Trauma and PTSD
Trauma and Post-Traumatic Stress Disorder (PTSD) Treatment in San Diego
Trauma can continue to affect you even when the danger has passed. You may understand what happened intellectually while your body remains tense, watchful or easily activated. Sleep, concentration, relationships and daily routines may all be affected.
Dr. Freeman provides individualized trauma and PTSD treatment for adults in San Diego and by California telehealth when appropriate. Treatment is paced, collaborative and connected to the problems the patient wants to change. Patients do not have to describe every detail immediately or choose a treatment method before meeting with him.
Treatment at a Glance
- 1. Who may benefit: Adults experiencing intrusive memories, nightmares, hypervigilance, avoidance, emotional reactivity, body tension, sleep disruption or other continuing effects of trauma.
- 2. Treatment focus: Safety, stabilization, readiness and the specific symptoms or areas of life the patient wants to change.
- 3. Approaches: Trauma-focused Cognitive Behavioral Therapy (CBT) strategies, Eye Movement Desensitization and Reprocessing (EMDR), sleep-focused care, psychoeducation and anxiety-management skills when appropriate.
- 4. Appointments: In person in San Diego and by teletherapy throughout California when clinically appropriate.
- 5. Related care: EMDR therapy, Insomnia treatment, anxiety treatment and services for active-duty military personnel and dependents.
How Trauma May Show Up
Trauma reactions vary. Some people have a clear memory of one event. Others have repeated experiences, medical trauma, loss, relationship harm or long periods of threat and responsibility. Symptoms may include:
- 1. Intrusive memories or distressing reminders
- 2. Nightmares or fear of sleep
- 3. Hypervigilance and exaggerated startle
- 4. Avoidance of people, places or situations
- 5. Irritability, anger or emotional reactivity
- 6. Numbness, withdrawal or disconnection
- 7. Anxiety, shame or guilt
- 8. Physical tension and difficulty relaxing
- 9. Concentration problems
- 10. Changes in work, relationships or daily functioning
These responses are not character flaws. Assessment helps clarify the pattern, how it affects your life and which treatment options may be useful.
Trauma, Sleep and the Nervous System
Sleep and trauma often reinforce one another. A nervous system that remains on guard may make it difficult to fall asleep or stay asleep. Nightmares can create fear of bedtime, and poor sleep can increase irritability, anxiety, pain-related distress and emotional reactivity.
Trauma treatment may not automatically resolve chronic insomnia. When insomnia has become a separate, self-maintaining problem, direct sleep treatment such as Cognitive Behavioral Therapy for Insomnia (CBT-I) may also be needed. The plan should address the loop rather than only the loudest symptom.
An Individualized Trauma Treatment Plan
Treatment begins by understanding the patient’s current symptoms, history, strengths, supports and goals. Dr. Freeman also considers sleep, health, pain, substance use, current safety and the ways the patient copes when distress rises. This helps determine where to begin.
Education and Stabilization
Before intensive trauma processing, some patients benefit from understanding their reactions and learning grounding, breathing, pacing or other self-regulation skills. Preparation is part of treatment, not a sign of failure.
CBT-Based Trauma Treatment
Cognitive and behavioral strategies can help identify patterns of avoidance, self-blame, threat prediction and other responses that keep distress active. Treatment focuses on more useful ways of responding without reducing trauma care to positive thinking.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
EMDR may help some people process distressing memories and reduce the emotional or physical activation connected with them. It is structured and paced, and it should be recommended only when it fits the patient’s readiness, needs and goals.
Sleep-Focused Treatment
CBT-I and related sleep strategies may be included when insomnia, nightmares or nighttime hypervigilance are part of the picture. Sleep care can be coordinated with trauma treatment rather than postponed indefinitely.
Behavioral and Anxiety-Management Skills
Treatment may include gradual changes in avoidance, arousal-management skills, behavioral planning and practice between sessions. The aim is to improve daily function as well as reduce distress.
Patients, Relationships and Cultural Context
Dr. Freeman works with teens, adults and older adults. Treatment is most often individual, and couples may be included when the presenting concern and treatment plan make that format appropriate.
The practice welcomes LGBTQ+ patients and people from varied cultural, relationship and spiritual backgrounds. Dr. Freeman considers identity, family, community, humor, beliefs and personal values when those factors matter to the patient, without assuming that one perspective fits everyone.
You Control the Pace
Good trauma treatment is not about pushing the patient into painful material before the patient is ready. Dr. Freeman explains the purpose of an intervention, checks how the patient is responding and adjusts the pace. Patients can ask questions, pause or say when something does not fit.
You may not need to describe every detail of a traumatic experience for treatment to be meaningful. What matters is having enough information to work responsibly with the memories, beliefs, emotions and body reactions that are affecting you now.
