Therapy for PTSD
Something overwhelming happened and your mind and body have not felt the same since. You might have nightmares, panic around reminders, constant tension, or a sense of disconnection. These reactions are not signs of weakness. They are your nervous system trying to protect you long after the danger has passed. PTSD is highly treatable, and with the right therapy you can recover and feel safe again.
What is PTSD?
More than just remembering
PTSD happens when a traumatic event overwhelms your brain's ability to process what happened. Instead of storing the memory as something in the past, your brain treats it like a current threat, keeping your nervous system in survival mode. Symptoms include intrusive memories or nightmares, avoiding reminders, persistent negative mood or self-blame, and feeling constantly on edge. These reactions must last more than a month and significantly affect your daily functioning.
What causes PTSD?
About three-quarters of Canadians experience trauma, but only a small percentage develop PTSD. Risk depends on the type of trauma, previous trauma exposure, lack of support, genetics, and repeated or prolonged danger. Sexual assault, physical violence, sudden loss, first responder work, military service, or ongoing abuse carry higher risk. PTSD is never a sign of weakness—it reflects how your brain and body responded to overwhelming stress.
General PTSD in Canada
Sources: Statistics Canada (Survey on Mental Health and Stressful Events). While often associated with the military, the vast majority of PTSD cases in Canada stem from civilian events like car accidents, assaults, and sudden loss.
Living with untreated PTSD
When memories become flashbacks
Flashbacks feel like the trauma is happening again. Your brain loses its sense of time, your body reacts with panic, and intrusive memories or nightmares appear without warning. These moments disrupt daily life and leave you drained and on alert.
The shrinking world of avoidance
Avoidance starts as protection but quickly expands. You avoid places, people, conversations, and even emotions that remind you of the trauma. Over time your life becomes smaller, and the avoidance that once felt helpful keeps you stuck in fear.
When your body won't rest
PTSD keeps your nervous system in high alert. You startle easily, struggle to sleep, feel tense or irritable, and scan constantly for danger. Your body behaves as if the threat is still present, making rest feel impossible.
Changed beliefs and disconnection
Trauma can alter your view of yourself and the world. You may blame yourself, feel unsafe, or become emotionally numb and disconnected from others. This protective shutdown blocks pain but also distances you from joy and connection.
The web of comorbidity
PTSD often comes with depression, anxiety, or substance use as you try to cope with overwhelming symptoms. Physical health can worsen too, creating a complex mix of issues that reinforce one another without proper treatment.
Relationships under strain
PTSD affects partners, family, and friends. Irritability, distance, trust issues, and emotional numbing make connection difficult. Loved ones feel helpless, and isolation grows, even though relationships are essential for healing.
How therapy treats PTSD
Why trauma-focused therapy is recommended
Leading clinical guidelines identify trauma-focused therapies such as PE, CPT, and EMDR as the primary treatments for PTSD. These approaches help you process the traumatic memory itself, which is essential for long-term recovery. Medication can support sleep, mood, or anxiety, but therapy addresses the root of PTSD and creates lasting change.
How trauma-focused therapy works
Trauma-focused therapy helps your brain fully process traumatic memories so they stop triggering your alarm system. The goal isn’t to erase what happened but to remember it without reliving the fear. Over time, your brain learns the trauma is over, and most people see meaningful improvement within a few months of structured treatment. These approaches are designed specifically for trauma, helping you regain a sense of safety, connection, and control.
The three gold-standard PTSD therapies
Prolonged Exposure (PE)
PE helps reduce PTSD symptoms by safely approaching trauma memories and avoided situations instead of pushing them away. Through repeated retelling of the trauma and gradual real-life exposure to safe reminders, your brain learns that remembering isn’t dangerous. Over time, distress decreases and your world becomes less restricted.
