Relapse Prevention and Posttraumatic Stress Disorder

Traumatic events are sudden and unexpected situations that can overwhelm one's cognitive and sensory processes and leave the victim feeling powerless, terrified, or horrified. Although the leading causes of traumatic stress today are participation in war and other combat situations, individuals can also be traumatized through their experience of natural disasters, catastrophic accidents, abuse, assault, life-threatening medical conditions, and other life events. Perpetrators of these traumatic experiences can range from unknown individuals such as foreign combatants or random strangers, to well-known neighbors or even one's own family members. Although it is often said that the human reaction to traumatic events is a perfectly normal response to an exceptionally abnormal circumstance, individuals who experience traumatic events can be left with biological, psychological, and social sequelae that can last from weeks to years.

During the past 30 years, social scientists, counseling theorists, and practicing therapists have worked to understand the impact of traumatic events on the lives of trauma victims and to develop effective therapy protocols. Throughout these years, numerous treatment methods have been verified as being efficacious in assisting traumatized individuals to better understand their traumatizing event, to establish effective coping strategies, and to significantly reduce or eliminate trauma-related symptoms. That being said, the very nature of traumatizing events can leave the survivor with many triggers and cues that can remain with individuals for the remainder of their lives. These triggers can reactivate specific memories of people, places, and things associated with the traumatic event, as well as feelings and other sensory stimuli that can transform the traumatic experience from something that happened in the past to something that is currently being reexperienced.

For trauma survivors, the recurrence of the post-traumatic symptoms and reactivation of ineffective coping strategies is considered a relapse. Because of the significant number of trauma cues and triggers that most trauma survivors must live with on a daily basis, relapse is a very real threat to the survivor's well-being, and this situation is commonly experienced and often expected. At best, a relapse can serve as a positive reminder of unfinished clinical work and assist individuals in identifying those areas of their lives that need ongoing treatment. At worst, relapses can lead individuals back to a trauma-centered way of living, where posttraumatic symptoms return and overwhelm day-to-day life. For this reason, relapse prevention planning is a common component of most treatment protocols.