PTSD & Other Trauma Treatment: Frequently Asked Questions (FAQs)

What is PTSD?

PTSD stands for Posttraumatic Stress Disorder. PTSD is a mental health disorder and diagnosis that was recognized by the American Psychiatric Association (APA), beginning in 1980, for people who are impacted by traumatic events. PTSD is not just a “memory disorder” but a set of symptoms that includes difficulty functioning in the present—right here, right now. Trauma that does not meet full criteria for technical PTSD can be as harmful and trauma that does. Traumatic reactions that don’t meet full PTSD criteria are sometimes called posttraumatic stress (PTS).

What is trauma?

Trauma is when you experience something you are not prepared to handle. Parts of your experiences can stay with you mentally, emotionally, and physically, leading to a traumatic reaction. What is traumatic is different for each person and the important thing is to get help when needed to resolve the issue.

What are examples of trauma?

Examples of trauma which you may have experienced include accidents, violence and abuse. While events like combat trauma and rape are sometimes categorized as “large-T” trauma, there are also so called “small-t” trauma, such as not being treated well, being yelled at by a teacher or parent, being neglected or not having anyone who cares about you. These can be as harmful, yet unseen, burdens you carry.

What if I don’t have trauma?

“Trauma” may not be the right word for you to describe what you want help for with therapy. Even so, a trauma approach may allow you to treat and resolve issues you have not been able to previously treat successfully. The start of trauma therapy involves working with the present symptoms, not with the past symptoms, and this allows the present symptoms to be treated, even if there is not a trauma or if the origin of the symptoms is unknown. For example, if you had panic attacks, treatment can start with the panic feelings even if you do not have a trauma or known event that caused or is causing the panic symptoms.

What if I don’t remember my trauma or know if it is real?

The important thing is to start with what you do remember and feel now. While the event itself is important, and while memories sometimes are recovered in the process, what happened is not as important as treating what you carry now. The primary goal of therapy is not to prove what happened but to treat and resolve your pain so you can life the life you want to live. Many impactful traumatic events occur prior to verbal memory, but there are ways to work with even pre-verbal memories, with methods involve working with the present symptoms now.

Why should my trauma be treated?

Trauma is not just a “memory disorder” but a larger problem because it can impair your functioning on an emotional and physical level, wherever you go. For example, if while abused you learned “I am a bad person,” you can carry that into all family, professional and social life. It can even even impact daily activities such as going to the grocery store. On the other hand, when you resolve the dysfunctional belief it can open the way to see yourself more clearly, as you really are, now.

What is a “trauma memory?”

When you go through a traumatic event, your brain records everything that happens. The pictures you see, sounds, smells and feelings are all recorded in a trauma memory network. This trauma memory includes physical sensations felt at the time, such as the clothes on your body or tightness in your stomach or other areas of the body. It also includes thoughts you may have had at the time, such as “I am not safe” or “there is no hope,” as well as emotions felt at the time are also recorded. Together, all this information is a part of your “trauma memory” which later can be activated in the present by what we call triggers.

How does trauma treatment work, exactly?

In trauma treatment we locate the trauma memory, including its visual, cognitive, emotional and physical sensation elements, and in a safe way go into the memory and work with it until it is no longer experienced as disturbing in the present. EMDR and other therapies have specialized, research evidenced procedures to work the the brain to help it digest or reprocess the memory until there is no disturbance. Trauma treatment can also include desensitizing triggers you may have which activate past traumatic disturbance.

What is the goal of trauma treatment?

The gold standard of trauma therapy is to get you to a point that emotionally and logically when you think of the trauma you think, “its over” and to the point it does not bother you anymore when you think about it or are reminded of it. This has been referred to as “getting the past in the past.” Getting a disturbance to a zero not only possible but something I see often and regularly.

What are risks of trauma treatment?

As with all therapy, there are potential risks that you should consider along with potential benefits. Trauma therapy involves feeling emotions. If you don’t way to feel your feelings therapy may not be the right thing for you—although therapy is very helpful in helping people to become comfortable with themselves and their emotions. Trauma therapy can be emotionally intense, and sometimes people feel a whole lot worse before they feel a whole lot better. Quitting when you feel a whole lot worse is probably the worst time to stop trauma treatment, and staying in therapy to work on disturbances that get activated allows for resolution and healing. Finally, if you are not in a place in your life where you are emotionally or physically stable, trauma therapy may not be right for you, or it may not be right for you right now. Working on trauma can increase destabilization and in that case a therapy approach of support and stabilization may be more appropriate for you.

How are risks managed with the therapy?

First of all, whether trauma treatment is right for you should be carefully considered, along with your therapist. If after a thorough assessment you and your therapist decide to go forward with psychotherapy that includes a trauma focus, the treatment plan you develop with your therapist should include necessary plans to develop and strengthen coping skills to help insure you will be able to be successful in your treatment goals.