When what happened keeps happening inside you
After a very hard experience, it is normal for the mind and body to react. Sometimes these reactions don’t fade with time. Here I explain why, which treatments are validated by research, and how I work, in particular with EMDR.
What is post-traumatic stress?
A traumatic event is a situation in which your life or physical integrity, or that of someone close to you, was threatened: an accident, an assault, an unexpected death, a disaster… Afterwards, many people have intense reactions for a while. When these reactions last more than a month and disrupt daily life, we speak of post-traumatic stress disorder (PTSD).
Its symptoms fall into four groups
Re-experiencing
Intrusive memories, nightmares, the feeling of reliving the scene, or intense reactions to anything that brings it back.
Avoidance
Efforts not to think or talk about it, or to avoid the people, places or situations that bring it back.
Changes in mood and beliefs
Guilt, shame, a sense that the world is dangerous, feeling detached from others, difficulty feeling positive emotions.
Being on alert
Startling easily, irritability, problems with sleep and concentration, feeling constantly on guard.
Between a third and a half of people exposed to a traumatic event develop the disorder; the others recover naturally. No reaction is a reason to feel ashamed.
What makes trauma more likely to take hold?
It doesn’t depend only on the event. Research distinguishes three groups of factors:
Before the event
Earlier characteristics and circumstances that make a person more vulnerable.
During the event
Its intensity, whether it involved interpersonal violence (especially from someone you depend on), or dissociative reactions at the time.
After the event
Very negative interpretations of what happened, unhelpful coping strategies, ongoing exposure to reminders and, above all, little social support.
Symptoms often start within the following three months, but sometimes appear much later. They can ease over time or flare up again under new stress.
Why doesn’t trauma just “pass”?
A memory that could not be processed
Two ideas help explain it. According to two-factor theory, everything associated with the event (a smell, a place, a sensation) learns to trigger the same fear; avoiding it brings relief but keeps the problem going. According to information-processing theory, when you avoid processing what happened emotionally, the memory is not integrated and keeps “popping up” as images, nightmares or reactions.
Something brings it back
Something outside or a thought activates the memory.
Intense reaction
Body and mind react as if it were happening now.
Avoidance
You push the memory away or avoid certain situations so as not to feel it.
Relief… and the memory stays intact
Unprocessed, the memory keeps its full charge.
That is why effective treatments have one thing in common: they help you approach the memory safely and gradually, so it is integrated and loses its charge, and they help you revisit the beliefs the trauma left behind (for example “it’s my fault” or “I’m not safe anywhere”).
What research says
The American Psychological Association’s clinical practice guideline (APA, 2020) ranks psychological treatments for PTSD according to the strength of the evidence:
Trauma-focused CBT
It includes cognitive processing therapy, cognitive therapy and prolonged exposure. They work on trauma-related beliefs and gradual exposure to the memory.
EMDR
Eye Movement Desensitisation and Reprocessing. The APA gives it a conditional recommendation; the World Health Organization lists it, together with trauma-focused CBT, among the recommended treatments for post-traumatic stress.
Other therapies
Narrative exposure therapy and brief eclectic psychotherapy also have support, though more limited.
“Conditional” means that the treatment can be effective, but the evidence is weaker or does not apply in the same way to everyone. We choose the approach together, based on your history and your preferences.
How I work with trauma
Assessment and safety
We look at what happened, how it affects you today and, if useful, use validated questionnaires. Before touching memories, we make sure you have stability and resources.
Understanding your reactions
Psychoeducation: knowing why you react this way removes a lot of guilt and fear.
Processing the memories
With EMDR or trauma-focused CBT techniques, at your pace, and without having to tell everything in detail if you don’t want to.
Getting your life back
Returning to the places and activities you have been avoiding, revisiting the beliefs left by the trauma, and preventing relapse.
I am trained in EMDR (Standard Training accredited by EMDR Europe) and I work integratively with CBT and ACT.
What you can start doing today
Anchor your body in the present
When a memory overwhelms you, name five things you can see and feel your feet on the floor. It reminds you that you are here, now.
Breathe more slowly
Breathing out slowly helps calm the activation of your nervous system.
Don’t stay alone
Social support is one of the most protective factors. You don’t need to tell everything to feel supported.
Look after your sleep and the basics
Regular hours, less alcohol and caffeine. A body on alert needs calming routines.
Gonzalo Garzo
Clinical psychologist · trained in EMDR (EMDR Europe)
I have been a clinical psychologist since 2018, and I am also an anthropologist. For years I combined psychology with management positions (see my LinkedIn profile), before dedicating myself fully to clinical work.
I work with an integrative approach: CBT, third-wave or contextual therapies (especially ACT, DBT and mindfulness), EMDR and humanistic psychology, adapted to each person’s needs.
I have lived in several countries and I can support you in English, French or Spanish, online or in La Rochelle.
Frequently asked questions
Do I have to tell everything that happened?
Not necessarily, especially at the beginning. We move at your pace. Some techniques, such as EMDR, don’t require you to describe the event in detail.
What is EMDR?
A therapy that combines recalling the memory with bilateral stimulation (eye movements, or alternating sounds or taps), within a structured protocol. It helps the memory to be processed and lose its emotional charge.
Can EMDR be done online?
Yes, with adaptations to the protocol and close attention to the safety of the session. We assess it according to your situation.
What if the trauma happened a long time ago?
It can still be treated. Symptoms can appear or come back years later, and it is not too late to work on them.
Shall we talk?
Sources
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- American Psychological Association (2020). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder.
- Astin, M. C. & Resick, P. A. (2002). Tratamiento cognitivo-conductual del trastorno por estrés postraumático. In Caballo, V. (Dir.), Manual para el tratamiento cognitivo-conductual de los trastornos psicológicos, vol. 1. Siglo XXI.
- World Health Organization (2013). Guidelines for the management of conditions specifically related to stress.
This page is for information only and does not replace a professional assessment. If you are in danger or in crisis, contact emergency services (112 in Europe, or your local emergency number). In France, you can also call 3114, the national suicide prevention line.