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6 Most of the treatment approaches for PTSD fall under the category of psychological therapy or psychotherapy. The goals of such programs include increasing self-understanding and self- acceptance, reducing problematic symptoms, and learning how to change behaviors and beliefs that are harmful because they block the PTSD survivor's enjoyment of life. The humanistic and existential psychotherapies are unique in that they purposefully help clients encounter fundamental issues such as guilt (e.g., survivor's guilt), emotional pain (e.g., feelings of shame) and personal loss (e.g., the end of a relationship) through the confrontation and development of purpose and meaning. This is not an easy journey; moreover, it requires a mature, willing, courageous therapist to travel alongside the suffering individual. Clients may become vulnerable through the nakedness of viewing the core areas of self as changed by trauma, often bringing them to separate themselves from inadequate ways of relating to their self-identity. The courage to act also rests upon the trauma survivor, as the will to make a choice may not appear so freely available and may often seem risky to face, given that the outcome is uncertain. This is a paradoxical point that may be the most liberating moment from PTSD's binding chains upon the psyche. It can be freeing, because, in facing the anxieties and horrors of the trauma, moments are created for "new opportunities to occur and provide tools for engaging life and future encounters" (Pitchford, 2009, p. 446). Such parts of the journey require time for rituals of "goodbye," but with openness to the reemergence of the "new" person. This is often a spiritual process wherein the metaphorical demon that suffocates the individual's soul via the trauma(s) is vanquished, and the person, through his or her courage to face the unknown, is thereby freed. This liberation, however, often occurs beyond mainstream psychotherapy's understandings of healing. At the same time, individuals are often accommodated by therapeutic programs that are not steeped in conventional psychological principles. These treatments range from acupuncture and hypnosis to art and dance, from MDMA and music therapy to massage and mindfulness meditation, from energy medicine and virtual reality therapy to pet therapy and sports. Some people with PTSD have a religious crisis, because a trusted pastor or priest took sexual advantage of them. Some people have spiritual crises, because they are plagued with guilt after a good friend is killed in a highway accident when they were driving the car. Others have existential crises, because their very being-in-the-world has lost meaning due to the inadvertent killing of civilians during a combat operation. For many trauma survivors, sexual dysfunction prevents them from the full development of intimacy with a prospective partner. Despite how the trauma may affect specific individuals, the overarching therapeutic "goal" is to support them in reconnecting to self and psyche, and in unveiling the choices over which they have control. This goal is meant to empower clients in demonstrating how they might decide "to act on those choices and potentially transform their lives" (Pitchford, 2009, p. 446). Reproduced with permission of The Licensor through PLSclear / Routledge