Cognitive Processing Therapy (CPT)
CPT focuses on how trauma changed your beliefs about safety, trust, control, and self-worth. It helps you identify unhelpful thoughts like self-blame or overgeneralization and replace them with more balanced perspectives. By shifting these “stuck points,” CPT reduces distress and improves daily functioning.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR uses bilateral stimulation, eye movements, tapping, or tones, while you recall trauma memories. This helps the brain reprocess what happened so the memories lose their intensity. Many people prefer EMDR because it requires less verbal detail while still reducing emotional and physical reactivity.
What to expect in PTSD therapy
Initial assessment and treatment planning
Your therapist begins with a structured PTSD assessment, exploring symptoms, trauma history, daily impact, and any co-occurring issues like depression, anxiety, or chronic pain. You don’t need to share full trauma details immediately. The focus is understanding patterns and safety. Together, you create a treatment plan based on your goals, readiness for trauma-focused work, and the approach that fits you best.
Psychoeducation and preparation
Early sessions help you understand how trauma affects the brain and why symptoms like avoidance and hyperarousal persist. You learn grounding, breathing, and emotional-regulation strategies so you can manage distress during trauma processing. This foundation reduces fear of symptoms and gives you tools to stay steady as you begin the deeper work.
Trauma processing
Whether through PE, CPT, or EMDR, this phase involves safely approaching the traumatic memories you’ve been avoiding. Processing can bring strong emotions at first, but over time the memories lose their intensity and triggers become more manageable. Your therapist guides the pace and helps you use coping skills between sessions to stay grounded.
Integration and rebuilding
As trauma memories process, therapy expands to address related beliefs, shame, guilt, distrust, and to rebuild parts of life narrowed by PTSD. You gradually re-engage with avoided situations, strengthen relationships, and reconnect with goals and interests. This stage focuses on creating a life no longer organized around fear or avoidance.
Relapse prevention and closure
Toward the end of treatment, you identify progress, build a plan for staying well, and learn how to respond if symptoms return. Some people complete therapy fully; others return for occasional check-ins. The goal is confidence and independence. You can remember what happened without being overwhelmed, engage with life again, and feel safe enough to move forward.
Find a PTSD specialist
Choosing the right therapist matters. Each province in Canada has its own regulations, which is why working with a recognized professional can make a real difference in your care. Stellocare takes the uncertainty out of the process by listing only verified therapists you can trust.
The right therapist for you
No therapists found with these specialties in Ontario.
Try selecting a different province.Managing PTSD symptoms
Canadian community services: General PTSD
Free clinician-led therapy groups
Trauma Practice for Healthy Communities
A registered charity (Ontario-based/Online) that believes trauma recovery should be accessible. They offer free, clinician-led online group programs. This is rare—most free groups are peer-led, but these are facilitated by trauma professionals to ensure safety.
Distance coaching (Government-funded)
Strongest Families Institute (SFI)
A non-profit offering evidence-based programs for adults and youth. Their "ICAN" (Conquer Anxiety and Nervousness) program is fully funded (free) by the government in many provinces (NS, NB, PEI, NFLD, ON, MB, SK, NT) and is done via telephone coaching, removing the barrier of leaving the house for those with severe PTSD symptoms.
Information & self-management
PTSD Association of Canada
A non-profit dedicated to education. While they don't offer clinical therapy, their site is a hub for "Self-Assessment" tools and coping strategies specifically for the general public (not just military), helping validate symptoms before seeking diagnosis.
Daily strategies for living with PTSD
Managing flashbacks and intrusive memories
- Reality orientation: Remind yourself where and when you are: "I'm in my home. It's November 2025. The trauma is over. I'm safe now."
- Sensory grounding: Engage your five senses—hold ice, smell something strong, listen to music, look at photos of safe places.
- Physical movement: Stand up, walk around, stretch, or do jumping jacks to discharge activation and reconnect with your body in present time.
- Safe person contact: Call or text someone who knows about your PTSD. Connection reminds your nervous system you're not alone and in danger.
