If you’re a survivor of trauma, the fear of having to relive that difficult moment can affect your entire life. A large portion of people cited the fear of opening old wounds as the main reason they chose not to seek PTSD treatment.[1]
But, as counterintuitive as it sounds, reliving trauma therapy, when done safely with a trained clinician, is one evidence-based technique is one evidence-based technique used for treating and managing PTSD. The aim is to help the brain recognize that the danger is no longer present, which has been shown to reduce PTSD symptoms. For those experiencing PTSD flashbacks, this type of treatment can help the brain stop replaying the event as though it’s still happening.
This article explores exposure therapy and other PTSD treatment options, so you can make an informed decision about your care. It will focus on:
One of the core features of PTSD is avoidance, and this is because after a traumatic event, the brain starts linking certain memories and situations to danger.[2] The brain then begins to avoid anything connected to these memories as a way to protect you from further trauma.
The problem with this process is that when the memory is avoided completely, the brain never gets a chance to learn that the danger has passed. This is why PTSD symptoms like flashbacks and nightmares can continue to be a problem for a long time after the event occurred.
The nervous system also continues to react as though the event is still happening, which explains anxiety-related symptoms that are common in those with PTSD.[3]
Exposure to the memories works by revisiting the memory in a safe and supportive setting so that the brain gets the chance to work through what happened.[4] If practiced over a period of time, the fear response starts to weaken because the person is learning that the memory itself cannot hurt them. Researchers call this fear extinction, and it is well supported by clinical evidence.[5]
Trauma-focused therapies are intentionally paced, so the person has a chance to build coping skills and learn emotional grounding before any direct memory work begins.
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
Not all PTSD treatment options involve revisiting trauma, but the ones that do can come in different forms. This is because of how unique and complex trauma can be for the person experiencing it, meaning a bigger “toolbox” of treatment options is available. Below, we explore some of the most effective examples:
Prolonged exposure is one of the most extensively studied trauma-focused treatments.[6] Patients are guided to deliberately and repeatedly talk through the traumatic memory in detail during sessions. Alongside this, the therapist assigns real-world exercises that involve slowly facing situations the person has been avoiding.
Gradually and safely revisiting the traumatic memory helps the brain learn that the memory itself is not dangerous. Large studies show that this approach can significantly reduce PTSD symptoms compared with other therapies or no treatment.[7]
Clinical guidelines from both the APA and the Department of Veterans Affairs strongly recommend PE as a first-line treatment for PTSD.[8]
EMDR is a highly regarded trauma-focused therapy that also involves bringing the traumatic memory to mind. The patient recalls the event while the therapist guides their attention using side-to-side eye movements or tapping. This process is thought to help the patient reprocess the memory in a way that reduces its emotional intensity.
EMDR does not require someone to talk through the traumatic event in detail for long periods, meaning it can be helpful for those who find it difficult to express themselves with words.
Instead, the memory is brought to mind in short bursts while the person follows guided movements from the therapist.
Research shows that EMDR can lead to reductions in PTSD symptoms and related depression, with results similar to other leading trauma therapies.[9]
Trauma-focused cognitive behavioral therapy combines changing how a person thinks about their trauma with structured exposure to the memory. TF-CBT includes learning to identify unhelpful beliefs while also gradually re-engaging with trauma-related memories or cues.
Cognitive processing therapy, one of the most recognized approaches in this area, focuses on helping people rethink the meaning they have attached to their trauma.
Studies show that trauma-focused CBT leads to greater improvements in PTSD symptoms than therapies that do not directly address the trauma. People who receive it are also more likely to no longer meet the criteria for PTSD compared with those who receive supportive counselling or no treatment.[10]
Clinical guidelines strongly recommend both TF-CBT and CPT as first-line treatments.
WET is an exposure approach that uses writing as the main way of processing the trauma. It usually takes place across a short series of sessions, where the person is asked to write in detail about their most distressing traumatic experience and what it means to them emotionally. The writing is guided by the therapist but remains a private activity rather than something spoken aloud.
It is thought that putting the memory into words on paper helps to organize thoughts and feelings that may have felt confusing beforehand. Even though WET is a shorter treatment, it’s been shown to perform just as well as longer therapies like CPT when it comes to reducing PTSD symptoms.[11]
Narrative exposure therapy is when a therapist helps the person build a clear timeline of their experiences, including both difficult and meaningful moments. This process helps the traumatic memories become part of a more complete and organized life story.
