In-person in Houston, online across Texas • In-network with Aetna, BCBS, Cigna, UHC/Optum, Tricare, Curative, Oscar • Therapy in English, Spanish, Portuguese, Farsi
Trauma
Doctoral-Level Trauma Therapy and EMDR in Houston, TX
Trauma does not always present as such. It may appear somatically, as hypervigilance, tension, or shutdown, or it may appear in the whole structure of a life: in the relationships pursued and avoided, in decisions made precipitately or deferred. Specific events are only part of the clinical picture. The remainder is what they came to signify and everything that has since been built around it.
Trauma therapy at Real Talk addresses single-incident and complex presentations, experiences lived in early relationships, and situations arising from ongoing and structural conditions rather than localized events. We also provide ongoing outpatient treatment for patients stepping down from hospitalization or intensive programs.
The choice of approach is a clinical decision made within the treatment rather than a selection from a menu. Depth-oriented psychotherapy examines how past experience has organized itself in repetition and in the patient's relations with others, and works with that structure rather than with symptoms in isolation.
EMDR and other clinical approaches are used, where indicated, to reduce the affective charge of intrusive memories. Where stabilization must precede any processing, the work is staged accordingly.
Many patients move through more than one approach over the course of a treatment.
Presentations We See
Post-traumatic stress disorder following a discrete event, including traumatic bereavement. