Trauma Treatment
What PE, CPT, EMDR, IFS, and VR can look like in practice.
Different approaches help address different difficulties: a memory that keeps intruding, a belief you can’t shake, or a situation you avoid. Understanding what’s affecting you helps guide the choice of treatment. Here’s what that process can look like.
How do we identify what to work on?
Sometimes one event stands out. Sometimes there’s a longer history and a reaction you want help changing. I ask about what happened, how your symptoms developed, and what’s difficult now. A few tools can help make sense of the picture:
A recent reaction: If a raised voice leaves you frozen, that moment gives us something specific to explore. What did you expect to happen? What did you feel in your body, and how did you respond?
A timeline, or chronology: Putting relevant experiences in order can show when symptoms began or changed. Approximate dates are enough; the purpose is to notice connections.
Recurring themes: Different experiences may carry a similar belief, such as “Speaking up gets me hurt” or “I have to handle everything myself.” Those themes can help us choose a focus.
Floatback: When appropriate, I guide an exercise that starts with a current feeling, body sensation, or belief and explores whether an earlier memory comes to mind. This can suggest a connection to explore; it doesn’t verify what happened.
Those connections help identify a useful focus for treatment.
Prolonged Exposure is a structured treatment for PTSD that addresses avoidance. Avoiding reminders can bring relief in the moment, but it can also make them harder to face over time. PE involves revisiting a trauma memory in session and approaching safe situations that have become difficult.
Say you’ve stopped driving after a crash. Treatment includes identifying which driving situations are safe and planning manageable practice, such as a short trip on a familiar road. You repeat that practice between sessions, building experience handling reminders of the crash.
Working with the memory itself is another part of PE. You describe it in detail with support and revisit it over time. I guide that process and check how it’s affecting you in sessions and between them.
Prolonged Exposure (PE)
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy is a structured PTSD treatment for the conclusions trauma can leave behind. These beliefs, called stuck points, often involve responsibility, trust, safety, control, self-worth, or intimacy.
For example, “I should have known” can turn hindsight into self-blame. In CPT, you examine that conclusion. What did you know at the time? What was within your control? How do the facts compare with the standard you’re holding yourself to?
Conversation and written exercises help you develop a more balanced understanding that you can apply outside sessions. The same process can help with beliefs like “No one can be trusted,” which can make every relationship feel equally risky. A detailed written account of the trauma is optional.
EMDR techniques and bilateral stimulation
Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy for distressing memories that uses bilateral stimulation, such as guided eye movements or alternating taps, as part of a broader treatment process.
I incorporate EMDR-informed techniques, including bilateral stimulation when appropriate, as an adjunct to my trauma work. These tools can support preparation and help us work with the thoughts, emotions, and body responses connected with a difficult experience.
For example, you might use gentle alternating taps while recalling a time you felt capable or supported. I guide the exercise and check how you’re responding.
Internal Family Systems (IFS) and parts work
Internal Family Systems offers a way to work with the parts of you that want different things. You may want connection while another part pulls away as soon as a relationship starts to matter.
If an inner critic calls you weak whenever you feel upset, I might ask what it fears would happen if it stopped pushing you. It may be trying to protect you from rejection or humiliation. Understanding that fear can make it easier to work with the response without adding more shame.
I draw from IFS to make room for these conflicts and help you respond with more flexibility. That might mean being able to ask for support even when a part of you insists you should manage alone.
Virtual reality (VR) in trauma treatment.
Virtual reality makes it possible to practice approaching a difficult situation in an immersive setting. I use VR in my Las Vegas office as part of therapist-guided exposure when it fits your treatment plan.
Each exercise has a setting and a clear goal chosen with you. I guide the practice and help you notice how you respond. Afterward, we discuss how to apply what you learned in daily life.
Choosing an approach
The choice depends on your symptoms, preferences, and the evidence for a treatment. I’ll explain what sessions involve and any practice between them. Your feedback helps shape the plan, along with changes in symptoms and daily life, such as fewer intrusive memories or being able to handle a situation that used to derail your week.
Are training and certification the same?
No. Completing training and earning a method-specific certification are different steps. It’s useful to ask a therapist what training they’ve completed and how they use an approach in treatment.
Let’s find an approach that fits.
I offer trauma treatment in person in Las Vegas and through telehealth across Nevada. VR sessions take place in the office.