Respond to at your colleagues postings that presented a different intervention strategy. Identify the similarities and differences in your individual interventions. Share any insights gained from your readings and comparison
HERE IS THE DISCUSSION THAT YOU WILL BE RESPONDING TO:
How Beths Trauma Impacts Her Marriage
Baggett et al. (2017) discuss the fight, flight, or freeze response associated with posttraumatic stress disorder (PTSD). Individuals with PTSD have developed a conditioned fear response after a traumatic event; they then avoid cues that remind them of the event and trigger the fight, flight, or freeze response (Baggett et al., 2017). Following her rape, Beth connected sex with the fear provoked by that traumatic event.
Physical intimacy is an integral part of committed romantic relationships and in our society, girls and women are socialized to believe that mens sexual needs are more important than theirs (Hitter et al., 2017; Levine, 2016). Furthermore, sexual intercourse is the typical way that married heterosexual couples procreate. These factors complicate Beths trauma response within the context of her relationship with Don.
The thought of sexual activity triggers Beths trauma response, so she avoids sexual contact with her husband. However, avoidance of sexual activity within the context of her marriage counters how Beth has been socialized to believe she should behave. She believes that because she is married and because she wants children, she should have sex with her husband. She may also think that her husbands sexual needs and desire for a child are more important than her feelings about sex. This causes her shame and guilt because she is unable to perform sexually the way she is supposed to and makes her afraid that he will leave her because her avoidant behavior renders her unable to satisfy his sexual needs and desire for a child.
Intervention to Assist Beth and Don
Applying a sex-positive framework to Cognitive Processing Therapy (CPT) combined with a sensate focus may help Beth and Don. CPT is based on cognitive behavioral theory (Baggett et al., 2017). It involves identifying points where ones appraisal of an event leads to repetitive thoughts and unwanted thoughts or feelings, then replacing that thought with one that causes less distress (Baggett et al., 2017). Prolonged Exposure (PE) is an evidence-based treatment for PTSD that involves repeated exposures to distressing stimuli that are typically avoided as a PTSD response (Baggett et al., 2017). It is based on emotional processing theory (EPT), which posits that there is a fear structure in which stimuli provoke a fear response (American Psychological Association [APA], n.d.). However, the fear structure can become distorted when a person does not process or cope with an event, resulting in harmless stimuli triggering the fear response (APA, n.d.). In these cases, according to EPT, repeated exposure to memories of the distressing event within a safe environment enables the person to decrease their emotional response and alter their cognitive appraisal of the event memory (APA, n.d.). A sex-positive approach takes an open, positive view of sex and sexuality as natural, healthy, and pleasurable, occurring within a safe and respectful environment (Baggett et al., 2017). Sensate focus follows EPT and involves the exposure aspects of PE within a sex-positive framework (Baggett et al., 2017). Individuals gradually expose themselves to sexual activities within a safe environment where they are encouraged to communicate boundaries and desires with their partner (Baggett et al., 2017).
CPT will help Beth identify the distressing thoughts that occur when thinking about sex and the role that sex (or lack thereof) plays in her relationship. A clinician can then work with her to change her thoughts to ones that cause her less distress. Additionally, CPT will allow her to change her appraisal of the context of sexual situations with her husband to approach it with less fear. Sensate focus will enable the couple to begin a sexual relationship within a safe environment emphasizing pleasure, respect of boundaries, and communication for both partners.
References
American Psychological Association. (n.d.). Emotional processing theory. APA Dictionary of Psychology. Retrieved July 26, 2022, from https://dictionary.apa.org/emotional-processing-theory
Baggett, L. R., Eisen, E., Gonzalez-Rivas, S., Olson, L. A., Cameron, R. P., & Mona, L. R. (2017). Sex-positive assessment and treatment among female trauma survivors. Journal o
.rEFERENCES:
Baggett, L. R., Eisen, E., Gonzalez, R. S., Olson, L. A., Cameron, R. P., & Mona, L. R. (2017). Sex-positive assessment and treatment among female trauma survivors. Journal of Clinical Psychology, 73(8), 965974.
Hitter, T. L., Adams, E. M., & Cahill, E. J. (2017). Positive Sexual Self-Schemas of Women Survivors of Childhood Sexual Abuse. The Counseling Psychologist, 45(2), 266-293.
