Doug Bremner is a physician, professor, researcher, writer and filmmaker from Atlanta, Georgia. He is a professor of psychiatry and radiology at the Emory University School of Medicine in Atlanta, Georgia, Director of the Emory Clinical Neuroscience Research Unit (ECNRU) and Mental Health Research at the Atlanta VA Medical Center. His article on post traumatic stress disorder is one of this site's busiest.


In the course of our lives, more than half of us will be exposed to some form of a psychological trauma, a threat to life or physical integrity to yourself or someone close to you. Bullying at school or online, life in a combat zone, sexual assault, child abuse, family violence, poverty and natural catastrophes are all potential sources of psychological stress.

The first step on the path to recovery from psychological trauma is to educate yourself.

Of those people who experience psychological trauma, about 15% will develop posttraumatic stress disorder (PTSD), in which they are haunted by the traumatic experience. It is helpful to know what psychological trauma and post-traumatic stress are so we can recognize the warning signs in ourselves and others. Everyone is different in their response to psychological trauma and its aftershock, PTSD. And we are equally varied in how it is best overcome.

Symptoms: What PTSD Feels Like

People with PTSD have survived a psychological trauma, but they can continue to re-experience the event in unwanted bursts of memories and visions; they may become depressed or simply numb or hypervigilant, ready for something terrible to occur at any moment. They may make an all-out effort to avoid re-encountering the traumatic circumstances. There are cognitive, or mental, aspects to PTSD as well. It is not usual for people to shut down mentally, as well as emotionally.

Intrusive Flashbacks

People with PTSD experience intrusive, uncontrollable and involuntary instances of re-living the traumatic event (or a moment within the traumatic event). These flashbacks can be triggered by situation or arise spontaneously, such as during nightmares or periods of relaxed attention. They are accompanied by feelings of fear and panic, and corresponding physiological responses such as heart palpitation, sweating or muscular tension.

A Desperate Need to Avoid Certain Situations

PTSD sufferers spend a lot of time and energy trying to avoid situations that might remind them of the traumatic event as well as distressing memories, thoughts, or feelings associated with the traumatic event. They may develop a phobic avoidance of parties, driving, or places with loud noises or crowded situations. People with PTSD are often hypervigilant — ready for the worst at all times. This hyperarousal can make them unable to sleep.

Emotional and Mental Fallout

Psychologically traumatizing events can leave a person with exaggerated and persistent negative beliefs or expectations about themselves, others, or the world. They can become prone to volatile anger, feel guilty or be fearful. Others shut down emotionally and become depressed or simply detached from their surroundings and the people around them, unable to experience love or pleasure or satisfaction.

Some victims of psychological trauma may be unable to remember much of the trauma, while, as mentioned, others relive it in unwanted flashbacks. Some are profoundly detached from people and events and unable to enjoy their favorite activities. Many believe that the traumatic event will never recede and that the future holds no promise.

Drug and alcohol abuse, self-medicating for any and all of these symptoms is common among survivors of traumatic stress. These abuses may also complicate recovery.

Recovering from Psychological Trauma

If you have been traumatized and it is influencing your life (or you wonder if it has influenced your life), is there anything that you can do about it?

Yes, there is, but you shouldn’t sit back and wait for someone else to do it for you. Some trauma experts will have lots of advice to give, and offer a quick fix. In my experience, however, most of these tricks will not lead to long-term results.

The best person to help you recover from psychological trauma is you. If you are trying to help a family member with PTSD, your first priority should be to do everything you can to empower them so that they can find their own pathway through the trauma.

It is important to know that there is no single magic pill or cure, and the memories of the traumatic event will stay with you and affect you on some level for the rest of your life. Your recovery is going to take time and patience. You will experience setbacks. But knowing this is a way of preparing yourself; don't let it discourage you.

The best person to help you recover from psychological trauma is you.

In our recent book, You Can’t Just Snap Out Of It: The Real Path to Recovery From Psychological Trauma, Lai Reed and I outline the START-NOW program for recovery from psychological trauma, as well as tools for coping with stress.

Each letter of START NOW refers to a different part of the self-guided recovery program. The program is outlined below, but we cover it in a lot more detail in the book.

