If you're struggling with difficult emotions, anxiety, or troubling memories from past trauma, Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy can offer powerful paths to healing and reclaiming your life. These evidence-based therapies are specifically designed to support you in safely confronting and overcoming the lingering impact of childhood trauma.

Cognitive Processing Therapy (CPT) helps you identify and gently challenge unhelpful beliefs about yourself, others, and the world that often develop after experiencing trauma. By working through these thoughts, you'll begin to reshape your perspective, freeing yourself from feelings of guilt, shame, self-blame, or powerlessness. You’ll discover healthier ways to interpret past events, which can significantly reduce feelings of anxiety, sadness, and isolation.

Prolonged Exposure (PE) therapy guides you in gradually facing traumatic memories, feelings, or situations you've avoided, helping you regain control over your emotional responses. Through safe, structured exposure, you'll experience reduced anxiety, lower stress, and lessened sensitivity to triggers, restoring your confidence and sense of safety.

Without treatment, unresolved childhood trauma can manifest in persistent anxiety, difficulty forming healthy relationships, self-sabotaging behaviors, emotional numbness, depression, chronic stress, or reliance on negative coping strategies. CPT and PE therapies directly address these patterns, helping you develop healthier coping skills, improve self-compassion, and foster meaningful connections in your life.

Together, these therapies provide clarity, emotional relief, and new perspectives. You'll be empowered with practical skills for coping, improved emotional regulation, and stronger relationships. By engaging in this process, you can free yourself from the lasting burden of past trauma and move forward into a healthier, more hopeful future.

Four types of Trauma: Acute, Complex, Vicarious, Generational

Acute trauma develops in response to a single event (like a car accident, sexual assault, or natural disaster).

Complex trauma develops in response to prolonged and repeated traumatic events (such as child abuse or neglect, domestic violence, or civil unrest).

Secondary/vicarious trauma develops in response to witnessing someone else’s trauma (typical among therapists, first responders, health care providers, and so on).

Generational trauma is passed down from one generation to the next, particularly when it’s experienced by a collective group (as in slavery or genocide).

Our trauma response usually occurs in three stages:

1. Emergency response:
Right after a traumatic event, you may experience psychological shock, also called an “acute stress response.” In psychological shock, your body is overwhelmed with emotion, which can show up in a variety of physical symptoms. A rush of adrenaline may result in shakiness, a rapid heartbeat, difficulty breathing, nausea, and chest tightness. These symptoms represent your body’s fight-or-flight response—it’s getting ready for immediate action in order to survive.

More recently, researchers have expanded the idea of “fighting” (becoming aggressive or screaming) or “fleeing” (running away) to include two additional emergency responses: “freezing” (staying still, avoiding decisions, or feeling numb or disconnected) and “fawning”(trying to please others to avoid conflict).

2. Short-term processing:
In the days and weeks following your trauma, you return to some sense of normalcy or routine. During this adjustment period, you may experience grief, stress, or flashbacks. You may also develop a trauma or stressor-related disorder that keeps you from recovering fully.

3. Long-term recovery:
In this later stage, you learn to make meaning from your trauma and integrate what you’ve experienced into your life story. You’re able to accept what’s happened without reliving your trauma endlessly.

Trauma and perception

Trauma relies on our own perception of danger and safety. This means different people can go through the same stressful experience and have different trauma responses.

For example, let’s say three roommates are home when a minor earthquake hits. The first person may develop trauma symptoms that are resolved in a few days or weeks. The second person’s symptoms may linger for months, eventually developing into posttraumatic stress disorder (PTSD). The third person may not be traumatized at all, having lived in an earthquake-prone area their entire life.

The third roommate had experience with and context for what was happening and remained calm.

The second roommate, however, didn’t realize the earthquake was minor and thought they were going to die. Even though they weren’t technically in danger, their perception of danger still caused a serious trauma response.

Big-T trauma and little-t trauma

Because trauma depends on an individual’s emotional response, many different circumstances can count as trauma. Some therapists use the ideas of “big-T” trauma and “little-t” trauma to differentiate how seemingly small things can traumatize us.

Big-T trauma refers to the clearly dangerous and extreme events we already associate with the word “trauma.” Examples include:  War, Natural disasters, Sexual violence, Physical abuse, Mass shootings, Terrorist attacks, Severe car accidents.

