Post-traumatic stress disorder (PTSD) is one of the most complex psychological conditions, yet also one of the most treatable. It develops after experiencing or witnessing a traumatic event and is characterized by a series of intrusive, avoidance, and hyperarousal symptoms that can profoundly disrupt a person's life. The good news is that today we have highly effective treatments, such as EMDR, that allow trauma to be processed and quality of life to be restored.
As a licensed health psychologist specialized in trauma treatment with EMDR, PTSD is one of the central areas of my clinical practice. In this article, I offer you a complete guide to understanding this disorder, recognizing its symptoms, and learning about the most effective treatment options.
What is PTSD?
Post-traumatic stress disorder is a mental health condition that can develop after experiencing or witnessing a traumatic event involving a real or perceived threat to life or physical integrity. Unlike normal stress reactions, which gradually resolve over time, in PTSD the brain becomes "stuck" in the alarm response, reliving the trauma as if it were happening in the present.
PTSD affects the way the brain processes and stores traumatic memories. Normally, memories are processed and integrated into our personal history. In PTSD, traumatic memories remain "frozen" in their original state, with all the emotional, sensory, and physiological intensity of the moment of the trauma. This explains why people with PTSD experience such vivid flashbacks: they don't simply "remember" the trauma, they "relive" it.
Types of trauma
Not all traumas are alike, and understanding the different categories helps us better grasp post-traumatic responses:
Type I trauma (single event)
Refers to a single, time-limited traumatic event: a traffic accident, a natural disaster, a terrorist attack, a one-off physical or sexual assault, or witnessing a violent event. Although a single event can be enough to trigger PTSD, the prognosis is generally more favorable than with repeated traumas.
Type II trauma (repeated or chronic)
Refers to traumas that recur over time: childhood abuse, gender-based violence, school or workplace bullying, repeated sexual abuse, or living in an environment of chronic violence. This type of trauma, especially when it occurs during childhood, can lead to what is known as complex PTSD, a more severe form of the disorder with additional symptoms.
PTSD symptoms
PTSD symptoms are classified into four main groups that must be present for at least one month to establish a diagnosis:
Intrusive symptoms (re-experiencing)
Flashbacks: Reliving the traumatic experience as if it were happening again, with vivid images, sounds, smells, and bodily sensations. Recurring nightmares: Distressing dreams related to the trauma that disturb sleep. Intrusive memories: Thoughts, images, or memories of the trauma that appear involuntarily and disturbingly. Distress when triggered: Intense emotional or physiological reactions to stimuli that recall the trauma (places, smells, sounds, dates).
Avoidance
The person actively avoids anything that reminds them of the trauma: places, people, activities, situations, conversations, or thoughts related to the traumatic experience. This avoidance can be extreme and significantly limit daily life. For example, someone who has been in a car accident may stop driving, avoid certain roads, or even avoid getting into any vehicle.
Negative changes in cognition and mood
Persistent negative beliefs about oneself, others, or the world ("I'm to blame", "the world is dangerous", "I can't trust anyone"). Disproportionate feelings of guilt, shame, or fear. Loss of interest in previously enjoyable activities. Inability to experience positive emotions (emotional numbing). A sense of disconnection from others. Partial amnesia about aspects of the traumatic event.
Hyperarousal (hypervigilance)
The nervous system remains in a state of constant alert, as if danger were imminent: irritability and disproportionate angry outbursts, difficulty concentrating, hypervigilance (constantly being on guard, scanning the environment for threats), exaggerated startle response (reacting disproportionately to unexpected noises), and difficulty sleeping.
Complex PTSD
Complex PTSD (C-PTSD) is a form of the disorder that arises as a consequence of repeated, prolonged trauma, especially when it occurs in relationships involving abuse of power (childhood abuse, gender-based violence, captivity). In addition to classic PTSD symptoms, C-PTSD includes:
- Difficulty regulating emotions: Extreme emotional reactions, episodes of intense anger, self-harm, or risky behavior.
- Altered consciousness: Dissociation, depersonalization (feeling disconnected from one's own body), or derealization (feeling that the world is unreal).
- Changes in self-perception: Deep feelings of shame, guilt, or worthlessness; a sense of being fundamentally different from others or "marked" by the trauma.
- Difficulties in relationships: Mistrust, difficulty forming bonds, patterns of revictimization, or avoidance of relationships.
EMDR: the gold-standard treatment for PTSD
EMDR (Eye Movement Desensitization and Reprocessing) is recognized by the World Health Organization and the leading international clinical guidelines as one of the first-line treatments for PTSD. Developed by Dr. Francine Shapiro in 1987, EMDR facilitates the natural processing of traumatic memories.
How does EMDR work?
EMDR uses bilateral stimulation (eye movements, alternating taps, or sounds) while the person accesses traumatic memories in a safe therapeutic environment. This stimulation facilitates the connection between the "frozen" traumatic memories and the brain's adaptive memory networks, allowing the memory to be properly processed and integrated. The result is that the person can recall the event without experiencing the emotional, sensory, and physiological intensity that accompanied it. The memory becomes something that belongs to the past, not something relived in the present.
Clinical studies have shown that EMDR can produce significant improvements in just 3-6 sessions for single-event traumas, and its effects are maintained over the long term. For complex traumas, treatment is usually longer but equally effective.
Trauma in children and adolescents
Children and adolescents can also develop PTSD, but their symptoms often manifest differently than in adults: behavioral regression, repetitive play with themes related to the trauma, general nightmares (not necessarily about the trauma), irritability, school difficulties, or changes in eating or sleep behavior.
Child therapy for PTSD uses age-adapted EMDR protocols, integrating play, drawing, and storytelling elements that make treatment accessible and safe. Parental involvement in the therapeutic process is essential to provide a safe environment that facilitates recovery.
Taking the first step toward recovery
If you think you may be experiencing PTSD, I want you to know two important things: what you feel is a normal response to an abnormal experience, and effective treatment exists that can help you. You don't have to keep living with the weight of the trauma.
At my practice in Igualada and through online therapy, I offer specialized EMDR treatment for PTSD and other trauma-related disorders. If you need help or want more information, get in touch with me. The first step is always the bravest, and you don't have to take it alone.