Calming hyperarousal
- Controlled breathing: Breathe in for 4 counts, hold for 4, exhale for 6-8. Longer exhales activate the parasympathetic "rest and digest" system.
- Progressive muscle relaxation: Systematically tense then release muscle groups, teaching your body the difference between tension and relaxation.
- Regular exercise: Physical activity discharges stress hormones, improves sleep, and reduces hyperarousal. Aim for 30 minutes most days.
- Sleep hygiene: Keep consistent sleep schedules, create a calm bedroom environment, limit screens before bed, practice relaxation before sleep.
Working with avoidance
- Notice avoidance patterns: What situations, places, people, thoughts, or feelings are you avoiding? Awareness is the first step toward change.
- Gradual exposure: Don't avoid everything forever. With support, slowly approach avoided situations in small, manageable steps.
- Reduce safety behaviors: Compulsive checking, excessive planning, or requiring company everywhere maintain anxiety. Gradually reduce these crutches.
- Stay engaged: Keep attending work, seeing friends, doing activities even when difficult. Complete avoidance worsens PTSD; selective engagement aids healing.
Challenging negative thoughts
- Identify thought patterns: Notice self-blame, overgeneralization, or catastrophizing. Write thoughts down to see patterns clearly.
- Examine evidence: What facts support this thought? What contradicts it? Am I confusing feelings with facts?
- Consider alternatives: What else could explain this situation? What would I tell a friend thinking this way?
- Practice self-compassion: PTSD makes you harsh with yourself. Speak to yourself as you would a friend who's struggling.
Building support and connection
- Tell safe people: Share your PTSD diagnosis with trusted friends/family. Let them know how they can help.
- Join support groups: Connecting with others who understand reduces isolation and provides hope.
- Maintain routines: Structure creates safety. Keep regular schedules for sleep, meals, and activities.
- Limit trigger exposure: While you work toward healing, reduce unnecessary exposure to violent media, news, or triggering content.
Common questions about PTSD therapy
Will I have to relive the trauma in therapy?
You will revisit the memories, but you will not be thrown back into the experience. Trauma therapy guides you to approach memories in a controlled and supported way while staying aware that you are safe in the present. Your therapist monitors your distress and adjusts the pace so processing feels manageable. The aim is understanding the memory rather than being overwhelmed by it.
Why do guidelines recommend therapy as the first treatment?
Trauma-focused therapy addresses the root problem, which is the unprocessed memory that keeps your alarm system active. Medication can help with mood or sleep, but it does not resolve the core trauma. Many people use both together, but therapy is the treatment that leads to lasting change for most individuals.
What if I cannot handle exposure therapy?
Therapists introduce exposure gradually and never push you beyond what you can handle. If you are not ready, approaches with less exposure are available. You can also begin with skill-building until you feel prepared. Processing trauma in some way is necessary for recovery, but there are flexible paths to get there.
How do I know if my therapist is qualified?
A qualified PTSD therapist has specific training in PE, CPT, EMDR, or TF-CBT. You can ask about their training and how often they treat PTSD. A good therapist explains their method clearly and uses a structured, evidence-based approach. If they avoid discussing specific trauma treatments, that is a sign to look elsewhere.
What if therapy did not help me before?
Many people try general talk therapy, which is helpful in many areas but not enough for PTSD. If you have never done PE, CPT, EMDR, or TF-CBT with a trained specialist, you have not yet tried a full PTSD treatment. Past attempts often miss the trauma-processing component that is needed for change.
Can PTSD return after treatment?
Once memories are processed, they usually stay processed. Stress or new traumatic events can bring some symptoms back temporarily, but most people regain stability using the skills they learned. A few booster sessions may help if symptoms rise again, but full relapse is uncommon once treatment is completed.
Should I tell others that I have PTSD?
Sharing is a personal choice. Telling trusted people can offer support, but not everyone responds helpfully. You can explore who to tell and how much to share with your therapist. You do not need to disclose at work unless you want accommodations. Choose what protects your wellbeing.
