What Is Trauma and PTSD — and Why Traditional Treatments Often Fall Short
DR. SURUCHI CHANDRA | NEUROTHERAPy
BETHESDA, MARYLAND I WASHINGTON DC
Understanding Trauma and PTSD
Trauma is any experience that overwhelms a person’s ability to cope—from accidents, assault, or loss, to chronic stress or early-life adversity. When the body perceives danger, the nervous system activates a fight, flight, or freeze response. In some people, especially after repeated or severe experiences, this survival system gets stuck in overdrive.
According to the National Institute of Mental Health (NIMH), Post-Traumatic Stress Disorder (PTSD) occurs when these reactions don’t return to baseline. Common symptoms include:
Complex PTSD (C-PTSD), described by Cleveland Clinic and trauma experts like Dr. Judith Herman (Harvard), often develops from chronic or relational trauma such as childhood neglect, emotional abuse, or captivity. In these cases, the injury is not just emotional—it’s neurological.
According to the National Institute of Mental Health (NIMH), Post-Traumatic Stress Disorder (PTSD) occurs when these reactions don’t return to baseline. Common symptoms include:
- Flashbacks or intrusive memories
- Avoidance of reminders
- Negative mood or self-beliefs
- Hypervigilance, irritability, or insomnia
Complex PTSD (C-PTSD), described by Cleveland Clinic and trauma experts like Dr. Judith Herman (Harvard), often develops from chronic or relational trauma such as childhood neglect, emotional abuse, or captivity. In these cases, the injury is not just emotional—it’s neurological.
Medically reviewed by Suruchi Chandra, MD — Integrative Psychiatry and Neurotherapy (Bethesda, MD)
This content is for educational purposes only and does not substitute for individualized medical advice.
This content is for educational purposes only and does not substitute for individualized medical advice.
Trauma-Informed Care
Trauma-informed care acknowledges that healing begins with safety—in the body, relationships, and environment. It focuses on helping patients regain regulation before asking them to relive or analyze their trauma.
In our clinic, we blend traditional psychotherapy with evidence-informed methods that target the nervous system itself, such as:
In our clinic, we blend traditional psychotherapy with evidence-informed methods that target the nervous system itself, such as:
- Neurofeedback: Using real-time brainwave monitoring to retrain brain circuits toward calm, focus, and resilience (supported by van der Kolk et al., 2006).
- Vagus Nerve Stimulation (VNS): Non-invasive stimulation of the vagus nerve to promote relaxation, improve mood, and reduce hyperarousal.
- Somatic and mindfulness-based therapies: Helping the body complete defensive responses and build tolerance for safe connection.
Even with the best treatments, 30–50% of patients continue to experience symptoms (VA PTSD Center, 2024). Why?
Judith Herman’s Three Stages of Recovery (Safety, Remembrance & Mourning, Reconnection) highlight why safety and stabilization come first. If the nervous system cannot calm, deeper processing may retraumatize rather than heal.
- Top-Down Focus: Most therapies start with thoughts or memories, while trauma often lives in the body’s implicit systems.
- Physiological Imbalance: The autonomic nervous system—especially the vagus nerve—may remain dysregulated, keeping the body in survival mode.
- Incomplete Integration: Traditional talk therapies may not fully engage sensory, emotional, and physiological healing.
- Chronic or Developmental Trauma: Complex trauma involves disrupted attachment and nervous system wiring that cognitive methods alone cannot rewire.
Judith Herman’s Three Stages of Recovery (Safety, Remembrance & Mourning, Reconnection) highlight why safety and stabilization come first. If the nervous system cannot calm, deeper processing may retraumatize rather than heal.
Why Many People Still Struggle
Standard PTSD Treatments
1. Trauma-Focused Psychotherapies
Guidelines from the VA National Center for PTSD and NIMH recommend evidence-based approaches such as:
These therapies help people safely revisit traumatic memories, reframe distorted beliefs, and reduce avoidance.
2. Medications
Selective serotonin reuptake inhibitors (SSRIs) like sertraline and paroxetine are FDA-approved for PTSD. They can reduce anxiety and intrusive thoughts, but rarely address deeper physiological dysregulation.
3. Adjunctive Supports
Group therapy, mindfulness, and lifestyle changes are often added to promote safety and connection.
Guidelines from the VA National Center for PTSD and NIMH recommend evidence-based approaches such as:
- Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT)
- Eye Movement Desensitization and Reprocessing (EMDR)
These therapies help people safely revisit traumatic memories, reframe distorted beliefs, and reduce avoidance.
2. Medications
Selective serotonin reuptake inhibitors (SSRIs) like sertraline and paroxetine are FDA-approved for PTSD. They can reduce anxiety and intrusive thoughts, but rarely address deeper physiological dysregulation.
3. Adjunctive Supports
Group therapy, mindfulness, and lifestyle changes are often added to promote safety and connection.
The Science: How Trauma Affects the Body
Neuroscientist and psychiatrist Bessel van der Kolk, MD showed through brain imaging that trauma reshapes key networks involved in threat detection, emotion regulation, and body awareness.
In his book The Body Keeps the Score and related studies, van der Kolk demonstrated that trauma is stored not just in memory, but in the body’s physiology.
That’s why survivors often say, “I know I’m safe, but my body doesn’t feel it.”
- The amygdala (alarm system) becomes overactive.
- The prefrontal cortex (rational control) goes offline.
- The insula (body awareness) shows altered activity—people may feel numb, detached, or flooded by sensations.
In his book The Body Keeps the Score and related studies, van der Kolk demonstrated that trauma is stored not just in memory, but in the body’s physiology.
That’s why survivors often say, “I know I’m safe, but my body doesn’t feel it.”
Dr. Suruchi Chandra, a Harvard- and Yale-trained psychiatrist, brings together emerging neuroscience-based therapies, trauma-informed care, nutritional approaches, and systems-level biology to advance thinking in psychiatry and help more patients find clearer paths forward.
See full bio.
About Dr. Chandra
Updated February 2026
- Trauma describes how overwhelming experiences can alter the brain and body’s ability to feel safe and regulate stress.
- PTSD (Post-Traumatic Stress Disorder) develops when the body and mind remain in a state of threat long after the event has passed.
- Standard treatments like therapy and medication can help, but many people still experience lingering symptoms.
- Newer, trauma-informed approaches address the nervous system itself, integrating neurofeedback and vagus nerve stimulation to help restore regulation and safety.
- Healing requires more than managing thoughts—it involves calming the body that remembers what happened.
Sources
- National Institute of Mental Health (NIMH): Post-Traumatic Stress Disorder
- VA National Center for PTSD: Understanding PTSD Treatment
- Cleveland Clinic: Complex PTSD
- Judith Herman, MD: Three Stages of Recovery
- Bessel van der Kolk, MD: Scientific Publications
