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Post-Traumatic Stress Disorder (PTSD)

We all have a healthy internal alarm system designed to keep us safe by alerting us to threats. Following a traumatic event, these alarm systems might become more sensitive, especially to things that remind you of the trauma, even if the thing itself isn’t actually dangerous. 


In Post-Traumatic Stress Disorder (PTSD), you may become hyperaware of these things, which act as triggers to your now overly-sensitive alarm system. Ordinary stimuli – certain smells, raised voices, a loud noise – now set the alarm off, and the alarm tries to help by heightening your anxiety and bringing to your attention all the dangers it thinks you may be exposing yourself to. It draws vivid reminders of your trauma to the front of your mind, which might make you feel like you are flashing back to the traumatic event itself. 


People with PTSD often report feeling constantly on edge, and they tend to avoid certain people, places, and situations for fear of triggering their alarm. They may experience ‘reliving’ symptoms via flashbacks and nightmares, which only reinforce their anxiety and avoidance. 

CBT for PTSD can help recalibrate the alarm, helping it to distinguish between ‘then-world’ threats and ‘now-world’ realities. In do so, our Penrith Clinical Psychologists can help you to feel more secure in your day-to-day life.

PTSD overview

PTSD occurs when fear, anxiety symptoms, and memories don’t go away or reduce as would otherwise typically be expected after a traumatic event, such as an accident, injury, assault, natural disaster or combat exposure.

They symptoms can be prolonged, and they impact how people cope in their day-to-day lives.

PTSD symptoms vary between people, and the intensity of symptoms can vary within a person’s experience. They may appear soon after the traumatic event, or they may first appear many years later.

PTSD symptoms

A person with PTSD might experience nightmares and/or flashbacks, in which it feels like their traumatic experience is happening again. They may have unwanted, repetitive memories of the trauma, often triggered by stimuli (e.g., sounds, smells, features) associated with the trauma.

PTSD is usually characterised by avoidance strategies. People may avoid places, people, activities, objects or situations that may be associated with the traumatic event. They may try to avoid remembering it, or they may resist talking about it.

A person with PTSD might develop persistent, unrealistic beliefs about themselves, others, or the world in general. They might experience difficulties tolerating or processing a combination of emotions, such as fear, anger, guilt, and shame.

Physiologically, PTSD usually manifests as heightened arousal, or feeling ‘on-edge’. This might coincide with feeling always on the lookout for danger, or being ‘jumpy’. In addition, the person with PTSD might experience reduced concentration, poor sleep, changes to appetite, reduced engagement in usual activity, and feelings of isolation.

PTSD treatment

Cognitive Behavioural Therapy has been widely researched and demonstrated as an effective framework to treat PTSD.

Following an assessment, a highly individualised plan is designed to address the specific experiences and symptoms of the person with PTSD. At Boyce & Dale Anxiety and Mood Disorders Clinic, our Clinical Psychologists will help you to understand the relationship between your thought patterns, feelings and physiological responses, and behaviours.

Importantly, they will then work with you on a plan to make healthy changes therein. This will involve better recognising and then challenging unhelpful/unrealistic thoughts, learning to better manage physiological symptoms, and reducing reliance on ultimately maladaptive behaviours.

Exposure may form a part of this process. It is a powerful strategy used to help people face and cope with situations and memories that feel too distressing to confront. It can be particularly helpful to address flashbacks and nightmares associated with past trauma.

Other options? We are continuing to learn more about PTSD and effective treatment as research continues. Medication can play an important role in conjunction with psychological therapy, and other modalities of psychological therapy have also been bringing about positive outcomes. Our focus at Boyce and Dale Mood and Anxiety Disorders Clinic at this time remains the delivery of CBT for PTSD.


If you have symptoms of PTSD, you have clearly already been through a lot. Remember, psychological therapy is meant to be helpful and empowering. A good CBT programme will be tailored to your specific needs, and you will be collaborating on it as it proceeds. Your pace is the right pace.

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