PTSD and Trauma Therapy in Edmonton

Individual therapy for trauma, PTSD and difficult experiences

Trauma doesn’t always look like frequent flashbacks or an obvious inability to function. You may find yourself avoiding reminders of an experience, feeling constantly on guard, struggling with guilt or shame, having difficulty trusting others, or noticing that certain situations trigger reactions that feel much stronger than you expect.

Mendable Psychology provides individual trauma therapy for adults in Edmonton and virtually throughout Alberta. Therapy can help you understand trauma-related responses, develop ways of managing symptoms, and, when appropriate, process distressing experiences using evidence-based approaches.

How trauma can affect you

Psychological trauma essentially changes how you view the world, yourself, and others.

One way of understanding psychological trauma is the impact on your nervous system. The nervous system regulates your body, turning up and down the level of activation in response to situations. You may notice that you always feel activated or unable to relax. Conversely, you may experience a sense of emotional numbness or feel “zoned out”.

What is a traumatic experience

A traumatic experience is an incident or series of events that overwhelm a person’s ability to cope and negatively alter their sense of safety, emotional well-being, relationships, and daily life. People can respond very differently to similar experiences, and experiencing something distressing does not necessarily mean that someone will develop post-traumatic stress disorder (PTSD).

When discussing PTSD specifically, the term traumatic event has a more precise clinical meaning. PTSD can develop following exposure to actual or threatened death, serious injury, or sexual violence. This may involve experiencing the event directly, witnessing it happen to someone else, learning that it occurred to a close family member or friend in certain circumstances, or experiencing repeated exposure to distressing details of traumatic events through one’s work.

Examples can include:

Serious accidents or life-threatening medical events
Physical or sexual assault
Intimate partner violence
Combat or military experiences
Natural disasters
Witnessing serious injury or death
Traumatic childbirth or medical experiences when there is actual or threatened serious injury or death
Repeated occupational exposure to traumatic events (ie. first responders, healthcare professionals)

The difference between trauma and PTSD

You may hear the informal terms “Big T” and “little t” trauma used to describe different types of difficult experiences. While these are not clinical diagnoses or formal categories of trauma, they may help in understanding the difference between an experience that could result in a PTSD diagnosis.

“Big T” is sometimes used to describe events involving significant threats to a person’s physical safety or life. “Little t” is commonly used to describe experiences that may not meet the specific trauma-exposure criteria required for a PTSD diagnosis but can nevertheless have a meaningful and lasting psychological impact. These experiences might include chronic criticism or bullying, emotional neglect, difficult family relationships, relationship betrayal, significant losses, prolonged workplace stress, or repeatedly feeling unsafe or unsupported during important periods of life.

The distinction does not mean that one person’s experience is more legitimate or deserving of support than another’s. Rather, it is important because not every distressing experience is considered a traumatic event for the purpose of diagnosing PTSD, while experiences that do not meet PTSD criteria can still contribute to anxiety, shame, avoidance, difficulties in relationships, changes in self-worth, or other forms of emotional distress.

Therapy does not require you to decide whether an experience was “traumatic enough” before seeking support. A psychologist can help you understand how past or current experiences may be affecting you and determine what type of treatment is appropriate for your concerns.

Traumatic experiences can alter the brain’s smoke detector of threat perception. Rather than fire, burnt toast sets it off.

Symptoms of PTSD and trauma-related distress

Symptoms of a classic trauma presentation tend to span across four different domains of mental health. These represent the criteria for which a PTSD diagnosis is based.

Re-experiencing symptoms

Intrusive thoughts
Flashbacks
Nightmares

Avoidance

Avoiding people, places, or things that remind you of the traumatic experience
Avoiding thoughts, feelings, and sensations that remind you of the traumatic experience

Negative thoughts and feelings

Loss of interest in previously enjoyed activities
Repeated feelings of fear, horror, anger, guilt, or shame
Negative beliefs about yourself or the world

Reactivity

Difficulty falling or staying asleep
Irritable behaviour or angry outbursts
Being “jumpy” or easily startled

Trauma-related diagnoses and concerns

Acute stress disorder

Acute Stress Disorder is diagnosed when a major trauma happens and symptoms last for over 3 days. A major trauma (Big ‘T’) includes direct exposure or witnessing of actual or threatened death or learning of violent or accidental death of a loved one.

Post-traumatic stress disorder

PTSD is diagnosed when a specific traumatic event happens and certain symptoms are present for a while. People with PTSD find it hard to handle reminders of their trauma and often avoid certain places or activities.

Complex trauma

Complex trauma is an area of much recent interest and research. It occurs when someone goes through long-lasting and traumatic experiences, although definitions do vary. Complex trauma is often related to childhood trauma or relationship violence. These experiences occur between close relationships (rather than a natural disaster) and are often long term.

Moral injury

Moral injury is not currently a formal trauma-related diagnosis. It is however, closely related to symptoms of PTSD. Moral injury occurs when your action (or inaction) in a situation is in violation of your values and morals. and result in distressing emotions and negatively altered belief systems.

Trauma in first responders and healthcare providers

First responders and healthcare professionals are regularly exposed to situations that most people encounter rarely, if ever. Serious injuries, sudden deaths, violence, medical emergencies, grieving families, and high-risk situations. While most professionals working in these fields expect some level of exposure to difficult events, it can be harder to anticipate the impact of these experiences over time.

