PTSD and trauma therapy

What PTSD is

PTSD follows an event that overwhelmed your capacity to act: a traffic accident, an assault, a robbery, a fire, a violent birth, a period in intensive care, witnessing a death. Afterwards the event does not settle into the past. It keeps intruding into the present.

Four things usually appear together:

• Intrusion. Images, flashbacks, nightmares. The memory arrives whole and unbidden, and carries the body sensations with it.
• Avoidance. Of the place, the road, the smell, the conversation. And of the feeling itself.
• Arousal. Startling at nothing, scanning rooms, sleeping badly, a temper that arrives before you do.
• Changes in mood and thinking. Guilt about what you did or did not do. A sense that the world has become fundamentally unsafe.

Why it does not fade on its own

Most people recover from a frightening event without treatment, and that is worth saying clearly. PTSD develops when the memory could not be processed — usually because the feelings that belonged with it were too much to have at the time.

Avoidance then seals it. You never get near the memory long enough for your nervous system to learn that it is over. So it stays live, and every year of avoiding confirms it.

How we treat it

Two approaches, often combined, chosen to fit you rather than the other way round:

• ISTDP works with the feelings underneath — the terror, the rage, the guilt — and with the defences you built to keep them out. It handles the part of trauma that is not really about memory at all.
• EMDR works directly on the memory itself and is particularly effective for single, bounded events.

Before either, we make sure you can feel something strong without either exploding or going blank. Skipping that step is the most common reason trauma therapy fails.

If it started in childhood, or went on for years

Then it is likely complex PTSD, and the treatment is genuinely different — slower at the start, and focused on regulation and sense of self before the trauma material. That is our particular specialism.

After an accident at work or on the road

Many people in Denmark are covered for psychological treatment after an accident, either through their employer's insurance, their own accident cover, or a scheme like Falck Healthcare or Dansk Krisekorps. We work with several of these directly. See insurance and reimbursement.