How do I know if I need therapy for a past trauma?
Updated on December 4, 2025
Many people live with the effects of trauma for years before they realize it. You might tell yourself you should “be over it by now,” or you might try to keep going even when life feels heavy. When a painful memory starts to shape how you think, feel, and act every day, it may be time to reach out for help.
In this guide, I walk you through the signs of unhealed trauma, why these symptoms happen, and what effective treatments look like.
What Trauma Can Look Like in Daily Life
Trauma is not only the event itself. Trauma is also the impact that stays with you afterward (American Psychiatric Association, 2013). Many people try to push through their day while carrying symptoms they barely notice anymore. These symptoms can start to feel normal. But they are not “just how you are.” They are clues that your mind and body still live in the shadow of something painful.
Below are common signs of unhealed trauma and why they matter.
1. Avoidance: The Silent Warning Sign
Avoidance is one of the core symptoms of post-traumatic stress disorder, or PTSD (APA, 2013).
You might avoid:
Certain places
Specific people
Situations that remind you of the trauma
Thoughts, memories, or emotions connected to the event
Avoidance can feel like protection in the moment. But over time, it keeps you stuck. When your world gets smaller because you are trying to stay safe, therapy can help you expand it again.
2. Re-Experiencing the Trauma
Re-experiencing happens when your mind brings the trauma back into your awareness, even when you do not want it.
You might notice:
Intrusive memories
Nightmares
Flashbacks
Feeling like the event is happening again
Physical reactions (heart racing, sweating, shaking) when reminded of the trauma
These symptoms can be frightening. They are not a sign of weakness. They are a sign that your nervous system still believes you are in danger.
3. Intense Emotions That Feel Too Big or Out of Place
Unhealed trauma often affects how you feel day to day. Your emotional reactions may seem stronger or more sudden than before.
Common emotions include:
Guilt
Shame
Fear
Anxiety
Depression
Anger
Confusion
You may feel numb at times, then overwhelmed at other times. Your emotions may shift quickly. Therapy gives you tools to understand and regulate these feelings so they no longer control your life.
4. Changes in the Way You Think About Yourself and the World
Trauma can change your beliefs. These beliefs often feel like facts, especially if the trauma happened in childhood.
You might think:
“The world is dangerous.”
“I can't trust people.”
“I am not safe.”
“Something is wrong with me.”
“I should have known better.”
These beliefs are common after trauma and often show up long before someone realizes they need support.
5. Physical Symptoms That Don’t Have a Clear Cause
Trauma affects the body as much as the mind. Research shows that trauma can influence sleep, digestion, immunity, pain, and energy levels (van der Kolk, 2014).
Physical symptoms may include:
Fatigue
Chronic pain
Headaches
Muscle tension
Trouble sleeping
When your body holds the stress of trauma, therapy can help you feel grounded again.
Self-Check: Do I Need Trauma Therapy?
If you're unsure whether therapy might help, a brief self-check can guide you. Many clinicians use the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5). It measures how much trauma symptoms affect your life.
If your score is 33 or higher, or your first seven items show significant distress …you may benefit from a trauma-focused assessment (Weathers et al., 2013).
This screener does not diagnose you, but it gives you useful information about what might be happening.
How Therapists Treat PTSD and Trauma
Trauma therapy works. Many people see real change when they use treatments backed by research. At Virtual CBT, we offer all four of these treatment approaches. Explore our trauma treatment and therapists.
Here are four of the most effective approaches:
Cognitive Processing Therapy (CPT)
CPT helps you understand how trauma changed your beliefs. You learn to notice unhelpful thoughts, challenge them, and replace them with balanced ones (Resick et al., 2017).
Explore the power of CPT for PTSD.
Prolonged Exposure (PE)
PE teaches your brain that you are safe now. You revisit memories in a gradual, guided way so they lose their power over you (Foa et al., 2019).
Discover the differences between CPT and PE.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR uses bilateral stimulation (like eye movements) to help your brain reprocess the trauma and reduce painful reactions (Shapiro, 2018).
Discover 5 benefits of EMDR.
Written Exposure Therapy (WET)
WET helps you process the trauma by writing about it in a guided, structured way. You describe the event in detail during each session so your brain can file the memory instead of reacting to it like it’s happening now. It’s a brief treatment—usually five sessions—and works well if you prefer writing over talking (Sloan & Marx, 2019).
Learn more about Written Exposure Therapy (WET) for PTSD.
Trauma-Focused Cognitive Behavioural Therapy (TF-CBT)
This approach helps you build coping skills, learn emotional regulation, and reshape the thoughts that keep you stuck.
All four treatments have strong evidence for reducing PTSD symptoms (APA, 2017).
Discover the differences between EMDR and CBT.
FAQ: Common Questions People Ask About Trauma Therapy
How long does trauma therapy take?
It depends on the treatment. Many structured therapies last 8 to 12 sessions, though some people need more support depending on their history and symptoms. Some people can respond early as well (in less than 8 session).
Can trauma therapy make things worse before they get better?
Therapy can bring up difficult emotions, but research shows that temporary discomfort is normal and often a sign of progress (Foa et al., 2019). A skilled therapist moves at a pace that feels safe.
Can childhood trauma show up in adulthood?
Yes. Childhood trauma can shape your beliefs, relationships, and emotional reactions well into adulthood (Felitti et al., 1998). Many people do not realize the connection until they explore it in therapy.
Learn more about how childhood trauma show up in adulthood.
What if I don’t remember the trauma clearly?
Many survivors have blurry or incomplete memories. Therapy does not need perfect recall. You can still treat symptoms even if the memory is unclear. But we don't go looking for "blocked" or "suppressed" memories.
How Therapy Helps You Heal
People often think trauma therapy is only about talking about the event. It’s not. Therapy helps you:
Feel safe again
Reduce avoidance
Regulate big emotions
Understand and change painful thoughts
Sleep better
Build stronger relationships
Reconnect with yourself
Healing trauma is not about erasing the past. It’s about loosening its grip on your present.
When Is the Right Time to Start Therapy?
You do not need to reach a crisis point. If trauma affects your life, your relationships, or your ability to feel calm, you deserve support now.
Many people wait because they fear judgment or believe their suffering “isn’t bad enough.” But trauma therapy is for anyone who wants to feel better—no matter the cause, timing, or details.
Work With a Trauma Therapist Who Understands
Our psychotherapists at Virtual CBT Psychotherapy specialize in trauma and PTSD. We use evidence-based treatments and provide a warm, compassionate space where you can heal at your own pace.
If you want to learn how therapy can help you feel safer, steadier, and more like yourself again, connect with us today.
Book Your Free Consultation
Book a free consultation to get started today. We will match you with a therapist who understands trauma and knows how to support your recovery. Learn about our therapy fees. You can choose to work with a registered social worker, registered psychotherapist, or online psychologist.
You deserve relief. You deserve clarity. You deserve healing.
Written by Melissa Lindstrom, RSW, MSW
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults.
Felitti, V. J., Anda, R. F., Nordenberg, D., & others. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258.
Foa, E. B., Hembree, E., & Rothbaum, B. O. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences.
Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive processing therapy for PTSD: A comprehensive manual.
Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures.
van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma.
