Post-Traumatic Stress Disorder (PTSD)

What can I expect from a CBT approach?

Trauma-focused Cognitive Behavioural Therapy (CBT) is an evidence-based treatment for PTSD. It helps you process the traumatic experience and develop a different relationship with the memories, emotions and meanings associated with it.

Together, we work to understand how the trauma continues to affect you and what may be maintaining your difficulties. Treatment typically involves working with memories of the event, including particularly distressing moments, and exploring the meanings you have attached to what happened. This can help you develop a more balanced understanding of the experience, including any beliefs about yourself, other people or the world that may have changed as a result.

Alongside this work, you will develop an understanding of how PTSD operates and learn ways of responding to distress. Depending on your difficulties, therapy may involve gradually approaching memories, situations, activities or feelings that you have been avoiding, so that they become less threatening and you can begin to reclaim parts of life that have been restricted.

The aim is not to forget what happened or minimise its significance. It is to help the memory become more clearly located in the past, rather than continuing to feel as though the danger is present now.

With treatment, many people experience fewer intrusive memories, less intense emotional reactions, reduced avoidance and improvements in sleep, mood and their sense of safety. Therapy can also help address guilt and self-blame, supporting a greater sense of perspective and control over how you respond to the experience.

Could a compassion-focused approach help me?

Compassion Focused Therapy (CFT) may be particularly helpful if the effects of trauma are accompanied by persistent shame, self-criticism, guilt or feelings of worthlessness.

You may understand intellectually that what happened was not your fault, yet continue to feel deeply ashamed or blame yourself for what you did, did not do or were unable to prevent. You might criticise yourself for how you responded during the traumatic event, or feel that your experiences have left you damaged or fundamentally different from other people.

These feelings can be particularly difficult to shift through understanding alone. CFT explores how experiences of threat, criticism, rejection or abuse can shape the way we relate to ourselves, and how self-criticism may develop as an attempt to protect ourselves from further harm, mistakes or rejection.

CFT may be worth considering if shame and self-criticism remain significant difficulties, including when you have already engaged in trauma-focused therapy. It is not a substitute for appropriate trauma-focused treatment where this is needed, but it may complement other approaches by helping you develop a more compassionate relationship with yourself and your experiences.

This can be especially relevant for people who have experienced prolonged or repeated trauma, such as childhood abuse or neglect, domestic abuse or other situations in which it was difficult to escape the threat. Some people with these experiences develop difficulties associated with Complex PTSD (CPTSD), which can include persistent problems with emotion regulation, self-worth and relationships, alongside the core symptoms of PTSD.

What does a compassion-focused approach involve?