Post-traumatic stress disorder (PTSD) is a condition caused by very stressful, frightening, or distressing events. What someone experiences as `traumatic` is often subjective so what causes PTSD in one person is likely to be different to another person. Traumatic experiences are things which are unwanted and ones where a person has no or little control over and are normally life threatening or feel life threatening.

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Any situation which a person finds traumatic can cause PTSD including:  serious road accidents; violent personal assaults, such as sexual assault, mugging or robbery; serious health problems and  childbirth experiences.

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The way the brain copes with traumatic experiences is to put the body and mind into a straight of alert for survival. This means that the Amygdala (which functions like an alarm signalling danger, and responds in `fight, flight, fawn or freeze mode ‘to keep a person safe). This is normally effective as for example if we `freeze` during physical attack we are more likely not to `win` the battle but to avoid antagonising our attacker and so avoid further risk or injuries, unwanted contact or being killed. This is why many people with PTSD often later feel confused or angry about what they may perceive as not `fighting back` either physically, or by not reporting their experiences to the authorities or telling loved ones. Feelings of guilt, embarrassment and shame are also often present and may prevent people from seeking help. Often people decide to keep these experiences to themselves in the hope it will go away. 

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Someone with PTSD often relives the traumatic event through nightmares and flashbacks, problems sleeping, such as insomnia, and find concentrating difficult. This is because the Amygdala was functioning well during the traumatic experience(s), but the part which process or stores memories, the Hippocampus wasn`t able to work too well. This is why those with PTSD often struggle to sleep or to stay asleep without awaking through the night, as this is when the brain tries to deal with these memories. Sensory stimulus like the smell of the same aftershave or music the person smelled or heard during the traumatic experiences will tend to `trigger` unwanted disturbing memories of the experience or just the feelings they felt and/ or the beliefs they had at the time e.g. `it must have been my fault otherwise it wouldn`t have happened`. I describe it as these beliefs and memories of thoughts, feelings and of the actual event (s) are all almost frozen in time, sitting there in the brain unprocessed (or in a  fragmented or disorganised way) until they are `triggered` by something in the present, but it feels like it is happening now as the feeling of being in danger returns.

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These symptoms are often severe and persistent enough to have a significant impact on the person's day-to-day life. PTSD can develop immediately after someone experiences a disturbing event, or it can occur weeks, months or even years later. PTSD is estimated to affect about 1 in every 3 people who have a traumatic experience, but it's not clear exactly why some people develop the condition and others do not. I have treated clients for PTSD for traumatic events in their lives which occurred maybe 50 years ago and find that many clients are affected by experiences dating back several decades and it hasn`t gone away on its own.

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People who repeatedly experience traumatic situations, such as severe neglect, abuse or violence, may be diagnosed with complex PTSD. Complex PTSD can cause similar symptoms to PTSD and may not develop until years after the event.It's often more severe if the trauma was experienced early in life, as this can affect a child's development.

PTSD can be successfully treated, even when it develops many years after a traumatic event.

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Recommended treatment includes; talking therapies – such as trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR). Both therapies involve `exposure work` also known as `reliving`, which in CBT treatment means that traumatic experiences are recalled sometimes written down or talked through. We then rate emotions felt while recalling the experiences and look at what is different now, and how does the person think about it now, their beliefs about themselves etc. We use grounding techniques and work on having an awareness of physical responses to these memories and how we can remember it is `not happening now`. This all helps to process the memory(s) and can reduce PTSD symptoms. The later stage of PTSD treatment is about `reclaiming` where we look at what the experiences took from the person and how it affected them and what they would like to do in their life now that the symptoms have reduced.

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I only treat clients for PTSD if I have assessed them for it using a PCL-5 which is a questionnaire used to rate symptoms and am always clear that as a Psychotherapist I cannot diagnose any disorder but can only say that an assessment like this would `suggest treating a particular disorder may be beneficial`. Having treatment for PTSD can be quite upsetting, tiring and emotional and I would only work on this if my client is fully aware of the treatment plan, has an agreed `safe space` and wants to work on this. It doesn`t work for everyone but in my experience so far it does work for most people and the benefits of this treatment seem significant.

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EMDR is also recommended in NHS and NICE guidelines and is something I hope to train in, in future as it seems to be really beneficial as well but there is apparently less research done on it compared to CBT, so CBT tends to be recommended first for this reason and not because it is necessarily more effective.

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I hope the information I have shared on this page is useful to people considering treatment. I would always recommend having a free 15 minute phone discussion with me (and other potential therapists you may have found in your search) before making any decisions about having treatment.