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

Julia König, Catholic University Eichstätt-Ingolstadt

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

Keywords: trauma, Posttraumatic Stress Disorder, PTSD, cognitive therapy, assimilation, accommodation

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