PTSD Symptoms Decrease When Emotions Are Appraised, Not Suppressed

Posttraumatic stress (PTSD) is a serious psychological condition that can significantly impair a person’s quality of life. For military personnel, PTSD rates are extremely high. Veterans who have experienced trauma may struggle with many different symptoms of PTSD. They may be hypersensitive to situations which remind them of the trauma and they avoid or suppress emotions that are related to the trauma. This form of expressive suppression, although perceived as an effective coping strategy by many who have PTSD, may actually do more harm than good. When a natural form of expression is suppressed or avoided after it has developed, the result can cause further exacerbation of PTSD symptoms. On the other hand, using cognitive reappraisal of an emotion before it has developed fully can allow a person to change their emotional reaction, and therefore the expression, of that emotion. It is believed that cognitive appraisal, and therapies that teach cognitive appraisal techniques, can be highly beneficial at reducing symptoms of PTSD.

To test this theory, Matthew Tyler Boden of the Center for Health Care Evaluation at the Veterans Affairs Palo Alto Health Care System recently assessed how well Cognitive Processing Therapy, a treatment designed to improve cognitive reappraisal, reduced PTSD symptoms in a sample of male veterans. He evaluated their use of both cognitive reappraisal and expressive suppression before and after treatment, and also measured the severity of their PTSD symptoms. Boden found that the therapy was highly effective at reducing symptoms by way of increasing cognitive reappraisals. Prior to and after treatment, the participants with high levels of expressive suppression had the most severe PTSD symptoms, demonstrating the negative impact of this type of coping. However, in those that developed and applied cognitive reappraisal, the decrease in symptom severity was directly associated with the use of this adaptive strategy. Boden believes that these findings underscore the importance of teaching clients with PTSD the value of adaptive coping techniques such as cognitive reappraisal. In military populations, the impact of this type of therapy could decrease not only symptom severity, but also risk for further psychological impairment, deterioration of well-being, and even suicide. Boden added, “Indeed, incorporating emotion regulation skill training into existing PTSD treatments may help to achieve these benefits.”

Boden, Matthew Tyler, et al. (2013). Emotion regulation and posttraumatic stress disorder: A prospective investigation. Journal of Social & Clinical Psychology 32.3 (2013): 296-314. Print.

© Copyright 2013 All rights reserved.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Collin

    April 3rd, 2013 at 4:17 AM

    No matter who you are or what you suffer with, it is never good to suppress your emotions, no matter how painful they can be. Eventually I think that we all know that they wil come back for you to confront at some point in time. Why not deal with them right away and then not have to go down that road again?

  • lyle

    April 4th, 2013 at 4:27 AM

    but the instinct to NOT want to hurt must be so strong that there will always be that temptation to suppress the memories instead of facing them

  • Over never being over it

    April 20th, 2013 at 9:09 PM

    Sometimes the pain is so painful you can’t cope with the pain and act out and make bad choices…….so on and so forth. You just want the pain to stop. When you have PTSD it hurts and it hurts really bad. So bad you can’t function. And recovery takes a very long time. And I’m sick of recovering. People don’t understand PTSD. Our society is set up to allow people time to heal. All you can do is try to move on. I feel broken when the flashbacks and triggers start. PTSD alters who you were. I don’t remember one happy moment when I look back at my life because all I see is the pain. I know they were there – happy times. I just don’t see them. But talking about the f**k I got here just makes it worse. Stuffing your emotions and moving forward allowing space between the trauma and preset knowing in the future you will build new memories is the only thing I’ve got. Never had a therapist give a shit about me enough to give me the tresent I needed. I asked my doctors for disability leave and they failed me. I needed time away to just go through the stages of the healing process. But society wants me to suck it up and not wine like I’m broken. I didn’t do this to me. It wasn’t my fault. And I don’t want to feel that pain ever again..

  • Monica M.

    January 23rd, 2016 at 11:55 PM

    Great article and in a great sense, yes, embracing the emotion that comes natural and releasing it makes sense …however, and to reply to Collin, the choice of expressing an emotion and “deal” with them as they come no longer becomes a choice…people with PTSD don’t just huddle and decide how all of us will handle trauma. For me it was quite the opposite, it is natural and importantly instinctual to suppress an emotion. The right to express anything honest becomes far from grasp because believe me if we could, there would be no PTSD.

Leave a Comment

By commenting you acknowledge acceptance of's Terms and Conditions of Use.

* Indicates required field.

GoodTherapy uses cookies to personalize content and ads to provide better services for our users and to analyze our traffic. By continuing to use this site you consent to our cookies.