Moral Resistance in Treatment of Post-Traumatic Stress Disorder

Abstract

This case study illustrates with a detailed report the treatment of a person with post-traumatic stress disorder (PTSD). The therapist noted that the patient did not improve despite all the necessary psychological interventions taken, the patient’s request for treatment, and his commitment to the treatment. Enquiry revealed that the patient unconsciously preferred to continue suffering and feeling guilty towards his deceased so. The patient was suffering in order to preserve his loyalty to his deceased son, a phenomenon which we name moral resistance. PTSD Symptom Scale Interview (PSSI) was applied pre and post treatment and in follow-up. The Traumatic Incident Reduction (TIR) was the main therapeutic strategy, as well as Rational Emotive Behavior Therapy (REBT). The study found significant effectiveness of TIR and REBT in treatment of moral resistance according to the PSSI scale. The total score decreased from 43, which indicated a very severe level of the disorder, to 10 a week after commencement of the treatment, and to 7 after a month. Scores of 4 was kept constant in 3- and 6- months follow-up.