychodynamic treatment (PDT) is a type of psychotherapy that involves the use of a Brief psychodynamic psychotherapy focuses on intra- and interpersonal processes rather than just symptom alleviation, and it aims to uncover unconscious and psychological meanings associated with the trauma. It makes use of a supportive therapy connection to figure out what the individual's specific traumatic events and circumstances mean to them, as well as the barriers to normal psychological processing of these events. It also aids patients in understanding the link between the trauma and previous developmental experiences that may have made them vulnerable to the development of PTSD. Conflicts are reenacted during therapy sessions, and dynamic therapists work to help traumatized people re-establish a sense of coherence and significance in their lives by identifying current living situations that aggravate PTSD symptoms.
• Interpersonal therapy (IPT) is a type of therapy in which two or more people The therapist facilitates the patient's comprehension of the relationships between their interpersonal behaviors and their trauma, which was originally created for the treatment of depression. To understand and cure symptoms, this therapy focuses on the patient's present life events as well as social and interpersonal functioning. It may also help with PTSD symptoms without focusing on trauma recurrence. As a result, IPT could be a viable option for patients who refuse or do not react to exposure-based treatments.

Interpersonal issues and affect dysregulation are the two major areas that IPT concentrates on for people with PTSD. It aids patients in recognizing and addressing troublesome affects, interpersonal functioning, and therapy response monitoring.

• EMDR stands for eye movement desensitization and reprocessing.10,11 This therapy is founded on the idea that the memory of traumatic or upsetting events can overwhelm normal and ordinary cognitive coping processes, causing the events to be inadequately processed and stored in a disordered memory network. The purpose of EMDR therapy is to process these traumatic memories, allowing patients to build more adaptive coping mechanisms and decreasing their remaining influence.

By combining imaginal exposure with the induction of saccadic eye movements, this therapy can help patients change how they react to memories of their trauma. The therapist urges the patient to think on memory while focused on the therapists' fingers moving quickly or other stimuli (eg, hand taps or sounds). The eye movements are thought to aid in the reprogramming of brain function in order to alleviate the emotional effects of trauma. The patient is taught to envision a painful experience, participate in negative cognition, and then articulate an incompatible good cognition, such as personal worth, self-esteem, and current accomplishments, as part of the EMDR process.

• Posttraumatic stress disorder (PTSD) can be treated with hypnosis.1,12 People who have been through a traumatic occurrence may want to forget about it in order to prevent the anguish of recalling it. These so-called repressed memories can resurface during therapy or be prompted by anything in the patient's regular life that reminds them of the traumatic occurrence. Repressed memories are problematic in treatment because many therapists deny their validity and accuracy. During hypnosis, repressed memories are frequently recalled. Many doctors, on the other hand, regard hypnosis as an unreliable therapy for memory exploration and warn of the potential of exacerbating PTSD in patients who dissociated after being traumatized. Inducing a deep state of relaxation with hypnosis, on the other hand, may assist people with PTSD symptoms such as hypervigilance, irritability, insomnia, and anger feel safer and less frightened.
• Therapy for coping skills.1,13,14 Stress inoculation therapy, assertiveness training, biofeedback, and relaxation training are all part of this program. To control anxiety or rectify misunderstandings conditioned during trauma, the therapy employs strategies such as education, muscle relaxation training, breathing retraining, role-playing, covert modeling, thinking stopping, and guided self-dialogue. The goal of the therapy is to improve coping skills for present conditions, with a focus on problem solving.
• Mindfulness-based psychotherapy (MBT) is a type of psychotherapy that focuses on Mindfulness psychotherapy is a technique for lowering stress brought on by memories of traumatic situations. The patients are taught to meditate by focusing on and being aware of the present moment, as well as accepting or being willing to experience thoughts and feelings without judgment.

Members recount their own stories in process-oriented or trauma-oriented groups. Others can be psychoeducational and address specific issues, such as anger management, assertion training, substance abuse, and co-occurring disorders; others are specialized and use evidence-based therapy, such as CBT and IPT; and still others are specialized and use evidence-based therapy, such as CBT and IPT. 18

Group therapy sessions give mutual support from those who have been through similar traumas, as well as a place for dealing with feelings of loneliness, social withdrawal, mistrust, and loss of control. The patient's realization that they are not alone allows them to help others and create a cohesive atmosphere in which they can safely share their traumatic experiences in a responsive and interactive personal and social context. 6,7,18

Spouses, significant others, and families may be included in treatment as an auxiliary to PTSD sufferers' primary treatment, which is usually time-limited and based on a problem-solving approach.

