What is PTSD? Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder:

Is There a Successful PTSD Treatment?

Author: Ginny NiCarthy, MSW, Counselor and Author

Posted on May 29, 2020


You wake from a nightmare sweating or shaking or screaming. Startled by an unexpected sound or touch, you nearly jump out of your skin. You try to shut out feelings about that awful thing that happened to you. In hopes of avoiding memory triggers, you take roundabout routes to work. Certain smells, sounds and sights re-stimulate the pain and fear of the past. You might begin to use alcohol or drugs in an attempt to diminish your feelings of fear, grief, self-blame or anger. Your nightmares, startle reactions, flashbacks and avoidance behaviors might make you wonder if you’re going crazy. These are normal responses to injury or threats to your psychological integrity that were accompanied by intense feelings of fear, helplessness or horror that can accompany a traumatic event.

Many people who experience a single trauma recover within a few weeks or months. However, if you’ve been raped or assaulted by someone you thought you could trust, it can be hard to regain your emotional balance. PTSD symptoms can persist for months or years, especially if the trauma is repeated. If you have experienced realistic, life-like terrifying flashbacks, sleep disturbances, depression or relationship problems for longer than a few months, these symptoms might indicate you’re suffering from Post-Trauma Stress Disorder.

PTSD was first identified as a treatable mental health problem among returning combat veterans who had experienced one horrific event after another in war time, with accompanying feelings of helplessness, fear and dread. Now, certain sights, smells or sounds might suddenly trigger a flashback—a realistic mental return to that place, time, experience that is linked together in memory with the feelings that accompanied it.

But you needn’t have fought in a war to develop symptoms of PTSD. Your emotional and physical wounds might be the result of physical, sexual or emotional assaults as a child (sometimes called Complex PTSD). Domestic violence--abuse and coercive control by a spouse, intimate partner, parent or other family member--can result in injury and traumatizing humiliation. PTSD also can result from car or train accidents, hurricanes or floods--events that might be no one’s fault. You might have lost your job, your home, your intimate partner, or witnessed a crime or violent death. Any of these events can provide the physical, emotional or spiritual shock resulting in the development of PTSD symptoms.

It takes resilience to cope with traumas. If you’ve ever watched a toddler learning to walk, you’ll see the development of resilience. The child takes off joyously, and then, smack! She falls down. Maybe she cries a little, but then gets up and courageously tries again. She keeps recovering. That’s the way life has been for many of us. We crawled, stood, walked and ran, refusing to give up when we fell flat.

However, sometimes a trauma is too much to just shake-off and continue, especially if it’s followed by additional emotional or physical assaults or if no supportive people are available to ease the fear and pain and to offer encouragement. If that’s what you have experienced, you might become fearful that as soon as you’ve gathered the strength to try again--smack, you’ll be hit again. We know that a history of childhood or other complex trauma make it much more difficult to cope with later trauma. Your reaction to trauma can change the way you look at the world, the people you know and even how you internally criticize or judge yourself. If depression and anxiety follow, you might start drinking or taking drugs to shut out the pain of PTSD flashbacks and other symptoms. (This may lead to “alcohol dependence secondary to PTSD,” or to alcohol or drug dependence, as a second but equal diagnosis, requiring chemical dependency treatment in addition to PTSD treatment.)

The way you interpret the meaning of the traumas has a lot to do with whether you recover quickly and how long PTSD symptoms last. You might begin to tell yourself you’re the one who is no good, blaming yourself for having been in the wrong neighborhood, with the wrong person or otherwise “asking for it.”

The way you interpret the meaning of the traumas has a lot to do with whether you recover quickly and how long PTSD symptoms last. You might begin to tell yourself you’re the one who is no good, blaming yourself for having been in the wrong neighborhood, with the wrong person or otherwise “asking for it.”

Believing the world is an evil place, that you can’t trust anyone, or that you deserve to be mistreated can result in even more grief. Wary of emotionally re-experiencing the trauma with its intolerable feelings of fear, anger or helplessness, you may find yourself avoiding people whose company you might otherwise have enjoyed.

When you use these avoidance methods of protecting yourself, you pay a high price--missing a lot of life’s pleasures and satisfactions. You discover that being alone and socially isolated increases your troubling reactions instead of reducing them.

But the good news is that new and reliable kinds of therapy are available for relief from PTSD symptoms. A counselor trained in one of the cognitive PTSD treatments can help you overcome the barriers to your recovery from trauma, so that you can live the full life you want and deserve.

A counselor can help you understand the difference between past trauma and your interpretation of it, which affects the way you feel in the present. She or he will help you identify and root out the self-talk messages you give yourself that make your situation worse. The counselor or therapist will provide a safe environment for you to explore new ways of viewing the situation and of modifying your methods of avoidance. Then you will be on the road to recovery.

Look for a counselor who is trained and experienced in the use of one of the forms of Cognitive Behavioral Therapy (CBT) which have been shown to be the most effective techniques in diminishing or obliterating PTSD symptoms. The most successful are Prolonged Exposure Therapy (PET), Cognitive Processing Therapy (CPT) or Eye Movement Desensitization and Reprocessing (EMDR). With these therapies, your memories of what happened remain intact, but the memories are no longer linked to the extreme emotional reactions that you experienced at the time of the original traumatic events.

Each type of cognitive behavioral therapy uses a slightly different method, but all are based on the counselors’ understanding of how the effects of trauma can be significantly modified through carefully guided step-by-step changes in your thoughts, feelings and behaviors.

Many people suffering from PTSD symptoms don’t begin the work of recovery for years after the trauma occurred and are surprised to discover that it is never too late to begin. After about three months in therapy there is a good chance you can live the life you choose, based not on past trauma, but on the pleasures, satisfactions, and realities of your new life experiences.

Ginny NiCarthy, MSW is a Seattle area counselor and author of a number of books relating to domestic violence victim treatment.

Other Resources - Post-Traumatic Stress Disorder:

Find an EMDRIA Certified EMDR therapist in the Puget Sound area on

Washington State Department of Veterans Department of Veterans Affairs--Veterans PTSD Program--PTSD Counseling Services. "The Post-Traumatic Stress Disorder (PTSD) Program attempts to create community-based avenues to counseling services that are less formal in nature, offering the highest level of confidentially possible. Services provided throughout the program include individual, couples, family, and veteran group counseling. Some contractors offer group services to women veterans and spouses of veterans. Veterans may be referred to specialized inpatient or outpatient treatment offered by the U.S. Department of Veterans Affairs Medical Centers or Vet Centers within Washington State.

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