PTSD and trauma

What is PTSD?

Post-traumatic stress disorder, or PTSD, is a set of psychological and physical responses that can develop after a deeply distressing or frightening event. It affects how the brain processes memory and threat, so the past can feel like it is still happening. Support is available for adults across Bromley.

The events that lead to PTSD vary widely. Road traffic collisions, serious illness or medical procedures, physical or sexual assault, bereavement in traumatic circumstances, domestic abuse, witnessing violence, and experiences during childbirth can all trigger it. What matters clinically is not how an event might look from the outside, but how threatening and overwhelming it felt to the person living through it. Two people can go through similar circumstances and have very different responses, and neither reaction is more valid than the other.

PTSD is not a sign of weakness or a character flaw. It reflects a nervous system that has learned, understandably, to stay alert to danger even once the danger has passed. Clinical psychologists for Bromley and south east London work online with adults to help that system settle and to process memories that have become stuck rather than filed away as past events.

Symptoms of PTSD

Symptoms tend to fall into a few overlapping groups. Intrusive memories, flashbacks and nightmares bring parts of the event back uninvited, sometimes with the same physical sensations felt at the time. Avoidance follows naturally from this: people often steer clear of places, conversations, people or even thoughts connected to what happened, which can shrink daily life considerably.

Changes in mood and thinking are also common. These include persistent guilt or shame, a sense of detachment from other people, difficulty recalling parts of the event, or a shift in how safe the world feels generally. Alongside this, many people notice heightened alertness: being easily startled, struggling to sleep, feeling irritable, or scanning rooms and situations for signs of threat. Concentration often suffers too, particularly at work or in situations that demand sustained attention.

These symptoms can appear within weeks of an event or emerge months or years later, sometimes triggered by an unrelated stressful period. Their intensity can also fluctuate, easing for a while and then returning after a reminder, an anniversary, or a new stressful event.

Types of PTSD

PTSD following a single distressing incident, such as an accident or an assault, often has a fairly consistent pattern of symptoms centred on that one event. Complex PTSD is different: it tends to follow repeated or prolonged trauma, such as ongoing childhood abuse or domestic abuse over years, and usually includes additional difficulties with emotional regulation, self-worth and relationships, alongside the core PTSD symptoms.

Birth trauma and medical trauma are also recognised presentations, where a physically frightening or dangerous experience during childbirth or serious illness leaves a lasting stress response, even when the medical outcome was fine. Delayed-onset PTSD describes cases where symptoms do not appear until six months or more after the event, which can make the connection to what happened harder to see at first. A psychologist can help identify which pattern best fits your experience, since this shapes how treatment is structured.

How therapy can help

Therapy for PTSD works by helping the brain process a memory that has been stored in a way that keeps triggering alarm signals, so it can instead be filed as something that happened in the past. NICE guidance recommends trauma-focused cognitive behavioural therapy and EMDR, eye movement desensitisation and reprocessing, as first-line treatments for PTSD. Both have a substantial evidence base and are established rather than experimental options; they are the treatments most likely to help, based on research across large numbers of people.

Trauma-focused CBT works with the memories, thoughts and behaviours connected to the trauma directly, often including a structured account of what happened alongside work on unhelpful beliefs the event may have created, such as self-blame. EMDR uses guided eye movements or tapping alongside brief recall of the memory, which appears to help the brain reprocess it without the need for lengthy verbal description. Which approach fits best depends on the person, the type of trauma, and how memories are currently experienced.

Our approach

Work begins with time spent understanding what has happened and how it is affecting day-to-day life now, rather than moving straight into trauma processing. This assessment stage also covers current safety, sleep, and any other difficulties running alongside the trauma, such as low mood or heavy drinking, since these often need attention too.

Pace is agreed with you, not set in advance. Some people want to move into trauma-focused work quickly; others need longer to build a sense of stability and trust first. Sessions are held online, which many people find easier than travelling somewhere unfamiliar shortly after a difficult day, and which works well for adults across Bromley, Beckenham, Chislehurst, Shortlands, Bickley, Hayes and Petts Wood, as well as further into south east London. Bromley South and Bromley North stations put much of the area within easy reach of central London, but online sessions mean travel is not part of the process at all.

What does PTSD therapy involve?

A typical course starts with an assessment of the event, current symptoms and general wellbeing, followed by psycho-education about how PTSD develops and why the symptoms make sense given what happened. Grounding and stabilisation techniques are often introduced early, giving a way to manage flashbacks or high anxiety between sessions.

The central phase of treatment focuses on the trauma memory itself, using EMDR or trauma-focused CBT depending on what has been agreed. Sessions typically run weekly, each lasting around fifty minutes, though EMDR sessions sometimes run longer to allow a reprocessing sequence to reach a natural stopping point. Final sessions usually focus on consolidating progress, planning for possible setbacks, and agreeing what ongoing support, if any, might be useful.

When to seek help

It is worth speaking to a psychologist if symptoms have lasted more than a month, if they are affecting work, relationships or sleep, or if avoidance is starting to shrink your life in ways that concern you. There is no threshold of severity you need to reach first, and no need for a formal diagnosis before making contact.

If you are in crisis or thinking of harming yourself, contact your GP, NHS 111, the Samaritans on 116 123, or attend A&E. For everything else, an initial conversation with a psychologist is the most useful next move, since it allows your specific situation, rather than a general description of PTSD, to guide what happens next.