Post-Traumatic Stress Disorder (PTSD) has become a subject of considerable debate for an unprecedented period in first responder circles. By description, PTSD has been identified as a psychiatric sequel to stressful events. Treatments for PTSD have been surrounded by controversies due to the different responses by different individuals. Among the principal strategies include Cognitive-Behavioral Therapy and Self-Concept. Researchers embracing cognitive approaches believe that the learning definition as a change in an individual behavior is too constricted; thus, they prefer studying the learners rather than the human memory complexities as well as their environment ( Pomerantz, 2016 ). On the other hand, proponents of self-concept theory have the affirmation that incorporating self-views in terms of religious, emotional, social and physical aspects aligns with reality, making it congruent. The application and comparison Cognitive-Behavioral and Self-Concept theories in their relation to PTSD reveals the potential of improving the condition
Cognitive-Behavioral Theory
Cognitive-behavioral theory’s (CBT) approaches rest on fundamental principles that an individual’s cognitions play a primary role in the development and maintenance of emotional and behavioral responses to life situations. CBT is a process of psychotherapy that treats and enhances emotions especially happiness, by transforming feelings, dysfunctional applied practice and beliefs. CBT focuses on how people think about the information received from the surrounding environment, how stimuli are perceived, how they inculcate it in their memories, and the data collected when needed for use. The goal of CBT for PTSD is to teach victims cognitive-reframing techniques. Consequentially the techniques help identify and restructure trauma-related events that either engender negative emotions or lead to dysfunctional behaviors in response to events or memories associated with the trauma (Gonzalez-Prendez & Stella n.d.). Available studies support the use of CBT to treat PTSD, although the self-concept theory is viable as well.
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Self-Concept Theory
Posited by Carl Rogers, the self-concept theory (SCT) relates an individual’s behavior to his or her beliefs and norms. It is the overarching idea that individuals possess regarding themselves in terms of the emotional, spiritual, physical and social aspects that make up the identity of human beings. The self-concept also entails the descriptive and cognitive aspects of a person. It is developed by the individual self-schemas and the interaction with the self-knowledge, self-esteem and social self-informing his or her personality as a whole. PTSD presents symptoms that can be difficult to cope with. Sequentially they suffer from low self-esteem. Besides, they may experience difficulties like depression which may yield negative thoughts and feelings of worthlessness. The self-concept theory helps combat the negative emotions and replace them with positive thoughts. Self-concept theory with its specific perception on the damage and repair of the self and self-object transference provides a focus where damage to self comes first (Kline, Berke, Rhodes, Steenkamp & Litz, 2018). After which other psychological systems take place to curb the trauma. Notably, SCT can be combat shock among people who have undergone hazardous scenarios like rape or severe accident in their lives
The Two Theories’ Contribution to Understanding and Improving PTSD
Both cognitive-behavioral and self-concept theories have been used for the treatment and management of mental disorders and behavioral dysfunctions arising post traumatic events. Based on their varying approaches they differ and are similar in the application for PTSD.
Similarities
One of the significant similarities between the two therapies is that they both need explicit identification of problems and the circumstances in which they occur. In addition, they are both well-structured whereby RST utilizes the ABC technique, while cognitive uses feelings and self-discovery ( Estes, 2014 ). Besides, both therapies concentrate on human emotion and behavior, which are correlated to the ideas, beliefs, thinking, and attitudes. These elements are said to have strong potency towards attitude transformation ( Hofmann & Otto, 2017 ). Finally, they are both empirical in that they collect hypothesis or evidence about the thoughts, guide patients and resolve problems in the end.
Differences
Despite the similarities, the theories differ based on the power of intervention. Firstly, SRT concentrates more on the philosophic bases regarding a disturbance with emotions, which makes the treatment powerful. The solution to SRT states is acceptance, where the patient has to accept the condition and the people around them learn to take the situation also ( Ehde, Dillworth & Turner, 2014 ). This is contradictory to CBT where acceptance is a non-issue. Secondly, SRT is also concerned with the concept of secondary disturbance involvement.