A review of 16 studies found that NET led to reductions in PTSD symptoms, and these improvements were still present at follow-up sessions. People receiving NET also tended to recover at higher rates than those who received no treatment or therapies that did not focus on trauma.[12]
Somatic experiencing takes a body-focused approach and puts the attention on physical sensations. The idea is that traumatic stress can remain in the nervous system after a distressing event, so by allowing a person to notice muscle tension or breathing changes in their body, they can release that stress.
The therapist then helps the patient notice and track subtle physical responses while revisiting the trauma memory at a controlled pace.
The evidence for SE is still developing, but early findings are promising. For example, one study found that 15 sessions led to notable reductions in PTSD symptoms compared to a wait-list group.[13]
If you’re living with complex trauma, you might be wondering if exposure therapies are suitable for you. This is a valid concern as people with complex trauma may experience difficulties that are more severe than typical PTSD symptoms, like trouble managing emotions or maintaining relationships.
Trauma-focused treatment incorporating exposure techniques can still work for people with complex trauma, but the approach may need to be adjusted. Official guidelines state that for adults with complex trauma histories, it’s recommended to start with stabilization and skill building before moving into direct trauma processing.[14]
The pace of treatment also matters more in these cases, and the overall plan may need to take co-occurring issues into account. Complex trauma therapy often requires a phased approach that addresses emotional regulation before memory work begins.
If you’re experiencing complex PTSD, the best thing to do is talk this concern through with your therapist. They will be able to assess and guide you on the best steps to take during therapy.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Trauma support is a phone call away – call 866-478-4383 to learn about our current treatment options. See our residences in Southern California’s Orange County & San Diego County. Take a look at our homes on the east side of the Metro area in Washington County. View our facilities in Fairfax County, VA within the DC metro area.
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PTSD treatment can take place in different settings, with two of the most common being inpatient and residential programs.
Inpatient trauma therapy tends to be a shorter-term option as it is designed for people who need immediate stabilisation. The focus in this setting is on medical support and getting the person to a place where they can engage with longer-term care.
Residential PTSD treatment offers a longer stay in a structured environment, where the person lives on site and takes part in treatment over a period of weeks or months. This type of setting can be especially beneficial for those who have been living with PTSD and need time away from their usual lives to focus on themselves.
Which setting suits someone best depends on how severe their symptoms are and whether other conditions need attention at the same time. All recommendations for PTSD treatment should come from professional mental health specialists as the disorder is incredibly complex.
For someone in acute distress, inpatient care may be the right starting point. For someone who is stable enough to take part in treatment but still needs an extra level of support, residential treatment is likely a better fit.
If one of the reasons you avoided PTSD treatment was that you feel as though you’re not ready to revisit trauma, know that this is a completely natural worry.
Reliving the event isn’t something you’ll head straight into, whether you feel confident about it or not. Before any direct exposure begins, therapists will spend time helping you build the necessary coping skills that make the later stages of treatment feel more manageable.
The main aim of the early phase of treatment is to build a foundation of safety and trust, so that when the time comes, you feel confident to proceed.
How long this preparation stage lasts depends entirely on the person, and the pace is guided by how you’re feeling, not by a rigid schedule. A good therapist will never push you into trauma work before you’re ready.
Something that helps to keep in mind is that even during this earlier phase, progress is happening. Learning to manage emotional responses and recognize your own stress signals is a meaningful part of PTSD recovery in itself. The memory work may be the part that gets the most attention, but the skills built before it are just as valuable.
If the idea of revisiting the trauma feels like too much right now, that doesn’t have to stop you from reaching out. Treatment can meet you where you are.
Deciding to start PTSD treatment is personal, and there’s no single right time to do it, but if your symptoms are affecting everyday life, it may be time to make that change. Whenever you’re ready, know that you have access to care that’s built around you.
A Mission For Michael provides specialized care for PTSD and trauma related conditions, including:
As an adult trauma treatment center, we understand that PTSD in adults often intersects with work, relationships, and long-standing patterns that require careful attention.
Therapy is at the center of everything we do, and by using trauma-focused therapies, our licensed clinicians help you understand how trauma affects your body and mind. Once the understanding is there, they’ll guide you toward safer and calmer emotional responses. This type of mental health treatment for trauma is designed to address both the psychological and physiological aspects of PTSD.
Our outpatient facilities include intensive outpatient and partial hospitalization programs, giving you the flexibility to heal from trauma at your own pace while still receiving structured care.
If you feel you could benefit from trauma-informed treatment, contact our team by phone or through our website. We’ll arrange an initial consultation to understand your needs and create a personalized plan.
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At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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