Understanding Therapy for Post Traumatic Stress Disorder

What Is PTSD and How Can Therapy Help?

PTSD – short for Post-Traumatic Stress Disorder – is one of those things that can totally change your life, without warning and often without anyone else really noticing. It’s more than just having bad memories or being a bit jumpy. PTSD sticks with you, messes with your head, body, and relationships, and can make everyday life feel impossible. But the good news? Recovery is possible, and you don’t have to go through it alone. This article will give you all the important info on this mental health issue but also a really good insight into how therapy can help, what to expect, and how to find the right therapist for you.

What Exactly Is PTSD?

PTSD happens after someone’s been through something traumatic – think serious accidents, abuse, war, violent events, or even the sudden loss of a loved one. It’s your brain and body’s way of saying, “I’m not safe,” even when the danger is long gone.

It’s a condition that affects people from all walks of life, and it doesn’t mean you’re weak or broken. PTSD is a normal response to an abnormal experience – it’s your nervous system trying to keep you alive. But sometimes, it gets stuck in survival mode.

How PTSD Affects You – Biopsychosocial & Neurobiological View

Let’s break it down a bit.

🧠 Neurobiology:

Trauma rewires the brain. The amygdala – your fear centre – goes into overdrive. The prefrontal cortex (the logical, reasoning part) goes quiet. And the hippocampus (your memory centre) doesn’t process trauma like a regular memory. That’s why flashbacks feel real – your brain hasn’t filed them away properly.

🧍‍♀️ Biological/Nervous System Impact:

You might notice your body’s always on high alert. Sweaty palms, racing heart, trouble sleeping – that’s your fight-or-flight response being triggered. And sometimes you completely shut down – that’s freeze or fawn. Your autonomic nervous system is constantly dysregulated, which means everything from digestion to sex drive can be affected.

💬 Psychological:

You might feel constantly anxious, numb, depressed, or irritable. Nightmares, intrusive thoughts, and a general sense that you’re not really here are common.

🌍 Social/Relational:

PTSD doesn’t just affect you. It can put a real strain on your relationships. You might push people away, avoid intimacy, lash out, or find it hard to trust others. Friends and family often feel confused, helpless, or hurt – and the disconnection can make things even worse.

Signs and Symptoms to Look Out For

Some common signs include:

• Flashbacks or nightmares
• Avoiding places, people, or conversations that remind you of the trauma
• Feeling jumpy or on edge
• Trouble sleeping or concentrating
• Feeling numb, detached, or emotionally flat
• Irritability or angry outbursts
• Guilt or shame
• Feeling like the world’s not safe anymore

If these symptoms have been hanging around for more than a month and they’re interfering with your day-to-day life – it’s time to seek support.

When to Get Help (Hint: You Deserve It)

You don’t have to hit rock bottom before reaching out. If you’re struggling, feeling overwhelmed, or just not yourself anymore, that’s reason enough to get help. Therapy doesn’t have to be a last resort – it can be the beginning of your healing journey.

Where to Find Help

There are loads of routes, depending on what’s available to you. The NHS offers services, but there’s often a wait. Charities like Mind and PTSD UK are great places to start.

For private therapy, check out Time for Therapy – a UK-based platform run by qualified UK therapists that helps you find the right qualified, trauma-informed therapist for you. You can filter by issues, approach, availability, and even online vs in-person options. It’s super easy to use, and you can feel confident that you’re in safe hands.

 How Therapy Can Help – And What to Expect

 Types of Therapy for PTSD:

• EMDR (Eye Movement Desensitisation and Reprocessing)
  Helps the brain reprocess traumatic memories so they’re no longer distressing. It sounds strange (moving your eyes while talking about trauma) but it’s incredibly effective.
• Trauma-Focused CBT
  Helps you challenge unhelpful beliefs and process traumatic memories. It’s practical, structured, and goal oriented.
• Somatic Therapies
  These focus on the body’s role in trauma – like Sensorimotor Psychotherapy or Somatic Experiencing. They help you release stuck survival energy and regulate your nervous system.
• Internal Family Systems (IFS)
  A therapy model that works with different “parts” of yourself – particularly those that hold trauma or try to protect you.
• Psychodynamic or Integrative Therapy
  Offers a more exploratory, long-term space to work through trauma and attachment issues.

What Happens in Therapy?

 Therapy for PTSD isn’t one-size-fits-all, but here are some of the common elements and techniques you might come across during your sessions:

🧱 Initial Foundations & Safety First

• Building trust and a strong therapeutic relationship
  Therapy starts by creating a safe, non-judgemental space where you feel comfortable talking.
• Pacing
  You’ll go at your speed. There’s no pressure to talk about trauma straight away — or at all if you’re not ready.
• Establishing boundaries and routines
  Helps you feel safe and in control of the therapeutic process.

🧘‍♀️ Regulation & Stabilisation Techniques

Before diving into any trauma work, many therapists spend time helping you learn how to feel more grounded and safe in your body.

• Grounding techniques
  These help bring you back to the present moment during distress.
  Examples:
  • 5-4-3-2-1 sensory technique
  • Touching textured objects
  • Feet on the floor + noticing surroundings
• Breathing exercises
  Used to calm the nervous system and reduce anxiety or panic.
  • Box breathing (inhale 4, hold 4, exhale 4, hold 4)
  • Diaphragmatic breathing (deep belly breaths)
• Progressive muscle relaxation
  Learning to tense and release different muscle groups to reduce body tension.
• Safe place visualisation
  Creating and returning to an imagined ‘safe space’ in your mind to feel secure and calm.