The Start Now Program

    S. is for Safety. Seek Safety and Support. Sometimes Silence is nice.

    T. is for Talk. Talk about your trauma and/or your loss. Tell people about how you feel. Translate feelings into words.

    A. is for Acceptance. Accept what happened to you. Accept yourself. Accept the past. It is also for Action. Take Action, move beyond your restricted sphere. Move out into the world and forward into the future. A is also for Altruism, or doing things for others. Altruism is a way of moving beyond yourself. When you practice Altruism and help others, you are really helping yourself. Use Altruism as a way to move beyond your trauma.

    R. is for Re-write history. Re-visit the scene of the trauma. Re-live it with new eyes. Take your memories and Re-visit them with new wisdom, knowledge, and experience.

    T. is for Transform. Transform yourself from victim into survivor by re-writing your history, and through volunteerism and altruism. Transform society to make it a better place.

    N. is for Notice other people around you. Go outside of your shell. Reach out to others. Volunteer. Help others.

    O. is for Observe yourself and Others. Observe the world around you, and Open yourself to being a part of the world.

    W. is for Wonder about the World. See things through new eyes. Win your fight against traumatic stress.

Educate Yourself About Psychological Trauma

The first step on the path to recovery from psychological trauma is to educate yourself. Knowledge is power, and the most important thing you need to do to educate yourself is to learn to know yourself, the motto of the great Greek philosopher Socrates. In this situation, you need to understand that your symptoms are just that — the effects of psychological trauma. Then you can begin to stop responding to them in quite the same way. You will have more of an overview, even if they continue to upset you greatly.

The more we know about the kinds of effects psychological trauma can have on us, the less they will take us by surprise and the less power they will have over us. You already know this — that’s why you’re reading this article, right?

If you meet with counselors, therapists, doctors, or others, ask a lot of questions. Take notes.

Your job is to become familiar with all the symptoms that can result from psychological trauma, so you can recognize them in yourself. Learn about the symptoms of PTSD, depression, and dissociation. Educate yourself about the techniques that have proven effective for coping with stress and the points of the START-NOW program.

If you meet with counselors, therapists, doctors, or others, ask a lot of questions. Take notes.

Your Symptoms Aren't You

By learning about the symptoms that can be caused by psychological trauma, including both the mental and the physical consequences, you can recognize the source. You can stop attributing things to the fact that you are evil, have a bad character, or have done something wrong, and you can recognize that your behavior is related to your life experiences.

Becoming more educated about post-traumatic stress can also help you stop listening to unhelpful advice, like, “Just snap out of it,” or “You need to move on”

When you know the biological basis of trauma-related symptoms and difficulties in coping, you come to see that your feelings of fear, or being bad or evil are not based in reality; and that, in fact, nearly every trauma patient has these types of thoughts. As you know more, you can begin to question your assumptions.

For example, sexual abuse survivors may think there was something wrong with them that led to their being singled out for abuse, and their abusers may have reinforced these ideas. But if that were the case, then why is it that car wreck survivors similarly have feelings of shame, guilt, self-doubt?

Overcome Your Negative Cognitions and Protect Yourself From Negative Consequences

Educating yourself helps you fight back; self-knowledge makes you better able to counter negative thoughts.

These negative attitudes and ideas are what we call negative cognitions. The fact is they aren’t true.

Take care of yourself by decreasing the stress in your life. Try to recognize when your relationships are recreating the abusive patterns of the past.. People tend to gravitate toward abusive relationships because they have a low sense of self-worth and think that someone who had their act together would not be interested in them if they knew what they were really like. Or maybe they recognize the defects of the other person, but fantasize about changing them.

Try to recognize when your relationships are recreating abusive pattern of the past.

If you feel you may have made a mistake, you can and should get out. Some fundamental aspects of peoples’ characters you just can’t change. You Can’t Just Snap Out Of It has a chapter devoted to relationships and ways to remove yourself from them.

Psychological trauma affects the brain and fear response systems like the amygdala, the frontal cortex and the hippocampus, underlying your symptoms, particularly the runaway thoughts that may overtake you. Most importantly, remember that you can recover. You can live a better life. You just need to actively seek help and become aware of the effects psychological trauma have had on your brain, your thought processes, your emotions, and your sense of yourself. It isn't easy, but it is do-able, and you can do it.

Adapted from You Can’t Just Snap Out Of It: The Real Path to Recovery From Psychological Trauma: Introducing the START NOW Program. By J. Douglas Bremner with Lai Reed, Laughing Cow Books, 2015.