6,7,18 Although PTSD does not transfer to other family members, patients' emotions of alienation and hostility can make it difficult for other family members to communicate with them. 18 Some family members may have sleep difficulties, physical abuse, or substance abuse. In most cases of domestic violence, marital/couple therapy is not recommended until the aggressive and abusing spouse has received successful individual treatment for domestic violence. 6,7,18

Relatives might voice their own fears and concerns during a family therapy session. A moderator encourages others to listen, and the family will be more prepared to comprehend and treat the PTSD patient as a result of this contact.

Spiritual alienation, which is defined as a detachment from God, the transcendent, or the divine, has been linked to traumatic distress. Posttraumatic spiritual growth has also been linked to the ability to make meaning of a traumatic occurrence in a way that “fits” with one's previous beliefs. 1,19 Patients who were able to derive meaning and purpose from their horrific experiences were less likely to acquire chronic PTSD, according to the study. 19,20 Developing a collaborative connection with God, seeking divine intervention during stressful life events, and attempting to make sense of suffering are all important aspects of considering one's life as part of a broader spiritual existence.

PTSD sufferers who engaged in greater spiritual and religious practices, such as praying, worshiping, and communing with other believers, were able to regain their trust in accepting their horrific occurrences and turn their hardship into an opportunity for spiritual growth, according to studies.

18 Patients with PTSD-related survivor guilt were also able to find relief by receiving forgiveness for their sins of commission and omission, as well as forgiving those who were responsible for the traumatic occurrences. 18,19

Primary care clinicians should inquire about the spiritual aspect of PTSD and assist their patients in finding meaning in their traumatized lives. A structure for health, mental well-being, and healing would result from spiritual alignment with the sense of life's goals. 18-22

The prognosis for PTSD1,16,17 is difficult to predict since it varies so much from patient to patient. Some people who do not undergo therapy will gradually heal over time. Despite the persistence of some symptoms, many people who get proper medical and psychological care are able to live a meaningful life. However, even with extensive treatment, some individuals continue to have deteriorating symptoms and may choose to end their lives by suicide. Early treatment, continued social support, pre-traumatic high functioning, and the lack of any co-occurring medical, mental, and substance addiction issues are all associated with a positive prognosis.

PTSD can be treated and managed with a combination of pharmaceutical, psychological, social, and spiritual interventions, while there is no definitive cure. When patients with PTSD are encouraged and supported to adhere to acute, continuation, and maintenance treatment, they can live a meaningful and fulfilled life with their family, friends, and community. The role of the primary care practitioner in recognizing, treating, and referring difficult PTSD cases to specialized care could be crucial.

For their support, encouragement, and inspiration, the author thanks Ms Fionna Sutherland, team manager, and all the Cottage staff members, as well as Ms Natalie Leger, team manager, and all the Faleola Services staff members.

1.S. Conen, E.L. Theunissen, A. Vermeeren, and J.G. Ramaekers. The effects of a morning versus an evening dose of hydroxyzine 50 mg on cognition in healthy volunteers over a short period of time. 2011;31(3):294-301 in J Clin Psychopharmacol.

3. Biological and clinical framework for posttraumatic stress disorder. Vermetten E, Lanius RA. 2012;106:291-342 in Handb Clin Neurol.

Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars, Yoder M, Tuerk PW, Price M, Grubaugh AL, Strachan M, Myrick H, Acierno R. Psychological Services, vol. 9, no. 1, pp. 16-25, 2012.

6.Böttche M, Kuwert P, Knaevelsrud C. An overview of the features and treatment options for posttraumatic stress disorder in older individuals. International Journal of Geriatr Psychiatry. 2012;27(3):230-9.

7.E.B. Foa, T.M. Keane, M.J. Friedman, J. Cohen (eds). The International Society for Traumatic Stress Studies has published Practice Guidelines for effective PTSD therapies. New York: Guilford Press, 2009. 2nd ed.

