What is PTSD? Understanding the Survival Response and How to Heal
When most people search for "What is PTSD?", they are looking for more than just a clinical definition. They are looking for an answer to why they feel "on-edge," why they can’t sleep, or why the world suddenly feels like a dangerous place.
Understanding the biology of trauma reduces its impact. If you’ve experienced trauma and are haunted by past memories, feel anxious, or numb, remember: it’s a biological survival response, not a personal failing. Sometimes, this biological survival response can get stuck in the “on” position, causing these feelings and reactions to persist over time.
Your Brain’s Security System
To understand PTSD (or Posttraumatic Stress Disorder), it helps to look at the brain’s "smoke detector" — the amygdala. Its job is to spot danger and scream "Fire!" to get your body ready to fight, run, or freeze.
In a healthy system, once the fire is out, the alarm stops. But with PTSD, the smoke detector becomes hypersensitive, mistaking harmless triggers for real danger. For example, your brain may mistake a burnt piece of toast—a loud noise, a certain tone of voice, or a crowded room—for a massive house fire. Your body reacts with the same intensity as if the original trauma were happening right now because, to your nervous system, it is.
Common Signs and Symptoms of PTSD
PTSD symptoms typically manifest in four primary ways. Recognizing these is the first step toward trauma recovery:
Intrusive Memories (The "Flashback" Response):
Unwanted memories, nightmares, or intense emotional distress when something reminds you of the trauma. Your brain is replaying the tape because it hasn't figured out how to file it away as "past."Avoidance Behaviors:
Avoiding certain places, people, or thoughts that feel overwhelming. While avoidance is a natural protection tool, it can eventually make your world feel very small.Changes in Mood and Cognition:
Persistent negative beliefs about yourself or others
Feeling detached or "numb"
Difficulty experiencing positive emotions
Hyper-vigilance (The "On-Edge" Feeling):
Easily startled, always scanning the room for exits, irritability, and sleep difficulties. This is the physical "smoke detector" of the brain stuck in hyper-arousal.
Complex PTSD (C-PTSD) vs. PTSD
It is also important to distinguish between single-event trauma and Complex PTSD (C-PTSD). C-PTSD often results from prolonged or repeated trauma, such as childhood neglect or being in an abusive relationship. If you feel like your trauma is "part of who you are" rather than a single event that happened to you, your healing journey may require a more relational approach, but the goal remains the same: recalibrating your nervous system.
Why Trauma Therapy is the Next Step for Trauma Recovery
Understanding the "what" of PTSD is helpful, but the "how" of healing usually requires professional support. Unlike general counseling, trauma-informed therapy focuses on helping your nervous system reset and feel safe again.
Starting this journey can feel intimidating. As I’ve written before, Why Trauma Therapy is Hard, the process of healing requires us to face the very things we’ve spent years trying to avoid. But it is in that brave work that true relief—and a return to yourself—is found.
Evidence-Based PTSD Treatment: PE and CPT
When it comes to treating PTSD, we don’t have to guess what works. Decades of research have led to the development of highly effective, structured treatments. Two of the most successful "gold standard" therapies for PTSD I provide are Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT).
While they have different approaches, both are designed to help you stop "avoiding" the trauma so your brain can finally process it.
1. Prolonged Exposure (PE): Facing the Fear
PE is based on the idea that we inadvertently keep PTSD alive by avoiding the memories and situations that remind us of the trauma. While avoidance keeps us safe in the short term, it prevents the brain from learning that the danger is over.
How it works: In PE, we gently and systematically approach the memories and "triggers" you’ve been avoiding.
The Goal: By talking through the memory in a safe environment (Imaginal Exposure) and gradually revisiting safe places you’ve been avoiding (In-Vivo Exposure), your nervous system begins to learn that these triggers are no longer dangerous.
The Result: Your "alarm system" calms down, and the memories lose their power to overwhelm you.
2. Cognitive Processing Therapy (CPT): Shifting the "Stuck Points"
Trauma often changes the "rules" we have about the world. You might find yourself thinking, "I can't trust anyone," or "It was my fault." In CPT, we call these "Stuck Points."
How it works: CPT is a bit like "detective work" for your thoughts. We look at how the trauma impacted your beliefs about safety, trust, power, esteem, and intimacy.
The Goal: We identify the unhelpful things you’ve been telling yourself about the trauma and work to develop a more balanced, realistic perspective.
The Result: By shifting these "Stuck Points," the intense emotions tied to the memory begin to fade, allowing you to reconnect with yourself and others.
Treating Complex PTSD (C-PTSD): Do PE and CPT Still Work?
If you identify more with Complex PTSD—which often includes symptoms like difficulty regulating emotions, feeling persistent shame, or struggling with relationships—you might wonder if structured treatments like PE and CPT are "enough" for your experience.
There is a common misconception that these therapies only work for "simple" or single-event trauma. However, current research and clinical guidelines (such as those from the Department of Veterans Affairs National Center for PTSD) emphasize that evidence-based treatments are the most effective way to treat the core symptoms of both PTSD and C-PTSD.
Why Structured Therapy Works for Complex Trauma:
Targeting the Core: While C-PTSD has extra layers, the "engine" driving the symptoms is often the same: unprocessed traumatic memories and avoidance. PE and CPT address that engine directly.
Managing "Disturbances in Self-Organization": For many with C-PTSD, the biggest struggle is how they feel about themselves or how they handle emotions. By processing the trauma through CPT or PE, many of these "secondary" symptoms (like chronic shame or emotional volatility) begin to decrease naturally as the nervous system stabilizes.
Adaptable & Flexible: As your therapist, I don’t just "follow a manual" blindly. We work together to ensure you have the grounding skills and stability needed to move through these treatments safely. We move at a pace that honors your history while still moving toward the goal of recovery.
The takeaway? You don’t have to spend years in "talk therapy" before you are "ready" for trauma processing. These gold-standard treatments are designed to help you reclaim your life, no matter how complex your history may feel.
Which One is Right for You?
Every person’s journey is different. Some clients prefer the "top-down" cognitive approach of CPT, while others find the "exposure-based" approach of PE to be exactly what they need to break free from fear. During our initial sessions, we will discuss your history and your goals to determine which path feels the most supportive for your unique nervous system.
Trauma Therapy in Minneapolis, Minnesota and Online Nationwide
You don’t have to carry the weight of your past alone. Whether you’re dealing with a single traumatic event or years of chronic stress, healing is possible with the right tools and a safe environment.
Are you ready to move out of survival mode? I specialize in helping clients navigate the complexities of PTSD and trauma recovery.
About Dr. Melissa Polusny
Dr. Melissa Polusny is a Board-Certified Clinical Psychologist and Professor at the University of Minnesota-Twin Cities with over 30 years of experience specializing in the assessment and treatment of PTSD and complex trauma. A recognized expert in evidence-based care, Dr. Polusny combines her deep academic expertise with a compassionate, trauma-informed approach to help individuals move beyond survival mode and reclaim their lives. Dr. Polusny provides PTSD therapy in Minneapolis, Minnesota and online trauma therapy nationwide.
Dr. Melissa Polusny provides online trauma therapy nationwide.
