CBT for PTSD and Trauma

Trauma changes the way your brain processes the world. It's not a weakness. It's not something you should be able to "just get over." It's your nervous system doing exactly what it was designed to do in response to something terrible. The problem is that it doesn't switch off when the danger has passed.

I've spent 13 years working with trauma. In NHS services, in military settings, and in private practice. I've sat with people processing combat, assault, accidents, childhood abuse, domestic violence, and loss. Every person's experience is different. But the mechanisms that keep people stuck are remarkably consistent, and that's what makes trauma treatable.

What trauma does

After a traumatic experience, your brain goes on high alert. That's useful when you're in danger. It becomes a problem when it stays switched on months or years after the event.

You might experience flashbacks or intrusive memories that feel like they're happening right now, not in the past. Nightmares. Being constantly on edge, scanning for danger, jumping at sudden noises. Feeling numb or disconnected from people you care about. Avoiding anything that reminds you of what happened, places, people, sounds, smells. Difficulty sleeping. Irritability or anger that seems to come from nowhere.

Some people develop these symptoms immediately. For others, it takes months or even years. I've worked with veterans who were fine for a decade after leaving the forces before PTSD hit them like a wall.

Types of trauma I work with

Trauma isn't just about the "big" events. It includes:

  • Military and combat-related trauma
  • Road traffic accidents
  • Physical or sexual assault
  • Childhood abuse or neglect
  • Domestic abuse
  • Witnessing violence or death
  • Medical trauma, including traumatic childbirth
  • Moral injury, being involved in or witnessing events that violate your moral code
  • Complex trauma from prolonged, repeated experiences

There's no hierarchy of trauma. What matters is the impact it's had on you, not whether someone else might consider it "bad enough." If it's affecting your life, it counts.

How trauma-focused CBT works

Trauma-focused CBT is a specific, evidence-based approach that NICE recommends as a first-line treatment for PTSD. It's not the same as standard CBT. The techniques are designed specifically for trauma.

Treatment typically moves through three phases.

Phase one: stabilisation

Before we touch the trauma itself, I make sure you're stable and have the tools to manage difficult moments. We'll work on grounding techniques that bring you back to the present when flashbacks or dissociation hit. Things like the 5-4-3-2-1 technique, breathing strategies, and body-based approaches. This isn't filler. These skills are essential for the work that comes next.

Phase two: processing

This is the core of treatment. Traumatic memories get stored differently from normal memories. They're fragmented, vivid, and feel current rather than past. Processing means helping your brain file these memories properly so they become something that happened to you rather than something that's still happening.

We'll also work on the meanings you've attached to the trauma. Guilt, shame, self-blame. "It was my fault." "I should have done something." "I'm damaged." These beliefs are almost always distorted, and they're what keep people stuck long after the event.

Phase three: reconnection

Once the trauma has been processed, we focus on rebuilding. Reconnecting with life, relationships, and activities. Planning for the future rather than being trapped in the past. Developing a relapse prevention plan so you know what to do if symptoms resurface.

Grounding techniques I teach

Grounding is about pulling yourself back into the present moment when trauma symptoms take over. I teach several approaches because different ones work for different people:

  • 5-4-3-2-1 sensory grounding where you identify five things you can see, four you can hear, three you can touch, two you can smell, and one you can taste
  • Controlled breathing using specific patterns that activate your parasympathetic nervous system and physically calm your body
  • Physical grounding like pressing your feet firmly into the floor, holding ice, or splashing cold water on your face
  • Cognitive grounding such as naming objects in the room, counting backwards, or reminding yourself where you are and that you're safe

These aren't long-term solutions on their own. But they're essential tools for managing symptoms while we do the deeper processing work.

How many sessions?

Single-incident PTSD, like a car accident or assault, typically responds well in 12 to 16 sessions. Complex PTSD, where the trauma was prolonged or repeated, needs more. Usually 16 to 24 sessions, sometimes longer.

I won't rush trauma work. Going too fast can destabilise you. Going too slow wastes your time and money. Finding the right pace is part of my job, and 13 years of doing this work means I'm good at it.

Pricing and next steps

Sessions cost £60 for 50 to 60 minutes. I offer concessions for military veterans, serving personnel, and blue light workers. If you've served, read more about my specific support for veterans.

Taking the first step is the hardest part. Book a free 15-minute consultation or call me on 07469 870 295. We'll just talk about what's going on. No pressure.

You can also learn more about my general CBT approach or how I work with anxiety and depression, which often accompany trauma.

13 Years Experience RAF Veteran BSc Psychology PgDip Mental Health DBS Checked Insured

Common questions

Do I have to talk about the trauma in detail?
Not straight away, and only when you're ready. We spend the early sessions building stability and coping skills before we go anywhere near the trauma itself. When we do process it, we work at your pace. You're always in control of how much you share.
What's the difference between PTSD and complex PTSD?
PTSD typically follows a single traumatic event or a series of events over a short period. Complex PTSD develops from prolonged, repeated trauma, often in childhood or in situations where you couldn't escape, like domestic abuse. Complex PTSD includes all the symptoms of PTSD plus difficulties with emotional regulation, self-perception, and relationships. Both respond to treatment, but complex PTSD usually takes longer.
How long does trauma therapy take?
For single-incident PTSD, 12 to 16 sessions is typical. Complex PTSD or trauma that spans years usually requires 16 to 24 sessions, sometimes longer. I'll give you a realistic timeframe after the assessment. I won't rush this work.
Will therapy make my symptoms worse before they get better?
Some people experience a temporary increase in symptoms when we start processing trauma. This is normal and expected. I'll prepare you for it and make sure you have solid coping strategies in place before we begin the harder work. I monitor this closely and we'll adjust the pace if needed.

Ready to take the first step?

Book a free 15-minute phone consultation. No pressure. No obligation. Just a conversation about whether I can help.

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