The patient, being conscious of all the time with issues that disturbs them, can be viewed as a necessary factor in having depression, panic attacks, and anxiety. SRT considers this, while CBT does not follow that principle. Finally, CBT focuses majorly on uplifting the esteem of the patient while SRT encourages self-acceptance (Dobson & Dobson, 2018). In other words, CBT identifies the person’s weakness and rates their behavior while SRT opens the patient’s eyes and sees the positive view of their situation.
Limitations of the Theories
As any theories, their approaches when applied for PTSD can produce iatrogenic effects. With the neurobiological and physiological vulnerability of individuals suffering from PTSD, iatrogenic effects are severe especially when trauma-focused techniques are employed. In CBT for instance, the techniques provoke anxiety in individuals for exposure to events they are already trying to avoid. SCT, on the other hand, can be inadequate leading to destabilization of the patient and the experience of negative side effects.
The most Useful Theory
Based on the similarities and differences of the two theories, self-concept provides a better understanding of PTSD because it distinguishes the two major problems; emotional and practical. It is preferable because it helps the patient take responsibility for their distress. It helps the patient recognize that neither an adverse circumstance nor another person can ever disturb anyone unless themselves (Ehde, Dillworth & Turner, 2014). The method also helps the patient identify their ‘must.’ This process comes after the patient has accepted their situation. It helps the patient dispute their ‘must’ because the only way one can ever remain disturbed about negativity is by strongly and persistently agreeing with the ‘musts.’ Once the patient has bared them, they can relentlessly confront and question their demands. Finally, it helps the patient reinforce their preference.
Cultural Aspects
Sometimes working with people can be rewarding and challenging. There are basic principles, which can be of importance in understanding human behavior's "what" and "why" (Pomerantz, 2016) . First, from the cultural aspect, people are complex since they are characterized by needs, beliefs, norms, customs, and specific human characteristics. A more comprehensive evaluation and determination of human behavior from cultural view are best to explain in terms of spirituality, psychology, and physiology.
According to some beliefs based on human behavior, it is evident that people tend to return to instances of unresolved conflict ( Estes, 2014 ). For example, people require an effective resolution from conflicts, in addition to a need for forgiveness of sin; however, the unavailability of these would mean people, in their human behavior, tend to return for purposes of closure.
Conclusion
Both the CBT and SCT have something in standard as well as differences in the context of comprehension and improvement of PTSD. However, their basic idea affirms human behavior and emotions are mainly generated by attitude, views, thinking, and beliefs. The two approaches have shown that the events or the people around the patients do not cause them. Based on similarities the two theories reveal that transforming the thinking of a person leads to behavioral and emotional change. Finally, this research SCT is more suitable for a patient that has PTSD because it helps them deal with the situations first by accepting, unlike CBT, which focuses on the individual thought process and ways of improving human behavior.
References
Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy . Guilford Publications.
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. American Psychologist , 69 (2), 153.
Estes, W. K. (2014). Handbook of Learning and Cognitive Processes (Volume 2): Conditioning and Behavior Theory . Psychology Press.
González-Prendes, A. A. and Stella M. Resko.
Hofmann, S. G., & Otto, M. W. (2017). Cognitive-behavioral therapy for social anxiety disorder: Evidence-based and disorder-specific treatment techniques . Routledge.
Kline, N. K., Berke, D. S., Rhodes, C. A., Steenkamp, M. M., & Litz, B. T. (2018). Self-blame and PTSD following sexual assault: a longitudinal analysis. Journal of interpersonal violence, 0886260518770652.
Pomerantz, A. M. (2016). Clinical psychology: Science, practice, and culture . Sage Publications.
Zettle, R. D., & Hayes, S. C. (2015). Rule-governed behavior: A potential theoretical framework for cognitive-behavioral therapy. The Act in Context (pp. 33-63). Routledge.
