A Solution Focused Approach to Therapy for PTSD

Last Friday I had an amazing CPD course about treating PTSD, run by Andy Workman, author of “Cavemen and Polar Bears“, and a former police officer himself.

One of the great advantages of the Solution Focused Approach is that we don’t need the client to relive the initial experience, because we know that so-doing can cause the limbic system to think the event is happening again, and hence make the trauma worse.

The course reminded us that the symptoms of PTSD have been recorded throughout history – Homer describing the trauma suffered by Achilles at Troy, and Odysseus experiencing flashbacks and Survivors Guilt on the voyage back. Herodotus writing about Epizelus at the battle of Marathon, experiencing “hysterical blindness” from the trauma. The great hero Ajax hallucinating (due to PTSD) a herd of cows as enemy soldiers, killing them, and then committing suicide out of shame. In the Mahabharata, the war between Pandavas and Kauravas describes the symptoms of PTSD in graphic detail. Many of Shakespeare’s plays include incredibly accurate descriptions of PTSD. Charles Dickens wrote about his PTSD following a major train accident.

And the great tragedy has been the mistaken belief that nothing can ever go wrong with the mind. The false belief that, in the human mind, “software bugs aren’t real bugs” – but the attitudes of our society are slowly improving.

In addition to the participants and responders to disasters, PTSD can also be suffered by the survivors and witnesses to such events,

…and it is also worth pointing out that there is a very wide range of responses to PTSD – active, hypervigilance, but they can also be avoidant, detached, or disinterested responses.

Alcohol etc. make treatment and recover a lot more difficult, as you might expect.


The metaphor used is “snakes and ladders”

  • progress can be quick it you are lucky
  • setbacks are rarely “back to the start”
  • even the first move brings you closer to the end
  • full recovery is possible

Solution Focused:

The key point is to work with “what do you want to do in life now“?

We don’t need to work with the traumatic event – indeed, doing do is often counter-productive. Instead, we look at “what are you currently unable to do, that you want to be able to do?”

We then Rewind and Reframe current behaviour, to help them have a better life in the here and now.