Little-t trauma refers to events and circumstances that are life-altering but not life-threatening. These situations may seem ordinary, but they can still produce a trauma response and damage our mental health. Examples include:  Divorce, Bullying, Getting fired, Unresolved relational conflicts, Financial or legal trouble.

It’s important to expand our definition of trauma beyond just big-T trauma. Multiple little-t traumas can build up over time and cause the kinds of severe symptoms that usually come from big-T traumas.

Effects of trauma

Trauma harms or threatens to harm our physical, mental, or emotional well-being. Different kinds of traumatic events can jeopardize different areas of our health, and most forms of trauma affect us in more than one way.

For example, you get in a car accident and break your leg. While the physical trauma of your broken leg is visible, the emotional trauma of the experience may be less obvious. Unresolved emotions may affect you psychologically (it leaves an imprint), showing up as fear and panic any time you get in a car.

Emotional or psychological trauma can also express itself physically. For example, if you’re struggling with the psychological trauma of a divorce or breakup, you might develop physical symptoms like insomnia, appetite changes, or muscle tension.

Common trauma disorders

Sometimes our trauma responses develop into mental health disorders known as “trauma and stressor-related disorders.” Common ones include:

*Posttraumatic stress disorder (PTSD) occurs when trauma symptoms last for more than a month after the trauma happened. PTSD symptoms include intrusive memories, avoidance, cognition and mood changes, and heightened reactivity.

*Acute stress disorder (ASD) occurs when trauma symptoms last for less than a month after the trauma happened.

*Adjustment disorders involve difficulty adjusting to a stressful event; these disorders persist for up to six months after the event has ended.

*Complex PTSD is a more severe form of PTSD that can follow long-term trauma or multiple traumas, such as an abusive relationship or a lengthy deployment to a war zone. 

How childhood trauma affects development

Experiencing or witnessing trauma in childhood can have lasting effects on a person’s development. Certain mental health disorders and developmental disorders may develop in response to trauma, especially if a child can’t access treatment, resources, and support and can’t process the trauma in a healthy way.  Childhood trauma can affect development in these common ways: Developmental delays, Oppositional-disobedient/hostile, Dissociative-emotionally detached, and Cognitive struggles (i.e.  if you’re repressing memories of childhood trauma, you might struggle to remember not just those traumatic memories, but also unrelated details and information).

Associated mental health challenges

Trauma can interact with, trigger, or worsen mental health disorders such as:  Anxiety, Depression, Addiction, Eating disorders, and Obsessive-compulsive disorder (OCD).

Evidence Based Trauma treatment options

*Trauma Informed Cognitive behavioral therapy (TI-CBT): TI-CBT, you can learn to identify unhelpful thought patterns at the root of your emotions and behaviors.

*Prolonged exposure therapy (PE): Exposure therapy allows you to confront traumatic memories and emotions in a safe, controlled environment.

*Eye movement desensitization and reprocessing (EMDR): EMDR helps you process traumatic memories in a way that encourages new connections and rapid processing.

*Somatic therapy: Somatic therapies, also known as body-based therapies, can help reconnect the mind and body after trauma. If you feel “out of body” after trauma, this treatment approach could be especially helpful. Common types include somatic experiencing, sensorimotor psychotherapy, yoga therapy and the Hakomi method (5 principles-mindfulness, nonviolence, mind-body holism, unity, organicity).

Medications: Antidepressants, Anti-Anxiety, Nightmares/Sleep Disturbances, Mood Stabilizers, Atypical Antipsychotics-in severe cases, may ease some trauma symptoms. Medication alone does not heal trauma; it is most effective when combined with therapy.

Post Traumatic Growth:

With treatment, you can learn to practice different forms of self-care, like meditation and mindfulness, that help you navigate trauma symptoms in healthy ways. You can also learn to regulate your emotions when trauma symptoms feel overwhelming. Benefits of post traumatic growth can be seen with deeper relationships, new possibilities, personal strength, spiritual development, and a greater appreciation for life. After trauma, your mind often tries to make sense of what happened. Some thoughts just pop up and feel intrusive, but, “it is deliberate reflection”, the times when you purposefully stop and process, that is what tends to support growth the most.