Taking The Leap: Seeking Initial Counseling After A Trauma

Medically reviewed by Andrea Brant, LMHC
Updated August 17, 2023by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Has Deep Distress Changed Your Outlook On Life?

For many, it can be a challenge to accept that they need help from others when trying to get on track and find their way after a traumatic experience. It can be humbling to accept that letting someone else it can help you to begin to feel healthy and happy again. Trauma can happen to anyone at any time, leaving many individuals to develop Post-Traumatic Stress Disorder (PTSD). 

70% of adults in the United States have experienced some kind of traumatic event in their life. Of those people, as many as 20% of them will develop Post-Traumatic Stress Disorder.

What Is Trauma?

Trauma can be anything that happens in your life that has a lasting impact and causes deep distress. It could be something as seemingly inconspicuous as a nasty comment made by a loved one or more of a physical trauma like an assault or car accident. It could be something from your childhood that you do not even consciously remember. You could also experience trauma from witnessing a serious or frightening scene, such as the mistreatment of someone else, that can affect you for weeks, months, or years to come. 

PTSD from trauma may also be caused by something like being diagnosed with a serious medical condition such as cancer or heart disease. Trauma is essentially a lasting marker in the brain resulting in unpredictable emotions, flashbacks, feelings of numbness, moments of dissociation, or even physical symptoms like nausea or headaches.

Trauma Is Multifarious

No case and no person are the same; while the same event may leave a lasting impact on one person, another may not be as deeply impacted. That same person may falter in another situation, as individual resiliency is idiosyncratic and hard to predict. We expect those exposed to a natural disaster, violent attack, or car crash to be traumatized by their experience, while forgetting that some traumas are more difficult to recognize, like racism, oppression, or discrimination.

Our society has deeply rooted patterns and mechanisms that can lead to the suppression of people based on their gender, race, or ideology. These can be traumatic experiences for individuals. Certain concessions that we encounter daily may not seem abnormal but may also be maladaptive coping that we utilize to survive trauma. These things affect us on a deeper level than we may recognize, validating a call for reflection into our existing thought patterns and schemas.

Some Causes Of Post-Traumatic Stress Disorder

Although military combat is an obvious cause of post-traumatic stress disorder, it is not the only cause. Traumatic experiences encompass a wide range of life events, and any of these may trigger a person to develop PTSD. Some of the most often reported causes include:

  • Violent physical attack.
  • Rape or sexual assault.
  • Serious accidents such as car or plane crash.
  • A natural disaster such as a tornado, hurricane, flood, or earthquake.
  • Abuse, neglect, or bullying.
  • Racial trauma.
  • Domestic violence.
  • Childbirth.
  • Witnessing or surviving a terrorist attack or other act of violence.
  • Serious illness.
  • Losing a loved one.
  • Fearing for your life for any reason.
  • Caring for others who are in a traumatic event (first responders).

If you are facing or witnessing the abuse of any kind, the National Domestic Violence Hotline is available. Call 1-800-799-SAFE (7233) or Text "START" to 88788. You can also use the online chat.

First Responders

One particular group of individuals who deal with trauma regularly is at high risk for developing post-traumatic stress disorder. These people include police officers, ambulance drivers or paramedics, emergency medical technicians (EMTs), firefighters, doctors, and nurses, search and rescue teams, the Coast Guard, and so on. The trauma they experience can have a widespread impact on their mental health. There are special assessments and support groups for first responders who think they may need help.

Shock To The System

Post-traumatic stress disorder, while often associated with military post-combat, is something that can develop in any individual who has experienced some sort of shocking or traumatizing event. A study done in Chicago, Illinois found that 43% of those patients who visited the Cook County Hospital were experiencing post-traumatic stress disorder, and most of them were gunshot or stabbing victims. 

When you encounter a stressor or experience a trauma, your nervous system reacts by releasing certain chemicals that elicit particular survival responses. This is known as the infamous fight or flight response, characterized by the activation of the sympathetic nervous system, meant to keep the individual from harm.

The Fight Or Flight Response

The fight or flight response, which is also known as the acute stress response, was discovered by physiologist Walter Cannon while studying the sympathetic nervous systems and stress response of animals during digestion. During the fight or flight response, the heart rate is high, and blood is mobilized toward the arms and legs, leaving less energy to be used for cognitive functions or immunity. This is why your thinking may seem fuzzy or muted during periods of fight or flight. 

People in this state may make rash decisions that are not based on clear thinking. With post-traumatic stress disorder, this response is elicited more frequently, leading the individual to experience extreme distress due to an over-reactive nervous system keeping them on edge and expecting a threat, even if there may not be an actual threat at that moment.

How Do You Know If You Have Post-Traumatic Stress Disorder?


