At my son’s home, the ominous aspects of this storm became painfully clear from the TV reports: I could see people’s despair in light of destroyed homes and businesses. Some people were injured and other dying. I was lucky. Still, I felt a sense of helplessness and alienation from the two previous days and nights. Now after watching the despair that people were experiencing on TV, I felt a sense of despair as well knowing that my professional and personal routines would be changing for days and weeks to come.
I was far from having posttraumatic stress disorder or a PTSD experience, but I began to think of the PTSD patients I’ve treated using nonmedicinal approaches and the psychological toll that Sandy was bound to have on my community. Certainly Sandy, not unlike Katrina, the earthquake in Haiti, and the BP oil spill – to name a few disasters, both natural and manmade – inevitably led to numerous PTSD cases.
My concern, as always, is who will treat these PTSD patients with the most appropriate treatments, such as cognitive-behavioral therapy [CBT], behavior modification [BM], or hypnosis coupled with behavior modification and guided imagery. With so few clinicians using or knowing these techniques, it concerns me that those suffering will be treated with a variety of psychotropics, which only rarely have been successful as studies have shown.
In light of the increasing number of manmade and natural disasters as well as the many other factors that lead to PTSD, such as war experience, incarceration, torture, abuse, and near-death experiences plus the subclinical/subthreshold variations of PTSD that I’ve written about, we need to establish treatment guidelines that work best and are used first once and for all.
Mental health professionals, whether psychiatrists, psychologists, social workers, or psychiatric nurse practitioners, should be expert in the CBT, BM, and hypnotic/guided imagery techniques that have the best outcomes.
Dr. London is a psychiatrist with the New York University Langone Medical Center. He has no conflicts of interest to disclose.