Trauma

Some experiences do not stay in the past. They show up in your sleep, in your body, in how you handle closeness, or in a steady sense of being on guard. I work with adults in Hollywood, Florida, and by secure video who are living with the effects of difficult experiences, whether or not they would call those experiences trauma.

What I mean by trauma

Trauma is not defined only by what happened. It also has to do with how an experience overwhelmed a person at the time, and what it left behind. It can follow an accident, an assault, a sudden loss, a frightening medical event, or violence. It can also come from growing up in a home that did not feel safe, or from relationships in which you were repeatedly hurt, ignored or controlled.

Some people remember everything in vivid detail. Others remember very little, or feel little when they talk about it. Many people never use the word for themselves. You do not have to compare your experience with anyone else’s, and you do not have to prove that it was bad enough. Having been through something difficult also does not mean you have post-traumatic stress disorder. Many people are affected by hard experiences without meeting criteria for any diagnosis, and a diagnosis is not what decides whether therapy is a reasonable choice.

How it can show up

The effects look different from person to person. Some that people describe include:

• Anxiety, or a feeling of being watchful and braced even when nothing is wrong.
• Avoiding people, places, conversations or feelings that bring something back.
• Irritability or anger that seems bigger than the moment.
• Feeling numb, flat, or far away from your own life.
• Shame, guilt, or a belief that what happened was your fault.
• Trouble sleeping, nightmares, or waking up on high alert.
• Difficulty trusting people, or difficulty feeling close to them.
• A sense of not being safe, even in situations that are objectively fine.
• Physical tension, pain or exhaustion that is hard to explain.

These responses often make sense given what a person has been through. Having them is not a sign of weakness, and it does not mean something is wrong with you as a person.

Why it can be hard to move past

Many people are told to put it behind them, and many have tried. Several things can make that hard:

• Avoidance. Staying away from reminders can bring temporary comfort, while the fear around them stays in place.
• A system that stays on alert. After a threat, the mind and body can keep reacting as though it is still happening, even years later.
• Self-blame. Many people carry the sense that they should have done something differently.
• Isolation. It can feel safer to say nothing, and silence can leave people alone with it.
• Experiences that were never talked through. Painful memories can stay vivid or fragmented until there is a safe place to make sense of them.

How therapy can help

Many of the patterns that bring people to therapy began as ways of coping. Staying guarded, keeping busy, going numb, or keeping people at a distance may have helped at one time. Part of our work is understanding how your patterns developed, what they have been protecting you from, and which ones still serve you and which no longer do.

I work at a pace you can manage. Early on, much of the work is about understanding what you are dealing with and making sure you have ways to steady yourself. You decide what to share and when. There is no requirement to tell me the whole story before we begin, and we can slow down or pause at any point. Depending on what fits, our work may include:

• Building ways to stay grounded when memories or feelings get strong.
• Talking through experiences when you feel ready, so they are not carried alone.
• Paying attention to the body as well as to thoughts and feelings.
• Looking at how what happened has affected your relationships, your work, and the way you see yourself, including your confidence and self-esteem.

I cannot promise a particular outcome. What I can offer is careful attention, honest conversation, and a process shaped around you rather than around a fixed program.

Safety, trust and the therapy relationship

Many traumatic experiences involve a disruption of safety or trust, so it makes sense if it takes time to feel comfortable with a therapist. I do not expect you to trust me right away. I would rather you test it, ask questions, and tell me when something is not working. Therapy is paced collaboratively, with close attention to what feels manageable for you. You are free to say no to anything I suggest, and we can change direction when needed. Part of what makes the work possible is a relationship in which you can notice what you feel and say so.

Where EMDR fits

I am EMDR-trained. EMDR is a structured psychotherapy approach that can involve briefly attending to distressing memories while engaging in bilateral stimulation, such as guided eye movements. It is one of the approaches used in trauma therapy. It is not right for everyone, and it is not right at every stage of treatment. If it seems like a good fit, we would discuss what it involves and decide together, and I would not use it without your agreement. Many people work with me through conversation alone, and some use EMDR as one part of their work alongside conversation.

You might consider reaching out if

• Something that happened, recently or long ago, still affects your days or nights.
• You feel on edge, numb, or cut off from other people.
• You avoid things in order to avoid feelings.
• You have tried to move on and it has not worked.
• You are not sure what you went through counts as trauma, but it still weighs on you.

Questions people often ask

Do I have to tell you everything that happened?

No. You can share as much or as little as you want. Many people begin by talking about how things are now, and the history comes later, if at all.

What if I am not sure my experience was serious enough?

There is no threshold you have to meet. If it is troubling you, we can talk about it.

Do I have to have PTSD to come to therapy for trauma?

No. Many people who come in do not have a PTSD diagnosis, and some have never been diagnosed with anything. If a diagnosis ever becomes relevant, we can talk about it.

Will I have to relive it?

You will not be asked to relive anything you are not ready for. Early work often focuses on stability and understanding. When and how we approach painful memories is something we decide together.

Do I have to do EMDR?

No. I am EMDR-trained, and it is one option among several. Many people work with me through conversation alone.

How long does therapy take?

It varies a lot from person to person, depending on what you are dealing with and what you want from the work. We can talk about what to expect after we have met and I have a clearer picture.

Can you work with trauma along with other difficulties?

Yes. Trauma often overlaps with substance use and process addictions, and we can look at these together.

What to expect at the start

We begin with a free 15-minute consultation. You can tell me a little about what is happening and ask how I work, and we can see whether working together feels right. If you decide to go ahead, early sessions are mostly about getting to know you, understanding what you are carrying, and making sure you feel steady enough to go further. Sessions are 53 minutes, in person in Hollywood or by secure video, and what you share is confidential within the limits of the law and professional ethics.

I am in private practice. My fee is $250 per 53-minute therapeutic hour, and I provide superbills you may submit for possible out-of-network reimbursement; coverage depends on your plan. You can read more on the Fees & Insurance page.

If you are in crisis or thinking about harming yourself, call or text 988, or go to your nearest emergency room.