Following a traumatic experience, a person may experience difficulties such as:

• Unwanted or intrusive memories of what happened
• Nightmares related to the traumatic experience
• Feeling as though the event is happening again
• Becoming distressed when reminded of what happened
• Avoiding particular places, people, conversations, activities, or memories
• Feeling constantly alert or “on guard”
• Being easily startled
• Irritability or anger
• Difficulty concentrating
• Problems sleeping
• Feeling emotionally numb or disconnected
• Difficulty experiencing positive emotions
• Persistent guilt, shame, or self-blame
• Negative beliefs about oneself, other people, or the world
• Difficulty trusting other people or feeling safe
• Withdrawing from relationships or activities
• Feeling detached from one’s surroundings or experiences

For some people, these difficulties can affect relationships, work, physical wellbeing, sleep, and their ability to participate in activities that were previously important to them.

A person may also begin organising their life around avoiding reminders of the trauma or preventing something similar from happening again. Although avoidance can provide relief in the short term, persistent avoidance can make it more difficult to process what happened and regain a sense of safety.

At People Psychological Solutions, our clinical psychologists work with individuals experiencing trauma-related psychological difficulties, including PTSD.

Assessment does not require someone to immediately provide a detailed account of everything that happened to them.

Instead, we first aim to understand the difficulties the person is currently experiencing, their circumstances, and how these difficulties are affecting their life.

Depending on the individual’s needs, this may involve:

• Understanding the traumatic experience and its context
• Exploring current trauma-related symptoms
• Understanding intrusive memories, nightmares, and other re-experiencing symptoms
• Identifying avoidance and situations that have become difficult
• Understanding changes in mood, beliefs, and relationships following the experience
• Assessing hypervigilance, sleep difficulties, and other changes in arousal
• Exploring how symptoms affect work, relationships, and everyday functioning
• Using standardised psychological measures where clinically appropriate
• Assessing psychological safety and current coping
• Considering other psychological conditions that may be present
• Developing an individualised formulation and treatment plan

Not every person who has experienced trauma requires the same form of treatment.

Understanding the person’s current difficulties, the nature of their traumatic experiences, their existing strengths and resources, and other psychological or environmental factors allows treatment to be planned appropriately.

There are effective psychological treatments for PTSD.

Major clinical guidelines recommend trauma-focused psychological therapies, including trauma-focused Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR), for adults with PTSD.

At People Psychological Solutions, the particular therapeutic approach used will depend on the individual’s presentation, needs, preferences, and the psychologist’s clinical assessment.

Treatment may involve:

• Understanding common psychological responses to trauma
• Identifying patterns that maintain trauma-related distress
• Developing strategies for managing overwhelming emotions where needed
• Gradually addressing memories or reminders that have become difficult to tolerate
• Reducing avoidance
• Processing the meaning associated with traumatic experiences
• Addressing excessive guilt, shame, or self-blame
• Re-evaluating beliefs about danger, trust, control, or responsibility
• Rebuilding activities and relationships that have been disrupted
• Developing strategies for managing future triggers and maintaining progress

Trauma-focused therapy is not simply about repeatedly talking about a painful experience.

Rather, treatment provides a structured way of helping a person process what happened, address patterns that continue to maintain distress, and gradually reduce the extent to which the traumatic experience controls their present life.

This is an understandable concern.

Beginning therapy does not mean that you will be expected to describe your most difficult experiences in detail during your first session.

Therapy begins with understanding your current difficulties, establishing treatment goals, and explaining the rationale for the therapeutic approach being considered.

When treatment involves directly processing traumatic memories, this is undertaken within a structured therapeutic approach and with your involvement in treatment planning.

At the same time, effective trauma treatment is not necessarily based on indefinitely avoiding difficult memories or emotions. For PTSD, evidence-based trauma-focused therapies may involve gradually engaging with trauma-related memories, thoughts, feelings, or situations as part of treatment.

Your psychologist can explain what treatment involves before you decide how you would like to proceed.

People affected by trauma may also experience other psychological difficulties, including:

• Depression
• Anxiety
• Panic symptoms
• Difficulties with sleep
• Substance-use difficulties
• Relationship difficulties
• Difficulties managing anger or emotions
• Dissociative experiences

Some people may also have experienced repeated or prolonged trauma and present with a more complex pattern of psychological and interpersonal difficulties.

A comprehensive clinical assessment therefore considers the person’s broader psychological functioning rather than assuming that every difficulty is explained by PTSD.

Where multiple difficulties are present, treatment can be planned according to their individual needs and priorities.