Trauma Treatment for Active-Duty Military and Dependents
Active-duty military personnel and dependents may seek trauma treatment for service-related or non-service-related experiences. Dr. Freeman has worked extensively with this population for approximately seven years. He does not assume that every military patient has PTSD or that trauma must be the only focus of care.
Dr. Freeman's Clinical Perspective
Trauma treatment does not have to begin with a detailed retelling of the most painful experience. Dr. Freeman first considers safety, current stability, sleep, coping resources and the patient’s ability to return to the present after becoming activated. Preparation is part of treatment, not a delay in treatment.
The treatment method follows the patient’s needs. Some patients benefit from education and stabilization before processing trauma memories. Others may use Cognitive Behavioral Therapy (CBT) strategies, EMDR or sleep-focused treatment. Insomnia and nightmares may need direct attention even while broader trauma work continues.
Dr. Freeman’s perspective is also informed by personal experience with grief, illness, loss and major life disruption. He does not assume that adversity automatically produces growth. He recognizes, however, that supported recovery can strengthen resilience, empathy, compassion and a clearer sense of what matters to the individual.
When Medical or Additional Care May Be Needed
Trauma-focused work must be paced around current safety and stability. When immediate danger, severe instability, substance withdrawal, urgent medical needs or a level of care beyond outpatient psychotherapy is present, crisis, medical or specialized services may need to come first or work alongside therapy.
The practice website and consultation request are not emergency services. In a life-threatening emergency, call 911. For immediate emotional support or a suicidal crisis, call or text 988 or visit the 988 Suicide & Crisis Lifeline.
Frequently Asked Questions
Is a PTSD Diagnosis Required to Seek Trauma Therapy?
No. People may seek help for trauma-related symptoms even when they are unsure whether a diagnosis applies. Assessment can clarify the pattern and treatment options.
Is It Necessary to Tell the Whole Story Immediately?
No. Treatment begins with assessment, preparation and an agreed plan. The pace should reflect your readiness, safety and ability to recover after difficult material.
Is EMDR the Only Trauma Treatment Dr. Freeman Uses?
No. EMDR is one option. Treatment may also include Cognitive Behavioral Therapy (CBT) strategies, psychoeducation, behavioral work, sleep treatment and skills for managing anxiety or arousal.
Can trauma therapy help sleep?
It may help when trauma is driving nightmares or hypervigilance. Chronic insomnia may also need direct CBT-I or sleep-focused treatment.
How long does trauma treatment take?
Many focused courses of treatment fall within approximately 8 to 12 sessions, but trauma care may extend longer when symptoms are complex or occur with other psychiatric, sleep, pain or medical concerns. Treatment is paced according to readiness and clinical need, and no result is guaranteed.
Related Services
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
Learn when EMDR may be considered as part of a broader trauma-treatment plan.
Insomnia and Sleep Problems Treatment
Learn how specialized psychological treatment addresses chronic insomnia, nighttime arousal and sleep-related habits.
Anxiety Treatment
Explore practical treatment for worry, avoidance, physical arousal and anxiety that affects daily life.
Services for Active-Duty Military Personnel and Dependents
Review care for active-duty service members and dependents without assuming that every concern is PTSD.
Related Reading From Dr. Freeman’s Blog
These articles explain common connections among trauma, the nervous system, sleep and trauma-focused treatment.
- Trauma and PTSD
Can PTSD Cause Insomnia? By Dr. Charles R. Freeman, Ph.D. Yes, PTSD can cause insomnia. Post-traumatic stress disorder can keep...
EMDR for trauma-related problems may help when painful memories, body reactions, nightmares, shame, fear, or relationship patterns continue long after...
Trauma affects sleep for years because the body may continue operating as if danger is still nearby, even when the...
Authoritative Information
Read educational information from the National Center for PTSD. This federal resource is provided for general education and does not replace an individualized assessment.
Clinical Content Information
Clinical content by Dr. Charles R. Freeman, Ph.D., a California-licensed psychologist with over 35 years of clinical experience. View California psychology license PSY #25414.
Learn more about Dr. Freeman’s professional background and clinical approach.
About Dr. Charles R. Freeman, Ph.D.
Dr. Freeman is a California-licensed psychologist in San Diego with over 35 years of clinical experience. His practice specializes particularly in insomnia and sleep problems and also includes anxiety, trauma and PTSD, chronic pain and behavioral medicine, CBT, CBT-I and EMDR. Appointments are available in person in San Diego and by teletherapy throughout California when clinically appropriate.
View California psychology license PSY #25414 or learn more about Dr. Freeman’s background and clinical approach.
Discuss Your Concerns
Patients do not need to decide whether they have PTSD or whether EMDR is right before contacting Dr. Freeman. A consultation can begin by discussing what is happening and what the patient wants to change.