Cognitive Processing Therapy: Effective Trauma Therapy at a Glance
When we experience traumatic life events, they can significantly affect how we view all aspects of our lives. We might not feel safe, feel as though we are able to trust others, or feel completely out of control. This can be the same whether a trauma is a single event or an ongoing situation, such as intimate partner violence or abuse. The physical response, emotions, and thoughts surrounding a traumatic event can be quite uncomfortable, and lead to overall avoidance of the event itself or anything that reminds us of it.
Unfortunately, this avoidance is precisely what can keep us stuck and prevent us from feeling better. Avoidance is often what leads to someone not just experiencing a traumatic event, but experiencing post-traumatic stress disorder, a disorder which often goes hand in hand with anxiety and/or depression. Because of this, approaching our traumas in a constructive and effective way is key to reduce trauma’s overall impact on our lives, and to move forward in healing.
What is Cognitive Processing Therapy (CPT)?
Cognitive Processing Therapy (CPT) is a type of cognitive-based therapy that addresses the way you think about both the traumatic event(s) you’ve been through, as well as how these beliefs may have extrapolated out into general, daily life. CPT is a method of therapy designed by Patricia A. Resick, PhD., ABPP, Kathleen M. Chard, Ph.D., and Candice M. Monson, Ph.D., which has been researched thoroughly over the past few decades, in many scenarios, with countless types of traumatic events showing successful treatment. CPT was designed to be utilized with adults 18 years of age and older. In order to discuss how CPT helps, we need to discuss how trauma affects us in both the short- and long-term.
Trauma’s Effects on our Brains and Thoughts
While there is a stigma surrounding trauma which encourages those who’ve been through a traumatic event to “get past it” or “get over it”, it’s important to know that to “get over” a trauma by itself is quite difficult. Experiencing a traumatic event has the capability to change one’s brain in its attempts to survive. The amygdala (remember that from our anxiety blog?) is the part of our brains that is in charge of the fight/flight/freeze response that will help us to avoid pain, or danger - in doing this, a traumatic event will leave a deep mark on the amygdala, changing the brain’s functioning. The brain will experience memories of the event, physical arousal symptoms, and intrusive thoughts often after a traumatic event.
Memories of the event have to do not just with factual memories, but also with our perspective of an event. When we experience a traumatic event, we might ask ourselves what went wrong, what we could have done differently, or how everything started. All of these questions and doubts attribute to “memories”, as we refer to them. In normal recovery of trauma, an individual approaches these memories rather than avoiding them - working through them, often with the support of loved ones or a therapist. This allows these memories to be fact-checked, and encourages healing rather than avoidance.
Physical arousal symptoms include things like poor sleep, restlessness, irritability, and hypervigilance or being “on edge”, among many others. These symptoms are common after trauma due to the bodily response that occurs when we experience a traumatic event.
Intrusive thoughts have to do with the ways that we remember the traumatic event(s) in an unwanted manner. While memories may start as intrusive thoughts, they often shift to being more purposeful (meaning you are consciously thinking about them). Intrusive thoughts are not asked for or brought up - things such as dreams about the event, or flashbacks, when we feel as though we are right back in the situation - reliving it - fall into this category.
All of these effects require work to recover from - we don’t just “get over it”!
So how does Cognitive Processing Therapy (CPT) help?
Cognitive Processing Therapy is based on the idea that our thoughts after a trauma can become distorted if we do not work through them or see alternative perspectives about our trauma. The thoughts both about the events itself as well as generalizable areas, such as groups of people or the world around us, can become distorted as well. CPT encourages us to challenge these harmful thought patterns with the facts of our trauma, and of the world around us, in order to improve our functioning and help us live healthier lives.
Cognitive processing therapy often involves a few core areas in which thoughts are addressed. These can include:
Challenging inappropriate blame towards oneself or others who did not intend harm or perpetrate the traumatic event
Reducing unhelpful negative emotions, such as guilt or shame
Encouraging individuals to reframe their thoughts about general areas which are affecting their functioning
Teaching the skills necessary to continue to challenge thoughts as they come up, even after therapy - which can prevent re-traumatization in the future
What to Expect from CPT
CPT is a structured, brief form of therapy, lasting anywhere from 6-24 sessions, with 12 sessions being the average length for most clients. These sessions typically last approximately 50 minutes each, and are recommended to occur at minimum weekly.
CPT is a type of therapy that is based on learning skills to change how we think - therefore, it is crucial that individuals participating in CPT utilize these skills outside of session in order to see the best improvement.
