Post-Traumatic Stress Disorder (PTSD) is a syndrome involving unwanted intrusion symptoms, avoidance of stimuli, negative alterations in cognition and mood, and marked changes to reactivity following exposure to a traumatic event more than thirty days prior. Many researchers view PTSD as a type of mental injury rather than a permanent condition. Recovery is possible and it’s never too late to start. 

To find a good counselor, listen to your emotions during your initial consultation. Rather than looking for someone who feels like a friend, find someone you trust and that you will listen to. 

The American Psychiatric Association , American Psychological Association  and the VA/DoD  recommend individual, manualized trauma focused psychotherapies that have a primary component of exposure and/or cognitive restructuring. These include prolonged exposure therapy, which is my preferred intervention for trauma due to the strength of the research behind it.

Childhood trauma is treated through therapy and sometimes medication for associated symptoms such as depression, anxiety, and sleep disruption. Often childhood trauma involves what is called “complex trauma” which refers to a series of traumatic events that occurred over a long period of time as opposed to a single incident of acute stress. Many survivors of childhood trauma do not meet criteria for Post-Traumatic Stress Disorder or benefit from interventions such as EMDR because they have already overcome avoidance symptoms. These survivors often see more value in challenging negative beliefs that reinforce guilt, shame, and anger, as well as rebuilding self-esteem and self-worth.

Acute stress disorder is a stress syndrome that occurs 3 days after exposure to a potentially traumatic event and can last up to thirty days, after which many survivors meet criteria for Post-Traumatic Stress Disorder. Treatment for acute stress disorder involves challenging negative beliefs associated with the event and learning stress management skills. Interventions such as EMDR or CISM that employ catharsis or emotional reliving of the event are strongly contraindicated as they can reinforce survivors’ self-doubt about their resilience, pathologizing normal human reactions. 

The length of therapy is determined by the acuity of symptoms and the goals that you set at the beginning of treatment. Some trauma survivors choose to work solely on intrusive memories and symptoms of avoidance, and may complete therapy faster than those who are interested in working on recovering self-esteem and challenging anger.