Post-Traumatic Stress Disorder (PTSD)


Patterns of communication and unresolved conflict.

PTSD (Post-traumatic Stress Disorder) is a mental health problem that can result from experiencing or witnessing a life-threatening event such as sexual assault, combat, car accidents, or natural disasters. After such events it is a natural reaction to have upsetting memories, feel on edge, have difficulties sleeping, or participate in daily activities like going to work or spending time with loved ones. However, if these issues persist for longer than a few months, it may be an indicator that it has developed into PTSD. It is also not uncommon for symptoms of PTSD to emerge much later after the event has passed.  

There are four categories of PTSD symptoms:

  1. Intrusion symptoms: Symptoms that involve reliving the event in some way, whether it be in memories, nightmares or flashbacks. Oftentimes these make it feel like you are going through the event all over again in the present.
  2. Avoidance of cues related to the event: Efforts to avoid memories, thoughts, or feelings connected to what happened or avoiding people, places, activities, or other external cues that are associated with the trauma.
  3. Negative beliefs and feelings: Changes in how you see yourself, others and the world are common following a traumatic event. Beliefs may form such as “I am bad”, “the world is a scary place” or “no one can be trusted”. Feelings such as guilt or shame may be present, as well as difficulty to feel any positive emotions. You may also find yourself withdrawing from others or not wanted to participate in activities that you used to enjoy.
  4. Changes in reactivity: You may find that following a traumatic event you feel more “keyed up”, also known as hyperarousal. This can manifest as increased irritability, behaving self-destructively as a means of coping, and feeling easily startled. Difficulties may arise with concentrating and with sleep as well.

How can counselling help?

A trauma-informed approach to counselling emphasizes creating emotional safety as a starting point. This is fostered through the development of a trusting relationship with the counsellor as well as through learning and practicing tools such as grounding that help you remain present and in control while facing difficult emotions, thoughts, and sensations. Because revisiting traumas can be very destabilizing, trauma therapists take care to attune to your state of mind moment-to-moment to ensure that it is healing rather than overwhelming. Within the context of emotional safety, traumas can be processed gradually and gently to allow deep and lasting change to be integrated.

A great deal of research has demonstrated the connection between trauma and the nervous system. As such, mind-body therapies such as EMDR, OEI, Sensorimotor Psychotherapy, and Somatic Experiencing are very effective in restoring balance to the body and mind.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

BC Provincial Mental Health and Substance Use Planning Council. (2013). Trauma-informed practice guide.

van der Kolk, B. A. (2014). The body keeps the score: brain, mind, and body in the healing of trauma. New York: Viking.

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