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Improving concentration after PTSD treatment

  • anonymous Asks ...

    I am an Afghan war vet with PTSD who has gone through some exposure therapy and CBT. I have found the therapy to be very helpful and my symptoms are pretty under control. However, I am studying for an economics degree now and I find that my concentration levels are not always up to the task at hand. They are noticeably worse than they were pre PTSD. Is there anything I can do to improve my ability to concentrate? I do not find the course work here all that difficult…that is when I am able to pay attention for sustained periods to what I am doing!

  • Dr. Ari Hahn Says ...
    Dr. Ari Hahn

    This is a very difficult and interesting question. While your PTSD treatment successfully addressed the external symptoms of PTSD, there are many internal processes that they do not reach. Although, thank God, I have not suffered traumatic stress, the idea of improving concentration is something that I have been personally researching for some time.

    It is obvious that our brains do a lot of work "behind the scenes" that support our thinking. We have all had the experience of being too tired to solve a problem and deciding to "sleep on it" and in the morning we have an answer. We have also experienced insight, when we suddenly come upon a solution that did not come from some sort of logical analysis. These are two examples of what psychologists call "nonconscious" processes. This is a relatively new area of scientific study, and there is very little practical advice directly from this research. It would seem that your problem, since it seems to result from experience, is connected with too many uncontrollable nonconscious processes that intrude into your window of attention. 

    There are, however, two possibilities of addressing this problem from other fields in psychology: pharmacology and meditation.

    If you go to a physician he might diagnose you with attention deficit disorder (ADD) and prescribe a stimulant such as Ritalin or Concerta. Since these are powerful drugs they have a good chance of improving your attention span. However, you do not have ADD since it is best biologically described as a malfunction of a specific area of the brain (the pre-frontal cortex, or the executive area.) Your problem is most likely generated in a different area of the brain, the part emotional area (the limbic system.) But taking a pill is the easiest solution, if it works, and if the side effects are not too bad.

    On the other hand, human beings have been struggling to quiet down emotions in order to be able to think clearly for thousands of years. It is one of the most common tasks of most religions. The most common tool is meditation. Meditation has been studied by psychologists for a few decades, and there have been non-religious applications around for many years (The Relaxation Response, by Herbert Benson.) Today there are many clinical psychologists who use meditation or meditation like practices. Recently there has been a small number of research studies looking at using meditation for PTSD, but there is not enough to draw any strong conclusions (although it would make for a good magazine article.) And even if there were a lot of research, it probably would not apply to you since you are basically symptom free (as far as PTSD goes.)

    While I believe that meditation is the best road for you to take, there are significant drawbacks (but no negative side effects.) The first and only really major drawback is that is takes a lot of time, effort and practice. If you dedicate yourself to learning to meditate you would need to spend at least 20 minutes, three times a week for a few months to get the results you want. You might feel some improvement sooner, but significant change takes time. It is much better to practice on a daily basis. Ninety percent (my estimate) of the people who try meditation fail because they cannot keep it up. Of course, most of those people do not have anything near the motivating factors that you have. Second, I do not think it wise to embark on such a project without a skilled mentor. It is just very difficult. Third, while spirituality is not a necessary factor for successful meditation, most people incorporate spirituality after practicing meditation for a while. So, if you are a religious person you should think from before you get very involved about how it can enhance your belief system, and if you are not religious, take that into account also.

    I am keenly interested in your situation. It is an area that I continue to study. Obviously, if you are interested in more details, you can contact me (my info is on my choose help home page.) I would really like to hear from you about how you address this problem and if you can succeed, and what that takes and what it feels like. There is no data about people in your situation. If we could gather enough details about your attempts to rebuild your concentration after PTSD treatment we could help myriads of people in similar situations.

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