Can online therapy work for PTSD?
Yes. Research shows that video-based trauma therapy is effective when delivered by a trained specialist. Online sessions offer convenience and may feel safer for some people. The important part is that your therapist uses evidence-based trauma treatment and is well trained in PTSD care.
Related concerns
References
- U.S. Department of Veterans Affairs & Department of Defense. (2023). VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. Retrieved from https://www.healthquality.va.gov/guidelines/MH/ptsd/
- American Psychological Association. (2017). Clinical Practice Guideline for the Treatment of PTSD. Retrieved from https://www.apa.org/ptsd-guideline
- Statistics Canada. (2024). Survey on Mental Health and Stressful Events, 2023. Retrieved from https://www150.statcan.gc.ca/n1/daily-quotidien/240527/dq240527b-eng.htm
- Statistics Canada. (2024). Posttraumatic stress disorder among adults in Canada: Key findings. Retrieved from https://health-infobase.canada.ca/ptsd-survey/
- Van Ameringen, M., Mancini, C., Patterson, B., & Boyle, M. H. (2008). Post-traumatic stress disorder in Canada. CNS Neuroscience & Therapeutics, 14(3), 171-181. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6494052/
- Public Health Agency of Canada. (2019). Federal Framework on Posttraumatic Stress Disorder: Recognition, collaboration and support. Retrieved from https://www.canada.ca/en/public-health/services/publications/healthy-living/federal-framework-post-traumatic-stress-disorder.html
- Canadian Psychological Association. (2024). Facts About Traumatic Stress and PTSD. Retrieved from https://cpa.ca/sections/traumaticstress/simplefacts/
- PTSD: National Center for PTSD. (2024). Overview of Psychotherapy for PTSD. Retrieved from https://www.ptsd.va.gov/professional/treat/txessentials/overview_therapy.asp
- Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6224348/
- Canadian Institute for Public Safety Research and Treatment. (2023). PTSD: Stigma Out, Understanding In. Retrieved from https://www.cipsrt-icrtsp.ca/en/ptsd-stigma-out-understanding-in-2023
- The Canadian Encyclopedia. (2024). Post-Traumatic Stress Disorder (PTSD) in Canada. Retrieved from https://www.thecanadianencyclopedia.ca/en/article/post-traumatic-stress-disorder-ptsd-in-canada
- Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2019). Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences (2nd ed.). Oxford University Press.
- Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.
- Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.
- van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
- Herman, J. L. (2015). Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror. Basic Books.
- Williams, M. B., & Poijula, S. (2016). The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms (3rd ed.). New Harbinger Publications.
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Evan Vukets
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Ekta Sehgal
Registered Psychotherapist (ON)
Melanie Zimerman
Canadian Certified Counsellor
Penelope Waller Ulmer
Registered Psychologist (AB)
Gauri Mathur
Registered Psychotherapist (ON)
Daniella Sanchez
Registered Social Worker (ON)
Delia Petrescu
Registered Psychotherapist (ON)
Jonathon Zarb
Registered Psychotherapist (ON)
Caitlin Pelkey
Registered Psychotherapist (Qualifying) (ON)
Patricia Dekowny
Registered Social Worker (AB)
Vrushalee Nachar
Registered Psychotherapist (ON)
Vanessa Fingland
Counselling Therapist (AB)
Joseph Bottros
Registered Psychotherapist (ON)
Ilona Farry
Registered Psychotherapist (Qualifying) (ON)
Ivana Di Cosola
Registered Social Worker (ON)
Renée Dangerfield-Allen
Registered Social Worker (AB)
Alexina Picard
Registered Clinical Counsellor (BC)
Michelle Lehoux
Registered Psychotherapist (Qualifying) (ON)
Elena Temelkova
Registered Psychotherapist (Qualifying) (ON)
Anna Evans
Registered Social Worker (ON)
Evan Vukets
Registered Clinical Counsellor (BC)