🧠 Psychoeducation

Understanding what’s happening to you can be incredibly empowering.

• Learning about trauma, PTSD, and the nervous system
  Your therapist might explain:
  • Why you feel the way you do
  • The role of the amygdala, hippocampus, and fight/flight/freeze
  • That your responses are normal reactions to abnormal events
• Normalising symptoms
  Helps reduce shame and self-blame by explaining that flashbacks, avoidance, or emotional numbness are trauma responses.
• Mapping triggers and trauma responses
  Understanding what sets off your symptoms and how they show up in your body or thoughts.

🧠 Trauma Processing (When You’re Ready)

Once you’ve got some tools and you feel more resourced, you may move onto processing trauma memories.

• Guided imagery
  Using visualisation to reframe traumatic memories or revisit them safely with support.
• Narrative work / Trauma timeline
  Telling your story in a structured, supported way — sometimes written, sometimes spoken — to help make sense of what happened.
• Imaginal exposure (in CBT-based approaches)
  Safely revisiting traumatic memories to reduce avoidance and help the brain process them.
• EMDR (Eye Movement Desensitisation and Reprocessing)
  Using eye movements, tapping, or sounds to help the brain reprocess stuck trauma memories.
• Inner child or parts work (IFS, Schema Therapy)
  Connecting with and healing younger or fragmented parts of yourself that hold trauma, fear, or shame.

🛠 Developing Coping Tools & Resilience

This is about rebuilding your inner toolkit so you can feel more in control again.

• Cognitive restructuring
  Challenging and changing unhelpful thoughts like "It was my fault" or "I’m never safe."
• Behavioural activation
  Encouraging activities that bring pleasure or meaning to combat avoidance and depression.
• Distress tolerance skills
  Techniques borrowed from DBT (Dialectical Behaviour Therapy) to manage overwhelming emotions without self-destructive behaviours.
• Self-compassion practices
  Learning to treat yourself with kindness, especially when old shame or guilt surfaces.

💬 Relationship & Attachment Work

For many, trauma has deeply impacted how they connect with others.

• Exploring trust, boundaries, and communication
  Especially relevant if trauma involved betrayal or abuse.
• Attachment-focused therapy
  Unpacking how your early relationships influence your current ones — and how to shift patterns that no longer serve you.

📅 Ongoing Support and Closure

• Reflecting on progress and setbacks
  Therapy is rarely linear — celebrating progress and navigating dips is part of the process.
• Relapse prevention planning
  Identifying warning signs and having tools ready for future tough times.
• Creating a life beyond trauma
  Exploring goals, meaning, identity, and reconnecting with joy, creativity, and purpose.

The Recovery Journey – What It Looks Like

Everyone’s journey is different. For some, it’s about learning to feel safe again. For others, it’s reconnecting with loved ones, building trust, or simply learning how to sleep through the night without nightmares.

You might go through:

• Periods of feeling worse before you feel better (totally normal!)
• Learning to regulate your nervous system
• Gaining awareness of triggers and learning how to manage them
• Processing grief, anger, or guilt
• Reconnecting with yourself and the world around you
• Learning how to feel again – safely

There’s no deadline. Some recover in months, others take years. There’s no right way – just your way.

What Qualifications Should a Therapist Have?

Look for therapists registered with or accredited by bodies like:

• BACP (British Association for Counselling and Psychotherapy)
• UKCP (UK Council for Psychotherapy)
• BABCP (British Association for Behavioural and Cognitive Psychotherapies)

Ideally, your therapist will also have specialist training in trauma or PTSD, not just general counselling skills. They should also be insured, and their initial training must have been taught in person and included at least 100 hours of supervised clinical practice. 

·      A good therapist will welcome you asking these questions and will often offer a free initial chat so you can decide for yourself if they are a good fit for you. Don’t be afraid to shop about – you don’t have to choose the first therapist you speak to.

·      Similarly, if you feel after a couple of sessions that your therapist is not quite the right fit for you, it’s absolutely fine to let them know and find a different one. You are entitled to feel comfortable with your therapist and find a different one if you are not.

There Is Hope – You Can Heal

It might feel like the trauma has taken over your life, but PTSD doesn’t have to define you. With the right support, you can feel better. You can laugh again. Sleep peacefully. Trust people. Feel safe in your body. You can have a life that’s not dominated by fear or memories.

You’re not broken – you’re surviving. And recovery is possible.

 Helpful Reading & Self-Help Resources

• “The Body Keeps the Score” – Bessel van der Kolk
  A deep dive into how trauma affects the body and mind, and how healing works.
• “Waking the Tiger” – Peter Levine
  Focuses on somatic approaches to trauma recovery.
• “Complex PTSD: From Surviving to Thriving” – Pete Walker
  Particularly useful if you experienced childhood trauma or emotional neglect.
• Apps like Insight Timer or Calm
  Great for grounding, sleep, and breathwork.
• PTSD UK (https://www.ptsduk.org/)
  Offers support, articles, and guidance for people living with PTSD.

 If you're reading this and recognising yourself or someone you love, please know: you're not alone. Recovery isn't about forgetting or erasing the past – it’s about learning to live with it differently, in a way that feels safe and manageable. You can get there – one step at a time.