PTSD and trauma

What is PTSD

Post-traumatic stress disorder (PTSD) is a set of symptoms that can develop after a frightening, dangerous or overwhelming event, when the mind has not fully processed what happened. It affects sleep, memory, concentration and the everyday sense of safety, and it responds well to structured, evidence-based therapy.

PTSD can follow a single frightening event, such as a car accident, an assault or a medical emergency, or it can build up after repeated or prolonged exposure to threat. It is not a measure of resilience or character. The nervous system has become stuck in a state of alarm, replaying the threat as though it were still present, and therapy works by helping the brain file the memory away as something that happened in the past rather than something still happening now.

Symptoms of PTSD

People with PTSD often describe:

• Intrusive memories, flashbacks or nightmares connected to the event
• Avoiding places, people or conversations that bring the memory back
• Feeling constantly on edge, easily startled or unable to relax
• Difficulty sleeping, concentrating or managing irritability
• Low mood, guilt, shame or a sense of being cut off from other people
• Physical symptoms such as a racing heart, tight chest or nausea when reminded of the event

These symptoms can appear within days or weeks of the event, or emerge months later. Their intensity often shifts with stress, anniversaries or reminders that turn up in ordinary daily life, which can make PTSD feel unpredictable even once someone understands what is causing it.

Types of PTSD

PTSD is not a single fixed pattern. Some people develop symptoms after one clearly defined incident. Others develop complex PTSD (cPTSD) after repeated or prolonged trauma, such as childhood abuse, domestic violence or sustained threat over months or years. Complex PTSD tends to bring extra difficulties with emotional regulation, self-worth and relationships, on top of the core PTSD symptoms of intrusion, avoidance and hyperarousal.

Delayed-onset PTSD is also recognised, where symptoms do not surface until six months or more after the event. Birth trauma and medical trauma are worth naming specifically, since both can be missed or dismissed if the event was not obviously dangerous to anyone watching from the outside, even though it was frightening or overwhelming to live through.

How therapy can help

NICE guidance identifies trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) as the recommended treatments for PTSD. Both work directly with the traumatic memory rather than around it, aiming to reduce its intensity and the physical alarm response it triggers.

Trauma-focused CBT

Trauma-focused CBT works through the memory of the event in structured detail, alongside the beliefs it has left behind, such as self-blame or a sense that the world is now permanently unsafe. Over a course of sessions, the memory is revisited, examined and put into a clearer, more accurate context, while practical strategies address sleep, avoidance and everyday triggers.

EMDR

EMDR uses structured eye movements or other bilateral stimulation while briefly recalling parts of the memory. This appears to help the brain reprocess the memory so it carries less charge and feels less current. Sessions do not require describing the event in full detail before change begins, and many people find EMDR sessions move at a different pace to talking therapy.

Our approach

We are clinical psychologists, working online with adults across Brighton and East Sussex, from Hove and Kemptown to Preston Park, Hanover, Withdean and Portslade. Sessions run by secure video call, which suits the mix of commuters, students and people who have moved down from London that the city attracts, many of whom fit therapy around a working day or a regular trip up to London Victoria or London Bridge from Brighton station.

Every course of therapy starts with an assessment to understand what happened, how it affects daily life now, and which approach is likely to fit best. Pace is agreed together rather than set in advance. Trauma therapy asks a lot of someone, and it works best when it happens on terms the person can actually sustain.

What does PTSD therapy involve?

A typical course of therapy begins with one or two assessment sessions, building a shared picture of the trauma, its triggers and its current impact on sleep, relationships and work. From there, therapy moves into active work on the memory itself, using trauma-focused CBT, EMDR or a combination of the two, alongside practical strategies for anxiety, sleep and everyday triggers that keep the alarm system switched on.

Sessions are usually weekly. CBT-based sessions typically last around fifty minutes, while EMDR processing sessions often run for up to ninety minutes to allow enough time to work through a memory in one sitting. Between sessions, there may be short exercises to practise, such as grounding techniques or noticing and recording triggers. Progress is reviewed regularly, and the number of sessions is adjusted to what someone actually needs rather than fixed from the outset.

When to seek help

It is worth seeking help if trauma symptoms have lasted more than a few weeks, are getting in the way of work, sleep or relationships, or simply feel too heavy to carry alone day to day. Support tends to be easier to take in early, though therapy can help just as much years after an event as it can soon afterwards, so there is no point at which it becomes too late to ask.

If you are in crisis or thinking of harming yourself, contact your GP, NHS 111, the Samaritans on 116 123, or attend accident and emergency. We will update this site as the practice develops.