一项新的研究探讨了以创伤为中心的心理治疗是如何起作用的

以创伤为中心的心理治疗被广泛认为是治疗创伤的最佳方法创伤后应激障碍(PTSD), but due to a lack of data, it’s not entirely clear how it changes the brain to aid the recovery process.

一项新的研究，最近发表在生物精神病学, may help shed some light on this. The researchers used neuroimaging to get a clearer look at exactly how psychotherapy changes the areas of the brain responsible for generating emotional responses to threats.

Functional magnetic resonance imaging (fMRI) scans helped the researchers identify how brain networks communicate with one another before and after trauma-focused psychotherapy treatment. They paid particular attention to the degree of communication or "traffic" (known as functional connectivity) between the parts of the brain that regulate emotion and the parts that controllogic and thinking.

研究人员发现，在接受过以创伤为中心的心理治疗的患者中，这些大脑区域之间的交流减少了。

Plus, greater connectivity changes were associated with bigger symptom reductions, which indicates that the restructuring of brain communication may be a unique feature of PTSD recovery. The hope is that these findings will help develop new and better创伤后应激障碍患者的治疗.

What Is Trauma-Focused Psychotherapy?

Trauma-focused psychotherapy is an umbrella term, which includes trauma-focusedcognitive behavioral therapy (CBT)andeye movement desensitization reprogramming(EMDR). Trauma-focused CBT allows individuals to identify their anxiety pattern and combat this by reframing thinking and partaking in healthy behaviors, while EMDR couples eye movements with traumatic memories in an effort to diminish both the intensity and frequency of painful thoughts and images, explainsLeela R. Magavi，医学博士，精神病医生和加州社区精神病学区域医学主任。

Another type of trauma-focused psychotherapy is exposure-based psychotherapy, which was the focus of the new study.

“基于暴露的心理治疗有助于创伤幸存者减少他们逃避场所、思想、感觉和记忆的倾向，”马加维博士说个人可以在治疗师的支持下想象、再现或访问恐惧的地方或想法。”

This type of therapy allows individuals to overcome their anxiety by safely exposing themselves to perceived fears. "Individuals who are traumatized may repress and suppress their emotions and memories for years at a time, which can adversely affect their cognition, self-esteem, and ability to engage in有意义的关系,”Magavi博士解释道。

Commonly, mental health professionals recommend or use trauma-focused CBT to target PTSD symptoms. In Dr. Magavi's opinion, exposure-based psychotherapy can complement trauma-focused CBT, or follow it.

“有些人经历了重大的flashbacks当他们从事暴露疗法，如果他们缺乏应对技能，他们通常会学习创伤集中CBT，这可能导致惊恐发作and further avoidance," Dr. Magavi explains. "However, for some individuals, exposure therapy is warranted to bring out hidden memories."

马加维博士说，个人也可以通过暴露疗法尽可能地“给自己接种”以避免悲伤。她建议患者写下他们最大的恐惧会显现的陈述，或者记录他们自己的声音。

"Reading or listening to these statements repetitively could help strengthen individuals and increase resilience, which could consequently improve emotional response to grief," she explains. She also advises pairing exposure therapy withmindfulness活动和各种应对技能。

马加维博士补充说：“我向我的病人解释说，脱敏是一种正常的人类现象；在经历了这么多次的事情之后，人类变得不太可能有情绪上的反应或经历震惊和绝望的感觉。”例如，我有一些朋友是肿瘤学家和姑息治疗医生，他们总是失去病人。每一次损失都是痛苦的，但随着时间的推移，对大多数人来说，对痛苦的反应会减弱。”

认识到每个人对痛苦的处理方式都是不同的，这一点很重要。”马加维博士说：“对于人格类型，思考多于感觉的人更可能将死亡等痛苦事件区分开来。”在这个痛苦的时刻，许多病人反刍和质疑自己和他们的道德准则，这就是悲剧和创伤对我们人类的影响。我们开始怀疑别人和自己。我们失去了对世界和未来的信任，也许，我们经历了存在主义和虚无主义的思想，随着时间的推移，这些思想可能会非常痛苦。”

How Do You Know If You've Been Through Trauma?

人们经历创伤的方式有很多种。”坦率地说，任何正在与无意识反应、情绪失调、不想要的或无法控制的行为作斗争的人，都会得到以创伤为中心的心理治疗的帮助，因为他们可能在生活中经历过创伤，”精神病医生兼作家Gayani DeSilva说，“大多数，如果不是全部，我们的无意识行为是由于防御机制，因为我们需要保护自己免受创伤或感知到的创伤威胁（我相信这也是创伤）

You can experience trauma at any age, of course, but therapy is different in general for adults and children, Dr. DeSilva explains—and a therapist needs to take into account the client's age, and well as their developmental stage and therapeutic needs, before starting therapy.

"Children are still developing德西瓦博士解释说：“他们的思维能力，仅仅是因为他们的认知发展。”另外，创伤还会阻碍大脑发育。必须考虑到这些因素。”

While adults' brains have essentially developed, they may have some cognitive issues directly due to the experience of trauma, depending on when it occurred. "An astute and skilled trauma-focused therapist will be able to assess their client's needs and adjust accordingly to understand and help their client heal," Dr. DeSilva says. "Young children do well with play therapy and sand therapy, while adults mostly engage in a talk-based therapy. Both teenagers and adults do well with EMDR therapy."