Cognitive restructuring: A posttraumatic stress disorder case report

This manuscript presents a case of psychological intervention for a 36 year old woman who seeks treatment after receiving exposure-based psychological treatment for a diagnosed vaginismus without satisfactory results. During the first interview, she is diagnosed with post traumatic stress disorder (PTSD) following sexual assault given the intense reexperiencing symptoms, including nightmares and flashbacks, continual and increased vigilance, avoidance of everyday activities (work, leave the house, etc.) and hyperarousal. She also suffers from major depressive disorder (MDD). The cognitive restructuring treatment employed highlights the role of emotional self-regulation in emotional disorders (Moses & Barlow, 2006) and synthesizes the principal cognitive restructuring models and techniques: (1) explaining the changes and sequelae that arise at a cognitive, physiological and behavioural level after experiencing a traumatic experience, emphasizing the role of emotional learning in the development of the problem; (2) self-monitoring training of thoughts, images, physiological and behavioural responses, associated with traumatic emotional learning, with the aim of interpreting the information in an adaptive way; (3) correctly reinterpreting everyday life cognitive, emotional and behavioural reactions, helping the patient to handle such reactions by using cognitive strategies; (4) reinforcing the patient s initiative to confront emotional situations; and (5) persuading of the efficacy of the treatment. After 32 sessions (the first 28 on a weekly basis), the therapeutic objectives were achieved, having eradicated PTSD, MDD and vaginismus.