Therapy for Trauma, Complex Trauma and PTSD

Trauma can take many forms. It may result from a single overwhelming event, or from experiences that unfolded over months or years. Sometimes the effects are immediately recognizable; at other times, people come to therapy because of anxiety, depression, difficulties in relationships, shame, self-blame, or a persistent sense that something from the past continues to shape their lives in ways they don't fully understand.

 

I specialize in working with adults who have experienced trauma and PTSD, including complex, relational, and longstanding trauma. With more than 30 years of experience as a clinical psychologist, I approach trauma treatment with the understanding that there is no single way to heal and no one treatment that is right for everyone.

 

Understanding Trauma and PTSD

 

After a traumatic experience, the mind and body can continue to respond as though the danger has not entirely passed. Some people experience intrusive memories, nightmares, heightened anxiety, avoidance, or a sense of always being on guard. Others feel emotionally numb or disconnected, struggle with guilt or shame, or find that their relationships and sense of themselves have changed. Trauma can also be less obvious. Experiences from childhood or within important relationships may continue to influence how we understand ourselves and others and impact what we expect from relationships, how safe it feels to trust or depend on someone, and guide the ways we respond to vulnerability, conflict, rejection, or loss. You do not need to have a diagnosis of PTSD to benefit from trauma-focused therapy. Sometimes people simply know that something they have lived through continues to have an emotional hold on them.

 

Complex, Relational, and Longstanding Trauma

When difficult or traumatic experiences occur repeatedly, particularly early in life or within important relationships, their effects can become woven into a person's sense of self. Sometimes there was no single event that felt traumatic; instead, a person may have grown up feeling unsafe or walking on eggshells, having to take care of others, or learning that their own needs and feelings could not reliably be expressed.

Years later, these experiences may show up as longstanding feelings of shame or inadequacy, difficulty trusting others, fear of abandonment, emotional overwhelm or disconnection, or painful patterns in relationships that can be difficult to understand or change. Therapy for complex trauma often involves more than processing particular memories. It can mean understanding how earlier experiences became part of the way you see yourself and relate to other people, and gradually developing different ways of experiencing yourself, your relationships, and your emotional life.

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My Approach to Trauma Therapy

 

My approach is psychodynamic and relational at its core. Together, we work to understand not only what happened, but how your experiences continue to shape your sense of self, your relationships, and the ways you move through the world. For some people, this broader exploratory psychotherapy is the heart of the work. For others, a more focused trauma treatment can be extremely helpful. Often, the two approaches complement one another. When appropriate, I incorporate evidence-based treatments developed specifically for trauma and PTSD, including Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing (EMDR).

 

Cognitive Processing Therapy (CPT)

 

CPT is an evidence-based treatment for PTSD that focuses on the ways traumatic experiences can affect beliefs about ourselves, other people, and the world. Trauma can leave people with deeply held conclusions involving blame, safety, trust, control, intimacy, or self-worth. CPT helps identify and examine these beliefs so that the experience can be understood in a way that is more accurate, compassionate, and less constricting. I am certified in CPT and may recommend it when a more structured approach to PTSD would be useful.

 

EMDR

 

EMDR is another evidence-based approach to trauma treatment. It is designed to help the brain process traumatic memories that can continue to feel emotionally immediate even when we know intellectually that the experience is in the past. I have training in EMDR and incorporate EMDR into my trauma-focused work when clinically appropriate. Neither CPT nor EMDR needs to exist separately from a broader psychotherapy. Depending on what you need, we may use one of these approaches for a period of focused trauma work while continuing to attend to the larger emotional and relational issues that brought you to therapy.

 

Medical Trauma, Chronic Illness and Major Life Changes

 

For 30 years, I served as Director of Psychological Services in Rehabilitation Medicine at Jacobi Medical Center and North Central Bronx Hospital. This work gave me extensive experience helping people and families cope with serious illness, injury, chronic pain, disability, loss of functioning, and sudden changes in the course of a life. Medical experiences can be traumatic in ways that are sometimes overlooked. An unexpected diagnosis, frightening hospitalization, painful treatment, accident, surgery, or loss of physical independence can profoundly alter a person's sense of safety and identity. For people facing these experiences, therapy may involve both processing what has happened and coming to terms with a life that may feel different from the one you expected.

 

Finding the Right Approach for You

 

I don't believe trauma treatment should be one-size-fits-all. Having training in specific trauma treatments is important, but so is knowing when to use them and when something different is needed. Some people come to therapy wanting to work directly on a traumatic experience. Others initially want help with depression, anxiety, grief, relationship difficulties, or a major life transition and only gradually recognize the role that earlier experiences may be playing. We can decide together what kind of work makes the most sense for you. Treatment may be focused and structured, more exploratory and open-ended, or a thoughtful combination of the two.

 

Trauma & PTSD Therapy in NYC and Westchester

 

I see adults in person at my office on the Upper West Side of Manhattan and in Westchester County. I also offer secure virtual therapy throughout New York State. I offer a free 15-minute phone consultation, which is a chance to talk briefly about what brings you to therapy, what you're looking for, and whether we might be a good fit. I'd be glad to hear from you.