Clinically reviewed by Dr John Ahern
This guide was written and clinically reviewed by Dr John Ahern, founder of Insight Psychology in Newtown, Sydney. Dr Ahern is a Registered Psychologist (AHPRA) and a member of the EMDR Association of Australia (EMDRAA). Trauma is a particular focus of the practice, including work with police, military and other frontline workers.
Last reviewed: [Month Year] · Next review due: [Month Year]
What Is PTSD?
Post-Traumatic Stress Disorder, known as PTSD, is a set of ongoing reactions that can develop after a distressing or life-threatening event, where your mind and body keep responding as though the danger is still there.
This can follow a single event, such as a car accident, an assault, a serious injury, or witnessing something distressing. It's particularly common in high-stress jobs like emergency services and first responder work. Not everyone who goes through a difficult event develops PTSD. It becomes something worth addressing when the reactions stick around, feel distressing, and start getting in the way of daily life — sometimes not showing up, or worsening, until well after the event itself.
The core experience usually involves flashbacks or intrusive memories, nightmares, feeling constantly on edge or easily startled, avoiding reminders of what happened, and a sense that the event still has a hold on you, even once you're actually safe.
What Is Complex PTSD (C-PTSD)?
Complex Post Traumatic Stress Disorder, known as C-PTSD, includes the core features of PTSD alongside deeper difficulties with emotional regulation, self-worth and relationships, usually developing after prolonged or repeated trauma rather than a single event.
It usually develops after ongoing or repeated experiences where getting away felt difficult or impossible — such as childhood adversity or prolonged exposure to trauma over time — rather than one distressing event.
Common Signs and Symptoms
Both PTSD and Complex PTSD can show up in similar core ways, even though what caused them, and what sits underneath them, can be quite different.
Intrusive memories
Flashbacks, nightmares, or distressing memories that surface unexpectedly.
Feeling on edge
Hypervigilance, an exaggerated startle response, or a constant sense that something bad is about to happen.
Avoidance
Steering clear of people, places or situations that are reminders of what happened.
A changed sense of self
Numbness, disconnection, or a sense that the past event still has a hold on you, even now.
These reactions can stick around for years without support, especially for people who have kept functioning and pushed through. That's not a sign of weakness. Both PTSD and Complex PTSD respond well to the right kind of therapy.
Understanding the Window of Tolerance
The "window of tolerance" is the zone where you can think clearly, feel your emotions without being overwhelmed by them, and stay connected to the people around you. Trauma tends to narrow this window, so it's easier to be pushed outside it by things that wouldn't affect someone else the same way.
Above the window sits hyperarousal: a fight-or-flight state that can feel like anxiety, panic, racing thoughts, or a constant sense of danger. Below the window sits hypoarousal: a freeze or shutdown state that can feel like numbness, disconnection, or exhaustion. Everyone moves in and out of their window day to day. Trauma just narrows it and makes the edges easier to reach, so a smaller trigger — a noise, a tone of voice, a particular situation — can tip you into one of these states before you've had a chance to think it through.
A big part of therapy is helping widen this window again, so more of daily life sits within a range you can manage, and the edges become less sensitive over time. More on this in "What we're working towards" below.
How Therapy Can Help With Trauma and PTSD
Trauma therapy is tailored to what happened to you. A single distressing event is usually treated with EMDR (Eye Movement Desensitisation and Reprocessing) and trauma-focused Cognitive Behavioural Therapy (CBT). Complex PTSD often needs a longer, more integrated approach that also draws on Schema Therapy.
EMDR helps your brain reprocess distressing memories so they stop feeling so vivid and overwhelming, without needing to talk through every detail of what happened. Trauma-focused CBT works with the thoughts and beliefs that keep the trauma response going — things like self-blame or a persistent sense of danger. For longer-standing, complex trauma, Schema Therapy adds another layer, working with patterns in self-worth, emotions and relationships alongside processing the trauma itself.
EMDR is central to trauma treatment
EMDR is one of the most established, evidence-based therapies for trauma and PTSD. See how the eight phases work and what to expect.
Our Phased Approach to Trauma Therapy
Trauma therapy at Insight Psychology moves through three phases: safety and stabilisation first, then processing, then integration — rather than diving straight into the hardest material.
Safety & stabilisation
Building practical tools for managing distress and feeling more grounded day to day, before any trauma processing begins.
Often the biggest early shiftProcessing
Working through the traumatic material itself, using approaches like EMDR and trauma-focused CBT, at a pace that suits you.
Integration
Bringing it all together afterwards — rebuilding a steady sense of self and strengthening your relationships and everyday life.
Safety and stabilisation comes before any trauma processing begins, and this is often where people notice the biggest early difference. Processing works through the traumatic material itself, at a pace that suits you. Integration is about bringing it all together afterwards, rebuilding a steady sense of self and strengthening your relationships and everyday life.
What We're Working Towards
The aim of this work is practical and specific: to help re-experiencing settle, to strengthen your ability to regulate emotion, and to build a stronger sense of safety in your relationships — widening your window of tolerance along the way.
Decreasing re-experiencing
Fewer, less intense flashbacks, nightmares and intrusive memories.
Strengthening regulation
More capacity to notice and manage strong emotions before they take over, rather than being swept into fight, flight or shutdown.
Safety in relationships
Feeling able to trust, connect and stay present with the people who matter to you, rather than staying guarded or shut down.
Together, these widen the window of tolerance described above, so day-to-day life feels more manageable and less like walking on eggshells around your own reactions.
Frequently Asked Questions
What's the difference between PTSD and Complex PTSD?
PTSD usually follows a single distressing event. Complex PTSD develops after prolonged or repeated trauma and includes additional difficulties with emotional regulation, self-worth and relationships, alongside the core PTSD symptoms.
Can PTSD develop from something that happened a long time ago?
Yes. Trauma responses can surface or stick around for years after the event, especially if it was never processed at the time. It's common, and completely valid, to seek support well after the event itself.
Does trauma therapy mean I have to talk through every detail of what happened?
Not necessarily. Approaches like EMDR are specifically designed to help your brain reprocess distressing memories without needing a detailed verbal account of everything that happened, which is often more manageable than people expect.
What does it mean that trauma "narrows the window of tolerance"?
It means the range of emotional intensity you can handle while still thinking clearly and staying connected gets smaller after trauma, so smaller triggers can push you into a fight-or-flight state or a freeze/shutdown state more easily. Therapy works to widen this window again.
Do you have experience working with police, military or other frontline workers?
Yes, this is a particular focus of the practice. Dr John Ahern works with police, military and veterans, paramedics, firefighters, and healthcare staff, whose work often means repeated, cumulative exposure to trauma rather than a single event. Therapy starts from an understanding of what the job actually involves, so these reactions are treated as an understandable response to abnormal, repeated exposure, not a weakness or something to be embarrassed about.
Will seeking therapy affect my fitness for duty?
This is a common and understandable concern. What's discussed in therapy is confidential within the usual limits that apply to every client, and seeking support isn't itself a fitness-for-duty issue. If you have specific concerns about your organisation's particular policies, these are worth raising directly so they can be talked through in relation to your situation.
How long does trauma therapy usually take?
This varies quite a bit. A single distressing event can sometimes be addressed in a relatively focused course of therapy, while Complex PTSD generally needs a longer-term approach. This is something to discuss and review as treatment progresses.
This page is general information only and is not a substitute for personalised psychological advice, diagnosis or treatment. A psychologist can assess your history, current symptoms, goals and support needs before recommending a treatment plan.
Insight Psychology is not a crisis service. If you are in immediate danger, call 000. If you need urgent mental health support in Australia, contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.