NET [NARRATIVE EXPOSURE THERAPY] FOR PEOPLE WITH PTSD

I have encouraged my patients to tell themselves [out loud] that it is ok for them to not be stressed as it became clear to me that their not being as anxious could create anxiety as they [their brain] were worried that they were no longer prepared to protect themselves by reacting to things and feeling anxious. Related to this, years ago I summarized a number of studies related to someone with PTSD , choosing to recall stressful events while maintaining a calm state. Writing about these events, while remaining calm, can further help reduce the likelihood of flashbacks and intrusive thoughts. I remember that I had summarized a number of studies that found the technique helpful. Recently I again reviewed information about NET [Narrative Exposure Therapy] that indicated that it is now called a short term, evidence-based psychotherapy to treat PTSD using repeated recall and re-experiencing of traumatic events in a safe and supportive environment with a trained and skilled therapist so that the memories become more coherent and less stressful to recall. This sounds like a variation of EMDR [Eye Movement Desensitization and Reprocessing] psychotherapy approach where behaviors are initiated with therapist support to occupy the brain so that emotional content can be explored without intense reactions. To be successful, this also requires a positive relationship with a trusted and qualified therapist. I realize now that what I call NET is for my patients who are ready to choose to recall traumatic events and not react to them with the writing part convincing their brains that they really do not need to react anymore. This is different from the NET and EMDR that I described above. I believe that the risk with these two treatments is that the person will not be able to handle the exposure and be re traumatized. I also believe that the risk of re traumatization is significantly reduced if there is a positive, therapeutic relationship with a therapist during these treatments. My patients who reassure themselves verbally and in writing that they no longer need to be stressed have felt calmer as they realize that they no longer need to be on guard to protect themselves from possible stresses.