What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very frightening or distressing events. While some cases surface quickly after the traumatic event, others may take years or even decades to develop. It is estimated that one in three serious traumas will result in PTSD.

The sorts of events the can cause PTSD include:

serious accidents
violent assaults, such as sexual assault, mugging or robbery
long-term sexual abuse, violence or severe neglect
adverse childhood experiences
war and other violent or extremely frightening situations
natural disasters

Symptoms of PTSD

It is normal to find any of the above events upsetting, but if you don't feel yourself and symptoms don't appear to be alleviating, seek help from your GP and/or a trauma-informed therapist or counsellor. The NHS website recommends seeking help if you still don't feel like you are improving after four weeks.

Examples of PTSD symptoms include:

flashbacks
repetitive and distressing images or sensations
feelings of guilt, moodiness and isolation
insomnia and/or nightmares
difficulty concentrating

For some people, a disruptive or upsetting incident in the present – anything which triggers similar sensory reactions such as sounds, smells, visuals – can dramatically bring up issues and memories that were thought long forgotten.

Some people will do what they can to avoid experiencing emotions or sensations that remind them of the original trauma. This can result in feeling numb and withdrawn. Other forms of emotional numbing can include substance abuse and drinking.

People who experienced trauma or chronic stress in childhood may also experience dissociation. Dissociative ability is highest in childhood. High levels of dissociative ability in adulthood are generally only present in people who experienced childhood trauma.

Treatment for PTSD

Psychotherapy is recommended by NICE as the first treatment for those with PTSD. In cases that develop quickly after the traumatic event, cognitive behavioural therapy (CBT), as well as eye movement desensitisation and reprocessing treatment (EMDR), have been found to be especially effective (see below).

Medication may also be prescribed in severely debilitating cases.

How can counselling help with PTSD?

Many people find that counselling helps them deal with the symptoms of PTSD, such as guilt and mood changes. Talking to a non-judgmental person works well for anyone going through a bad time or who has emotional problems they can’t manage effectively on their own. There is no shame in seeking help. Research shows that it can help whatever the age or background of the person involved.

CBT works on the idea that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. By breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel, CBT aims to deal with your current problems rather than focusing on what has happened in your past..

Eye Movement Desensitisation and Reprocessing (EMDR) begins by taking a thorough client history and a preparation phase which involves creating self-soothing activities and building positive resources. The distinctive technique employed by EMDR practitioners is bilateral stimulation. That means that the brain is activated on alternating left - right - left sides by various means via the body. This can be by moving the eyes from right to left, by playing a simple sound in alternating ears or by tapping gently on different sides of the body such as on alternate knees, shoulders or hands.

This bilateral stimulation is thought to help the brain to process information which has got stuck due to emotional and sensory overload. EMDR is often very effective for trauma, and it can be especially successful for one-off traumas such as a car accident.

If the trauma was repetitive and long-term it is of course more complex and will likely take longer to resolve. One of the key components of recovery from trauma is to foster a feeling of safety and reconnection; therefore, the relationship with your therapist will be of fundamental importance.