Immediate counseling after traumatic event is uncommon, and many people may not know that they are experiencing post-traumatic stress disorder until something happens that causes a noticeable reaction. For example, you may be having nightmares but not connect the two until the nightmares become worse or you start being unable to go places or talk to people. You may experience a panic attack or overwhelming emotions without seeming cause at work or school. Here are some of the most common symptoms of PTSD:

  • Nightmares
  • Flashbacks (reliving the traumatic incident)
  • Terrifying images or thoughts
  • Panicking when you see or hear something that reminds you of the traumatic incident
  • Aggravation or feeling on edge
  • Dissociation (not being aware of where you are)
  • Trouble concentrating
  • Inability to sleep or stay asleep
  • Lack of sexual drive
  • Inability to do certain tasks
  • Lack of interest in normal activities you usually enjoy
  • Trembling, shaking, shivering
  • Reckless or self-destructive behavior
  • Panic attacks (rapid heart rate, sweating, shaking, nausea, agitation, feeling like you are going to die)
  • Avoiding certain places or people that remind you of the traumatic incident
  • Depression, feelings of sadness
  • Feeling numb or cut off
  • Feeling alone or like nobody cares
  • Self-medicating with drugs or alcohol
  • Inability to have a lasting relationship
  • Guilt or hopelessness
  • Lack of appetite
  • Chronic pain or nausea
  • Blaming yourself for the traumatic incident
  • Constant anger or shame
  • Thoughts of harming yourself or others

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available to assist 24/7.

If you have any of these symptoms related to post traumatic stress disorder, it may be time for you to talk to someone. Whether it is a friend or a therapist, you may benefit from telling someone what you are experiencing. You may have trouble keeping a job, having a lasting relationship, and caring for yourself. In addition, continual stress can contribute to physical problems like heart disease or stroke. Letting someone trusted to know what you are going through can open up a potential avenue of healing.

Initial Counseling

Here are two common initial counseling methods that may help you after experiencing a trauma.

Has Deep Distress Changed Your Outlook On Life?

Cognitive Behavioral Therapy

Treatment for those who have experienced trauma is unique in every case, but usually involves some form of cognitive behavioral therapy (CBT) to attempt to recognize and smooth out the existing triggering thought patterns and behaviors and replace them with healthier and less reactive ones. Cognitive behavioral therapy can be used to address all kinds of mental health disorders such as depression, trauma, bipolar disorder, and generalized anxiety disorder. It works by breaking down the link between the mind (cognition) and the body (behavior). The initial session typically involves the therapist completing an assessment to determine whether you have PTSD and other mental health disorders such as depression, disassociation, and anxiety. From there, you and your therapist will work together to determine avenues and goals for treatment.

Trauma treatment typically, but not always, takes about five to 15 sessions that last between 30 and 60 minutes, depending on the cause and severity of the post-traumatic stress disorder. The premise behind cognitive behavioral therapy is to establish coping strategies that target problem behaviors and thought patterns, essentially bolstering positive coping strategies and thought patterns in the brain through attended, repeated exercises. 

Online Therapy

Although visiting with a therapist can be intimidating, the internet has allowed for the emergence of online interfaces like BetterHelp.com, which help to remotely connect those needing help with appropriate licensed mental health professionals. BetterHelp.com is the largest mental health care resource in the world with over 20,000 licensed therapists and counselors to help you.

With online therapy, you can interact with a therapist or counselor however and whenever you want and you do not even have to leave your house. This is especially good for those people who are experiencing post-traumatic stress disorder which makes it difficult to leave the house. Online therapy can be conducted via video conferencing, texting, email, telephone, and instant messages. By identifying and working through our traumas and how they affect us, we can find ways to cope and live a more satisfying and comfortable life.

Online therapy is just as effective as in-person therapy for a variety of conditions and concerns, including PTSD and trauma. A 2020 meta-analysis evaluated 15 studies conducted on the efficacy of online therapy for PTSD treatment. This analysis found that quality of care, patient satisfaction, and reduction of PTSD symptoms with online therapy were all comparable to those of in-person therapy.

Trauma-informed Therapy for Longstanding PTSD

For those who have experienced a traumatic event in the past and are currently experiencing symptoms of PTSD, there are some forms of trauma treatment that are used to help manage symptoms and decrease the emotional impact of the experience over time. These include:


Eye movement desensitization and reprocessing (EDMR) is an interactive form of trauma therapy that uses specific eye movements along with talk therapy to help process a negative experience such as a sexual assault or other violent attack. It targets the memory itself, and uses bilateral movements to decrease the physical and mental impacts of that memory to improve mental health. EMDR may also be done online, though it can be difficult to find an online EMDR practitioner. 


Cognitive Processing Therapy (CPT) is a specific type of cognitive behavioral therapy. It is different than eye movement desensitization and reprocessing because instead of focusing on the traumatic experience itself, it guides trauma survivors through the emotions connected to the experience. With CPT, your trauma therapist offers strategies to analyze and challenge thoughts surrounding your trauma, to attempt a new perspective. Like CBT, CPT can be done either in person or online. 

Exposure Therapy

This form of trauma treatment that encourages patients to confront their fears in a safe environment, to break the pattern of avoidance and fear. Like EDMR it is trauma focused. For example, if a client experienced a deadly tornado, their therapist may slowly incorporate photos and live footage of natural disasters into their sessions. VR, visualization, and real-life exposure may also be used to help people recover from their trauma responses. Some forms of exposure therapy are tailored for in person sessions, though other forms may be done online as well.


Anyone can experience trauma and PTSD, regardless of age, gender, economic status, race, sexual orientation, or religion. Trauma can be difficult to recognize in ourselves, and is often a humbling experience to work through, at least partially because it can often require asking for help from others. We cannot, nor should we, try to work through and fix everything on our own. Trauma affects our mind and body in a variety of ways and can worsen if not properly addressed and work through. Therapy, whether in-person or online, can help, as can reaching out to family or other loved ones, going to support groups, journaling, and practicing meditation. 

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