The first step of treatment with me is going to be an initial consultation, where we talk to each other on the phone to figure out what’s been going on and why you’re seeking services. This is a birds-eye view, so we won’t get deep into the details.

 

After your consultation, we’ll have what’s commonly called an “intake session.” This is essentially a long interview, sometimes almost an hour long, where I learn a lot about you. We’ll talk about your background, your childhood, what things have been like for you recently, what symptoms you’re experiencing, how you’re sleeping, what you’ve tried before, and more. This is a crucial step in understanding you as a complete person, which is important to me - I don’t see you as just a diagnosis, and I don’t want to put you into a box. This also lets me see what else is going on - like Depression, Anxiety, Insomnia, Suicidal Thoughts, or something else - and whether that needs to be part of our treatment plan as well.

 

If you’re experiencing symptoms consistent with a diagnosis of Post-Traumatic Stress Disorder (PTSD) I’ll assign that diagnosis and get to work. That’s when we shift into the treatment phase.

 

The primary treatment that I use for PTSD is typically Cognitive Processing Therapy (CPT). This treatment involves fully understanding the scope of your trauma - not just what happened, but how it has changed the beliefs you have about yourself, other people, the world around you, the past, and the future - and the way that it impacts your daily life.

 

From here, we’ll move step-wise through a treatment that is designed to have an end point. That might sound odd to you, but I honestly believe that you don’t need to be in therapy for very long when working on trauma if the treatment being used is being applied properly. For CPT, this means I’ll help you learn how to pay attention to your thoughts and your beliefs, how to categorize them, how to challenge them, and how to replace them. From there, we’ll move towards understanding how these thoughts and beliefs touch other aspects of yourself and your life, challenging and replacing them each time.

 

At the end of treatment, you should be able to look back on where you were at the beginning of treatment and notice a huge difference.

 

Now, you might notice that above I said I “typically” use CPT for PTSD. That’s because sometimes I’ll use a different treatment instead: Prolonged Exposure (PE) therapy. PE is helpful when the symptoms of the trauma involve a lot of physical bodily feelings, or the person has tried CPT with another clinician before me, or the nature of the trauma itself suggests to me that PE would be indicated.

 

PE shares with CPT the fact that it has an end-date in mind, and that it has a very logical, step-wise approach. Though with PE, in addition to recognizing, challenging, and replacing thoughts, we’ll also physically or mentally expose ourselves to certain aspects of the trauma in a controlled way. For example, it’s fairly standard for this treatment to involve you writing down a narrative of exactly what happened to you. Then, you’ll record an audio clip of you reading that narrative out loud. Then, you’ll listen to that audio clip as part of your homework. This carefully exposes you to the trauma again and again until you learn to process it, stop being as afraid of it, and recover from it.

 

Both treatments can feel distressing at times, which is why I’ll keep a careful eye on things to ensure that you’re not being put through more distress than is necessary. Treatment for PTSD can feel emotionally exhausting at times, but the rewards that come from it are profound. I’ve seen people change drastically through treatment - sometimes into completely different people, in a good way!

 

 

PTSD vs C-PTSD

 

I’m often asked if I treat C-PTSD too, or if these treatments work for C-PTSD. For those who don’t know, Complex Post-Traumatic Stress Disorder (C-PTSD) is a label used when a person has compounding traumas, or a complicated history of trauma, or has difficulty choosing a single most distressing trauma.

 

I’m going to be blunt: I usually don’t use this label. Here’s why: in my experience, I can only count a very small number of PTSD clients that I’ve seen that had only one single traumatic event. The majority of my trauma clients have a complex history of trauma. Does this mean that they should all have been assigned the diagnosis of C-PTSD? No, I don’t think so. Instead, I think that trauma and PTSD is generally complex and messy, and I don’t think adding a C- to the beginning of the diagnosis makes that more true.

 

So will CPT and PE work on C-PTSD? In my experience, yes, just the same as it should with PTSD.

 

 

Why I enjoy treating PTSD

 

The two defining characteristics of my PTSD clients have been remarkable change remarkably fast. I find it to be extremely rewarding when I see someone grow and recover from their trauma in just a few months. Truly, there’s nothing like it!

 

Also, I get very frustrated when I hear about people being in trauma therapy for years, so I’m always relieved to know that someone is working with me after going through all of that. I feel motivated to help them finally become unstuck and start recovering, no matter how long ago the traumatic event was, or how persistent it is in their daily life.

