Trauma & PTSD

What trauma does

Trauma isn’t only what happened — it’s what the nervous system keeps doing with it afterwards. A memory that won’t settle fires as though the danger is still here: flashbacks, feeling permanently on guard, broken sleep, and the avoidance and numbing you use to get through the day. Whether it was a single event or years of it, the aim is the same in principle — helping the memory become something that happened, rather than something that keeps happening.

EMDR and trauma-focused CBT

For post-traumatic stress, the approaches with the strongest evidence — and the ones NICE recommends first — are EMDR and trauma-focused CBT. EMDR (Eye Movement Desensitisation and Reprocessing) is a structured way of reprocessing stuck memories so they lose their charge; you don’t have to talk through every detail for it to work. Trauma-focused CBT works directly with the memory and the beliefs it left behind, at a pace you control. For a single, discrete trauma, this is often where we start.

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When CAT is the better route

Single-event trauma and long-running, relational trauma aren’t the same problem. When the harm was repeated, early, or bound up with the people who were meant to keep you safe, it tends to live in patterns — in how you relate to yourself and others now. That’s where CAT fits. We map those patterns as reciprocal roles, and the reformulation letter — written to you early on — puts the story and its patterns into words, often for the first time. EMDR and CAT can also work alongside each other. The route is chosen together, at the first session. More on how I work.

What treatment looks like

Most courses run 12–20 sessions, sometimes longer for complex trauma. We don’t rush into the memory: the first phase is about safety and stability, so that the processing work, when it comes, is something you can hold. It isn’t instant, and I won’t pretend it is — but trauma responds well to the right approach, and you stay in control of the pace throughout.

Common questions

Do I have to describe what happened in detail? Not necessarily — EMDR in particular doesn’t require you to talk through every detail. We work at a pace you set.

Is it safe to “bring it all up”? We don’t dive straight in. The early work is stabilisation; processing only happens once you have the footing for it.

What if it was a long time ago? Trauma doesn’t have an expiry date — old memories respond to treatment just as recent ones do.

What’s the difference between EMDR, CBT, and CAT here? EMDR reprocesses the memory itself; trauma-focused CBT works with the memory and its meanings; CAT works the relational patterns that complex trauma leaves behind. We match the approach to what you’re carrying.