How Successful Is PTSD Treatment, Really? Can You Heal From Post-Traumatic Stress Disorder Without It?

Of course traumatic experiences — poignantly defined in one study as "inescapably stressful events that overwhelm people's existing coping mechanisms" — leave a lasting psychological mark. In one way or another they, like all our other significant experiences, change us forever.

For some people who lived through trauma, those changes will fit into the clinical picture of post-traumatic stress disorder.

Their minds may force them to "relive" the trauma again and again, as if it were happening in the present. Reminders of the trauma they went through may be so painful that they try to avoid them at all cost. They're likely to be constantly on alert, always ready for novel threats, and quick to startle as they react to every little threatening stimulus on their paths. Their memories may have gaps that render them unable to make sense of certain things, and they may be left with a deep distrust of others as well as themselves, along with gut-wrenching guilt and shame. Unable to experience positive emotions or enjoy life very much, they may still not be left completely emotionally numb, as the most primal emotions remain — anger and fear. 

The set of possible consequences of trauma that we call PTSD can be debilitating. They mess with every aspect of life, and not in a good way.

In our modern western world, mental health stuff that interferes with functioning causes people — from doctors to random strangers on the internet — to advise us to see a psychologist, for therapy and maybe some pills. Is that really the only approach, or even the approach that maximizes overall wellbeing in the long-term? 

Is that true? Can you heal from PTSD without formal treatment? How successful are the most popular treatment options for post-traumatic stress disorder, really? And why might treatment backfire and not just perpetuate your symptoms, but also potentially make them worse?

I wanted answers, and figured you might too, so I dove into a fascinating rabbit hole. 

Can PTSD go away 'on its own'? How successful does PTSD treatment tend to be?

One research paper (which, full disclosure, sought to show that PTSD outcomes are better when people enter treatment) demonstrated that somewhere between nine and 82 percent of people who once met the diagnostic criteria for PTSD will reach remission on their own, without treatment. This means that they no longer tick all the boxes needed to be diagnosed with post-traumatic stress disorder. (It doesn't necessarily mean that their past trauma no longer causes them emotional pain, or that there aren't other lasting psychological consequences.)

The severity, duration, and number of traumatic events a person experienced all play a role in predicting how likely they are to recover from PTSD without formal treatment. Given the fact that many studies have shown that people who have loving and helpful social support networks are less likely to develop PTSD in the first place, I think it also stands to reason that social support and inclusion improve a person's chances of reaching remission. 

On the other hand, different studies show that between 30 and 50 percent of people who were treated for PTSD still have symptoms — enough to still meet the diagnostic criteria, and still have PTSD — after finishing treatment. This applies to all the most popular treatment approaches, including cognitive behavioral therapy, EDMR, and cognitive processing therapy. 

Secondary victimization: How 'treatment' can become a further barrier to recovery

People with PTSD will naturally have eroded trust in the world and humanity. While they may have lived through traumas that "weren't anyone's fault" — like natural disasters, accidental fires, or other accidents — PTSD also often results from some sort of interpersonal violence. 

Research shows that it's not uncommon for people who have survived interpersonal violence to be retraumatized or further traumatized by the people running the very services designed to help them. This is true not just for police officers investigating crimes, or doctors treating victims of violent crimes, but also psychologists. One study mentioned a therapist who told a rape victim they had a desperate need for attention — and this was why they were raped — as an example, but similar victim-blaming can affect people who experienced all kinds of different traumas. I, myself, encountered a therapist who decided not to work with me any longer, because my account of childhood sexual abuse made her, a professional who went to school to help people like me, uncomfortable, and it impacted me quite deeply at the time. 

What can you do if you're not ready to seek treatment?

Research conducted among survivors of the wars in former Yugoslavia strongly indicated that a personal approach of simply trying live your life as if the trauma never happened, coupled with a wider culture that favors a similar "coping mechanism", doesn't really work. That is, trying to suppress your symptoms, never processing what happened and how it affects you, means you're likely to be stuck with PTSD for a very long time. 

If you're not ready for treatment yet, if you've been in treatment and it didn't help you or made your symptoms worse, or if you're still undecided, you can still take steps to try to process the trauma and live a healthy life. 

Consider journaling about your trauma and your PTSD. Find someone safe and non-judgmental who can listen to you. Sometimes it helps if this is a person who also survived trauma, and especially the same kind of trauma. If you don't have anyone like that in your life, or don't feel comfortable sharing your deepest feelings with someone you know personally, online support groups can be extremely helpful.

Don't embrace unhealthy coping mechanisms like substance abuse, rageaholism, drowning yourself in work just to avoid your own emotions, or reckless and self-destructive behaviors — like so many people with post-traumatic stress disorder do. Do find positive ways to distract yourself, like regular physical exercise, spending time in nature, making things with your hands, or whatever else works for you.

If you're religious, immerse yourself in a faith community. If not, still try your best not to lock yourself out of society. Find ways to participate, and nurture relationships with people who are good for you. 

Read about PTSD treatment approaches and see which ones you can help yourself to at home — meditation, breathing exercises, reflecting on the past, and noticing your symptoms and thoughts as they come to you in a conscious way, are certainly all things you can attempt by yourself. 

The bottom line

I am not advocating against psychotherapy for post-traumatic stress disorder here. A therapeutic approach that works for you, explored with the help of a therapist who's right for your needs, can absolutely help you reduce your symptoms. In reality, however, not everyone has access to therapy — some might find themselves on waiting lists, while others are simply unable to afford treatment. Not everyone is willing to attend therapy. Not everyone who does seek treatment has good experiences of the kind that help them move forward, either.