 

 

"What if I’m experiencing PTSD and something else? Which gets treated first?"

 

This is the classic push and pull of clinical psychology, and we have to stay flexible throughout the treatment. Generally, I try to treat whatever is causing you the most distress first. For PTSD clients, that’s typically the PTSD (even if other things, like depression, are happening). However, that being said, there are certain conditions that require attention at the front as well. For example, suicidal thoughts will require our focus, at least partially, to ensure that you stay alive long enough to make progress on your PTSD. Similarly, insomnia can make PTSD symptoms worse, and insomnia responds so well to treatment that it’s wise to give that a lot of attention at the beginning.

 

A quick note about PTSD and Suicidal Thoughts: when I was on my clinical residency (internship), I participated in clinical trial research designed to see which should actually come first: treatment for suicidal ideation, or treatment for PTSD. The classic logic for many years had been that the suicidal ideation should be treated first. What we learned through our research is that PTSD should often times be treated first, so long as you give some attention to the suicidal thoughts to ensure that the person stays alive. This makes sense, as for a lot of people, their suicidal thoughts are sometimes driven by their PTSD symptoms! So rather than focusing solely on a person’s suicidal thoughts and doing that until the suicidal thoughts go away completely, I prefer to focus on the PTSD, while ensuring that the suicidal thoughts don’t evolve into suicidal behavior. Kind of a nuanced approach to things, but I think it matters.

 

So which comes first: PTSD, or something else? It comes down to my clinical judgement based on the severity of your symptoms, the interactions of what’s going on, and everything else happening in your life. The benefit of working with a clinical psychologist is that making these decisions was a core part of my clinical training.

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Frequently Asked Questions about PTSD and PTSD Therapy

 

"How long does PTSD therapy last for?"

 

Typically, my PTSD clients who are receiving CPT or PE are with me for 10-12 sessions, give or take one or two appointments. I can of course see you longer than that, and I probably will if there are other things happening in addition to the PTSD symptoms, but CPT and PE generally take 10-12 sessions.

 

Sometimes, I’ll have a client that notices that a component of CPT or PE had a lot to unpack. If that’s the case, we’ll slow down and spend an extra session or two on it, or longer if needed. But regardless, there should be an end in sight for PTSD treatment, and it’s my goal to get you there.

 

"Is it true that PTSD can never be cured?"

 

I hear this often, and answering it is a little tricky, so I figured I’d just be straight up and honest here: it depends on what you mean by “cured.” If you think of being “cured” as meaning you’ll never experience a thought related to your trauma again, I’m not sure I can guarantee that. I’ve heard of some people experiencing that, but I’m skeptical. However, if you think of “cured” as meaning you’ll no longer be highly distressed by a thought related to your trauma, I think we can get there together.

 

To illustrate what I mean, let’s pretend you have PTSD related to a car accident. If you think that being “cured” of this sort of PTSD involves never again thinking about your car accident, then no, I don’t think that’s possible. I think about car accidents I’ve been in and I don’t have PTSD! But if you think that being “cured” of this sort of PTSD involves no longer being distressed by these memories - meaning, you are no longer afraid of driving in the car, or you don’t white-knuckle grip the steering wheel the whole time you’re driving, or you no longer have distressing intrusive thoughts about it, or you no longer have distorted beliefs driven by the accident - then I think that’s a very realistic goal to reach for.

 

"Do you offer EMDR for PTSD?"

 

I do not. This is because I’m not convinced that EMDR really does what it claims to do. Also, I’ve found the evidence for the use of CPT or PE for the treatment of PTSD to be a lot more compelling.

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"Do you offer brainspotting for PTSD?"

 

I do not. This is because I’m not convinced that brainspotting really does what it claims to do. Also, I’ve found the evidence for the use of CPT or PE for the treatment of PTSD to be a lot more compelling.​

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"Do you prescribe medications for PTSD?"

 

I don’t, as I’m not a psychiatrist, but I can coordinate care with your psychiatrist if you’d like. If you don’t have a psychiatrist, but are interested in medications, let’s talk about it - I can usually make a referral for you.

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"How do I start a PTSD treatment with you?"

 

If you’re ready to work with me on your PTSD, I’d be honored to work with you. Just text or call me at 205-797-1897 or email me at info@NorthStarPsyc.com to get started. We’ll find a time to have a quick consultation call, and from there (if we’re a good fit) I’ll schedule your first intake appointment.

 

I hope to work with you soon!