Post-traumatic stress disorder (PTSD) - a brief exploration

What Is PTSD?

During World War 1, the term Shell Shock was used to describe what was initially thought to be the effect of intense artillery fire on those involved in warfare, but was later understood as the result of stress soldiers experienced in intense combat. The term PTSD became well known when it was associated with veterans of the Vietnam War, and was later mentioned in the third edition of the American Diagnostic and Statistical Manual of Mental Disorders in the early 80s.

Today, PTSD is researched, understood and valued by many as a very real and impactful mental health condition. PTSD is used to describe a range of symptoms people may develop in response to experiencing events outside of their normal range of experiences, such as natural disasters, mass catastrophes or serious accidental injuries.


PTSD often has a delayed response, meaning an individual may not experience its symptoms at the time. It is common for people to feel distressed, confused and upset in the wake of a traumatic event, and may also feel emotionally numb, withdrawn or detached.

The impact, effects and psychological difficulties experienced through PTSD are diverse, depending on the individual, and there is no typical pattern in which PTSD occurs, furthermore, not all those who experience traumatic experiences develop PTSD, and of those that do, some may experience prolonged difficulties, whereas others find their symptoms disappear in a relatively short space of time.

Below are some of the symptoms an individual may experience with PTSD.

Reliving aspects of the trauma

  • vivid flashbacks – feeling the trauma happening again

  • intrusive thoughts or images

  • experiencing nightmares

  • intense distress at real or symbolic reminders or representations of the trauma

  • physical sensations - shivering, trembling, sweating or nausea. 

Feeling on edge

  • panicking when reminded of the trauma

  • becoming easily upset or angry

  • disturbed sleeping patterns, or lack of sleep

  • aggressive, irritable behavior

  • difficulties concentrating

  • easily startled or frightened

  • self-destructive or reckless behaviours.

Avoiding feelings

  • unable to express affection for others

  • using alcohol or drugs to avoid painful memories

  • keeping busy

  • repressing memories or unable to remember aspects of the event

  • feeling detached or numb

  • avoiding situations which remind you of the trauma.

Some people who experience PTSD may also develop other mental health difficulties, which could include:

  • severe anxiety or panic

  • a phobia

  • differing levels of depression

  • a dissociative disorder

  • suicidal thoughts and feelings.


The situations and experiences which people find traumatic vary, however PTSD typically develops from situations which are life threatening, disturbing and highly traumatic. These could include:

  • a serious accident, such as a car crash

  • an event where you feared for your life

  • personal assaults such as rape, sexual assault or a violent attack

  • childhood sexual abuse

  • a traumatic childbirth, either as a mother or partner

  • witnessing a violent death

  • extreme war or combat

  • a natural disaster

  • losing someone close to you in disturbing circumstances.

There are other factors which can make people more vulnerable to developing PTSD, or could even make the symptoms experienced more severe. These could include:

  • experiencing repeated trauma, as a soldier in war, or a civilian experiencing war

  • having little support from family, friends or professionals

  • previously experiencing anxiety, depression or other mental health difficulties

  • dealing with added stress at the time, such as a bereavement.

If you experiencing trauma at an early age or if the trauma was extended over a period of time, as in the case of prolonged childhood abuse, then you may be diagnosed with what is known as ‘complex PTSD’, meaning that treatment required is more long term and intense, than that which is needed to recover from a one off traumatic event. Of course, there are no absolutes with PTSD, and each individual will respond to prolonged or one off experiences differently.


After a traumatic event, many people find it hard to accept what has happened, and may behave as if nothing bad occurred. This response may allow time away from the trauma, and subconsciously, you may be beginning to process what you experienced. When you are ready, you may find some of the following ideas helpful.

Talk to someone

Talking about your experiences can be a good way of coming to terms with what happened, and turning to friends or relatives, or seeking professional help can assist you in the first stages of understanding your trauma.

Talk to people with similar experiences or contact an organisation

It may be helpful to share your experiences with others who have been through something similar. This can be an extremely important step in moving away from isolation and towards regaining control. There are many UK organisations which can assist, such as Assist Trauma Care, Combat Stress or Freedom From Torture. Taking the first step in searching your local area will make a big difference to you gaining ownership of your life, and realising that your past experiences do not own you.

How psychotherapy can help

Psychotherapy can assists you in delicately exploring your trauma, and seeing how your past experiences have impacted your feelings in the present. In a safe environment, you can explore the emotional responses you have experienced through your trauma, and can go at your own pace to learn ways to manage these intense emotions and feelings.

In closing

What makes traumatic experiences so difficult to manage and process, is that they undermine our fundamental beliefs we hold that our lives are safe, secure and manageable. They are outside of our normal range of experience, which makes them shocking, overwhelming and powerful.

Everyone has a unique response to trauma, and will proceed at their own pace. Talking before you want to may not be helpful for you and it may take you a little more time before you feel ready to speak.

By seeking the right support and learning to understand and manage the impact of these experiences, you can find light, movement and progression, and move toward seeing you are not bound to, or owned by your past experiences.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London N6 & NW5
Written by Joshua Miles, BA, MSc, BPC, BACP Accredited Psychodynamic Psychotherapist
London N6 & NW5

Joshua is an experienced integrative psychotherapist. He has assisted people in exploring their past experiences at depth & worked with them to make connections between their experiences and their current difficulties, and helps them to form strategies to cope and manage. He is based in Shoreditch, East London, & works with adults of all ages.

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