shutterstock_134737757Posttraumatic Stress Disorder or PTSD is anxiety disorder that can leave the person immobilized on many levels due to the acute or chronic stress; it can be accompanied with depression, panic attacks and severe outbursts of anger that will be discussed in this article including the therapy.

Definition and Diagnoses of Trauma

Trauma is the experience and psychological impact of events that are life-threatening and include a danger of injury so severe that the person is horrified feels helpless, and experiences a psychophysiological alarm response during and after the experience (Shauer, 2005: p 5). The history of the study of trauma goes back to 1880 and 1890 (Charcot, Frued, Janet, Breuer, Herman 1992). The psychological trauma became recognised and a real diagnosis in the Diagnostic Statistical Manual only in 1980. Some of the clients that come to Westminster Psychotherapy Ltd know that they experienced trauma and they will self-diagnose and self-refer for the treatment of trauma and other clients self-refer with bad depression, high stress or outbursts of anger and later during the assessment, it becomes clearer that the clients were traumatized. The diagnostic criteria for posttraumatic stress disorder (PTSD) include experienced or witnessed a traumatic event; the traumatic event is re-experienced through intrusive thoughts, dreams or images; persistent avoidance of anything associated with the trauma and numbing; continued over-arousal expressed in insomnia, outbursts of anger and hypervigilance, the symptom must be present for minimum of four weeks, the symptoms cause distress and negative impact on most aspects of the client’s life.

The Traumatic Event in Your Mind and Body

During highly stressful situation or trauma, our body will go psychologically and physiologically through a number of different processes that will include the ‘fight or flight’, development of hyperarousal or hyporarousal also known as freezing or dissociation, and acquisition of maladaptive beliefs and flashbacks and negative emotions associated with it. I will explain now in a more detail the mechanism of the trauma. When a person is experiencing a highly stressful event (rape, car accident, bullying, domestic violence) there is a system in our mind called the limbic system that sends messages to the autonomic nervous system. This enables our body to protect us from the stressor or traumatic situation either by flying away from it or fighting it, a reflex known as “fight or flight”. The automatic nervous system, which consists of sympathetic (SNS) and parasympathetic nervous systems (PNS), instructs firstly the SNS, which starts arousal by producing stress hormones to enable us to go into the fight or flight reflex.  If we manage to flee or fight off the stressor during trauma, our body should go back to its natural homeostasis. However, if we are unable to do this, the limbic system will contact the other branch, PNS, for help (Rothschild, 2003). With regards to the development of hyperarousal, as the SNS continues with high arousal, the body is becoming hyperaroused and may become over-conditioned to fear and studies confirmed that our ability to think clearly during high stress is inhibited (Shauer at al., 2005). Therefore, in this hyperaroused state some persons may form distorted beliefs accompanied by feelings of shame, anger, and guilt (Rothschild, 2003).  Ongoing stress may lead to chronic hyperarousal evident in persons who suffered trauma (Shauer et al., 2005). I will now explain how people acquire freezing or dissociation which is the product of prolonged hyperaroused state. If the SNS fails to fight the stressor, the PNS freezes to protect the individual from emotional and physical pain – a state known as dissociation, which is an indicator of PTSD and one of the classic symptoms of trauma (Levine, 1997 and Rothschild, 2003).  This state is associated with hypoaroused response (Hartman and Zimberoff, 2006).  Levine (1997) described dissociation as an experience of sensing and perceiving the environment as though time is slowing down. One of my clients described the experience of freezing in the following way: “I did not feel anything, I felt numb”. Many clients that self-refer for the treatment of the posttraumatic stress disorder or trauma, or other issues that are related to the trauma present with maladaptive beliefs or thinking patterns that could be or does not have to be accurate but that will maintain the traumatic symptoms. Therefore, the work with traumatized client always involves work with the beliefs and their thinking patterns. Ehlers and Clark (2000) suggested that after a traumatic event, persons may form excessively negative appraisals of the event, which may shatter previously positive beliefs. However, not all survivors of trauma may form negative beliefs and this may be the result of a person’s genetic make-up and temperament (Binder et al., 2008). One of the most excruciating part of the trauma is the flashback. During trauma, the function of the hippocampus may be damaged and the information may not be well stored and may freely move around in the form of flashbacks, which are terrifying moments similar to reliving the event (Levine, 1997; Rothschild, 2003). Shauer et al., (2005) suggested that a flashback is an activation of a fear network, which is a powerful interconnection of cognitive, emotional, sensory and physiological elements encoded during a traumatic event. Triggering one of the elements may activate the whole network, leading to a flashback.  Persons learn to protect themselves from re-experiencing the flashback by avoiding talking about the traumatic experience and thinking about it, a process known as avoidance. In terms of the avoidance, it has been always advised that unless we have something more useful to offer to our clients it is best to not to touch the avoidance and therefore the treatment of trauma always inevitably includes paying attention to going at the clients’ pace.


This article provided a shortened version of what is trauma, what happens in our mind and body pathologically and it explained some aspects of the treatment. If you have suffered a trauma and are considering seeing someone, try to understand that I am a recovered sufferer of a posttraumatic stress disorder and therefore a therapist that will understand your experience well from a clinical point of view and also from a personal empathic point of view.   My work includes a tailor-made approach drawing on a more than one therapeutic approach with a key focus on the cognitive behavioural therapy that I have been supervised and trained in and in terms of the time for the treatment of the trauma, I usually see improvements in my clients in the range of three to six months which would be the equivalent to twelve or twenty-four sessions. If you would like to book an appointment for the trauma or posttraumatic stress disorder, PTSD treatment and therapy, please do not hesitate to contact me directly by calling me or texting me Leona on 07505 124 933.