Post-Traumatic Stress Disorder

This is the first in my series of articles on the most common psychological disorders in Australia. These articles are meant as a brief summary of the disorder and their treatments. They are by no means a comprehensive description of all presentations and treatments options. I apologise in advance if the descriptions below seem a simplification or miss part of your lived experiences of these disorders or their treatments.



Daniel* escaped a violent car accident with his life. He physically recovered, although that was far from easy. Psychologically, four years later, his recovery was about to begin.  

The Traumatic Event

Disaster strikes. The hallmark of Post-traumatic Stress Disorder (PTSD) is the traumatic event. This event must be related to actual or threated death, serious injury or sexual violence. Exposure to this event could be via directly experiencing the event, witnessing the event, or, learning that the event occurred to a close person (for example friend or family member).

Like physical trauma, which damages the body, a psychologically traumatic event sears its mark into the mind. The traumatic event, so unexpected, disturbing or terrifying, is not easily shaken off. Instead, it embeds itself in a part of our memory and consciousness. A bad thing has happened, and we wish to get on with life and forget about it. But we have changed, the divide between past and present has now broken down.

The Symptoms


The trauma insists on being remembered. Unlike most other past experiences and memories, the trauma pops up uninvited and unwelcome. It may feel like it is all happening again: A flashback. It may appear in dreams and nightmares. It may emerge in visions and memories when encountering a trigger. These intrusions bring the past into the present often feel as bad as the original event.


The trauma insists on being forgotten. Our selves busily build barriers against intrusive re-experiencing of the trauma event. Unconsciously (for the most part) we valiantly, but futilely, try to keep ourselves safe by distancing and detaching from anything trauma related.

We change our physical landscape. Stay away from crowds. Avoid people who will ask us how we’re going. Avoid contexts which match those where the trauma occurred. Avoid conflict and anger.

We change our mental landscape. Put up mental barriers from remembering the trauma, then memories associated with the trauma, then any distressing memories, then anything in the past at all. Avoiding feeling anything at all. Drinking and using drugs to numb.

Fight or flight

The intrusive trauma experiencing ramps up our body’s danger response mechanism: the fight or flight system. We can’t relax now. Trauma is ongoing. Ever vigilant. Easily startled. Easily angered. Sometimes, seeking out dangerous and risky situations which validate the fight or flight response.

Meanings and Understandings – broken and lost

The old Self couldn’t and can’t handle this. What does it mean? What I thought about safety was wrong. What I thought about trust and intimacy was wrong. I thought life was predictable, controllable, just. My life was travelling along a path, it has veered off, I am lost. I am not who I thought I was. I can’t accept.

The Treatment

Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) are the main evidence-based treatments for this disorder. Evidence-based means that studies have shown their effectiveness as compared to doing nothing or other treatment types.

Cognitive-behavioural therapy involves two main processes: exposure and cognitive reappraisal. Exposure means nearing elements of the trauma experience in a safe environment to learn that they are safe. This could be bringing a trauma memory to mind or being near a trauma trigger in real life. Cognitive reappraisal is learning from, understanding and integrating the trauma experience.

Daniel did CBT for the trauma memory. He replayed the memory of the car crash, recorded himself recalling it and listened to it numerous times. He remembered that during the crash he felt more concerned for his own life than the safety of pedestrians on the side of the road. This part of the memory filled him with guilt and shame and had shattered his understanding of himself as a good person. Therapy helped him integrate the memory and associated beliefs into an updated version of himself and his identity.

* names and key details changed to protect anonymity

One thought on “Post-Traumatic Stress Disorder”

Speak Your Mind


Suite C5
102-106 Boyce Rd
Maroubra Junction, NSW 2035
(02) 8958 2585

Have Questions?
Send a Message!

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.