Sometimes there’s one particular call, patient, incident, or outcome that sticks with you. Other times, there isn’t a single event you can point to. It may be years of seeing difficult things, making high-stakes decisions, working under pressure, and then having to move on to the next call, patient, or shift without much time to process what just happened.

You might notice that you’re more irritable at home, have trouble sleeping, replay certain situations in your mind, or feel more on edge than you used to. Some people start avoiding particular calls, situations, conversations, or reminders. Others feel detached or numb. You may still be doing your job well while noticing that it takes more effort to keep everything contained.

Cumulative trauma exposure

Trauma in first responders and healthcare professionals isn’t always connected to one catastrophic event. Cumulative trauma can develop through repeated exposure to distressing or potentially traumatic situations over the course of a career.

There can also be experiences that hit differently because of the circumstances surrounding them. A call may remind you of your own family. A patient may be particularly difficult to forget. You may have known what someone needed but been unable to provide it because of staffing, resources, policies, safety concerns, or circumstances outside your control.

These experiences can sometimes contribute to moral injury. That is, the distress that can occur when you’ve witnessed, participated in, or been unable to prevent something that conflicts with your personal values, beliefs, or sense of what should have happened. Moral injury can leave people with guilt, anger, shame, helplessness, or questioning their own integrity and identity.

Continued functioning despite trauma symptoms

One reason occupational trauma can be difficult to recognize is that struggling doesn’t necessarily look like being unable to function, especially in earlier stages. Professionals often continue working and may appear unaffected.

Changes in mood and behaviour can onset gradually. Some examples can include: less patience, difficulty leaving work at work, feeling numb or engaging in behaviours that numb emotions. Being affected by the work doesn’t mean you’re no longer capable of doing it. It may simply mean that your mind and body have been asked to carry a lot for a long time.

How trauma therapy can help

Trauma therapy can help you understand how difficult or traumatic experiences continue to affect your emotions, thoughts, relationships, and responses to situations in the present. Therapy cannot erase or undo what happened. Instead, treatment focuses on reducing the ongoing impact of the experience and helping you feel more able to respond to the present without being overwhelmed by reactions connected to the past.

Specific trauma therapy focuses on three different phases which include: (a) stabilization, (b) trauma processing, and (c) reconnection. These phases are generally worked through in this order to best support recovery.

Stabilization

Before processing traumatic experiences, therapy focuses on developing strategies for managing emotions, physical reactions, anxiety, sleep difficulties, and other symptoms. This is a crucial step to improve your most immediate concerns and eventually to prepare you for trauma processing.

Learning about trauma can help make sense of reactions that otherwise feel confusing or difficult to control. This may include understanding why you feel constantly on guard, avoid certain situations, become overwhelmed by reminders, experience intrusive memories, or feel emotionally numb or disconnected.

Processing traumatic experiences

Evidence-based trauma therapies can help people process distressing memories and change some of the beliefs, emotions, and responses that have remained connected to what happened. Depending on the treatment approach, this may involve working with memories, thoughts, emotions, avoidance patterns, or physical responses associated with the experience.

Trauma processing should be collaborative and purposeful. You do not necessarily need to describe every detail of what happened, and treatment should not involve being pushed to disclose experiences before you are ready. Traumatic experiences can influence how you understand yourself, other people, and the world around you. You may find yourself thinking, “I should have done something differently,” “I can’t trust anyone,” or “I’m not safe even when nothing is wrong.”

Therapy can help identify and work through beliefs related to guilt, shame, responsibility, trust, safety, control, and self-worth that may have developed or become stronger following traumatic experiences.

Reconnection

Trauma therapy can help you gradually reconnect with situations, relationships, activities, or parts of yourself that have become associated with fear or distress. That is, getting you back into the world and living a full life again.

The goal of trauma therapy is not to forget what happened. It is to help the experience take up less space in your present life, so that decisions are increasingly guided by your current needs, values, and circumstances rather than by the ongoing effects of the trauma.

Specific therapy approaches for the treatment of trauma and PTSD

EMDR therapy

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based trauma therapy approach. EMDR uses bilateral movements to help reduce distress associated with traumatic memories. More information about EMDR therapy can be found at the National Centre for PTSD website.

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy or CPT is a type of therapy that focuses on the belief systems that develop from traumatic events. Read more about CPT on the National Centre for PTSD website.

Prolonged Exposure (PE) Therapy

PE is a therapy approach developed to treat the diagnosis of PTSD. PE reduces distress and PTSD symptoms by repeatedly exposing the person to the traumatic material. You can learn more about PE at the National Centre for PTSD.

Trauma-focused Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is a therapy approach that addressed the interaction of our thoughts, feelings, and behaviours.

Other trauma therapy approaches

Several other therapy approaches are being explored for trauma therapy and PTSD treatment. Some of these include:

Somatic approaches (body based therapies)
Psychodynamic therapy approaches
Art and music therapies

Therapists treating trauma and PTSD

Trauma therapy in Edmonton | Contact Us

Mendable Psychology | Edmonton Psychologists | Trauma and PTSD Counselling

Office located in Mayfield West Edmonton