The empirical state of psychodynamic therapies, by Gibbons MB, Crits-Christoph P, and Hearon B. 4:93-108 in Annu Rev Clin Psychol, 2008.

Interpersonal psychotherapy (IPT) for PTSD: a case study, Rafaeli AK, Markowitz JC. 2011;65(3):205-23 in American Journal of Psychotherapy.

12.Hypnotically aided exposure response prevention therapy for an OIF veteran with OCD. Proescher EJ. 2010;53(1):19-26 in American Journal of Clinical Hypnosis.

Resilience and vulnerability in the face of stress and terrorism, by Z. Zemishlany. ISRAEL MEDICAL ASSOCIATION JOURNAL. 2012;14(5):307-9.

14.Sones HM, Thorp SR, Raskind M. Posttraumatic stress disorder prevention. 2011;34(1):79-94 in Psychiatr Clin North Am.

15.Wahbeh H, Lu M, Oken B. Mindful awareness and non-judgment in the context of PTSD symptoms. Mindfulness, vol. 2, no. 4, pp. 219-227, 2011.

16.Kingsley G. Combat-related posttraumatic stress disorder: a contemporary group treatment. 2007;35(1):51-69 in J Am Acad Psychoanal Dyn Psychiatry.

17.JAMA. 2012;308(7):714-6. Najavits LM. Expanding the Boundaries of PTSD Treatment.

18.Greenman United we stand: emotionally oriented therapy for couples in the treatment of posttraumatic stress disorder, PS, Johnson SM. J Clin Psychol, 2012, vol. 68, no. 5, pp. 561-569.

Antidepressant treatment, posttraumatic stress disorder, survivor guilt, and spiritual awakening. 20.Khouzam HR, Kissmeyer P. J Trauma Stress, vol. 10, no. 4, pp. 691-6, 1997.

Religious and spiritual elements and the repercussions of trauma: a review and model of the interaction. 21.Schaefer FC, Blazer DG, Koenig HG. 2008;38(4):507-24 in International Journal of Psychiatry and Medicine.

Hani Raoul Khouzam, MD, MPH, FAPA, works as a consultant psychiatrist at the Matariki Community Mental Health Centre in New Zealand's Manukau County. He is a psychiatrist at the VACCHCS in Fresno, CA, and a health sciences clinical professor of psychiatry at the University of California San Francisco (UCSF) Fresno Medical Education Program.

What is religious psychosis?

Religious delusions are preoccupied with religious themes that are outside of the expected views for an individual's background, such as culture, education, and previous religious experiences. These preoccupations are at odds with the subject's mood. Delusions that arise in psychotic depression are also included in the criteria; however, they must occur during a major depressive episode and be consistent with mood. According to some psychologists, all or virtually all religion is delusion.

Religious delusions were shown to be unrelated to any specific set of diagnostic criteria in a 2000 study, however they were connected with demographic variables, particularly age. Religious delusions were found to be older, and those with religious delusions had been placed on a pharmacological regimen or begun a treatment program at an earlier stage in a comparative analysis of 313 patients. Their overall functioning was shown to be worse than that of a group of patients without religious illusions in the setting of presentation. The first group also had a higher mean number of neuroleptic medications of various types during their hospitalization and scored higher on the Scale for the Assessment of Positive Symptoms (SAPS), had a higher total on the Brief Psychiatric Rating Scale (BPRS), and were treated with a higher mean number of neuroleptic medications of various types.

In 2007, researchers discovered a clear link between religious illusion and “temporolimbic overactivity.” This is a syndrome in which abnormalities in the limbic system of the brain manifest as symptoms of paranoid schizophrenia.

Religious delusions with themes of spiritual persecution by malicious spirit-entities, control exerted over the person by spirit-entities, delusional perception of sin and remorse, or delusions of grandeur were observed in a 2010 study by Swiss psychiatrists.

Religious delusions are, on average, less stressful than other types of delusions. According to a research, followers of new religious organizations show similar delusory cognition to psychotic patients, as measured by the Delusions Inventory, however the former reported feeling less troubled by their experiences than the latter.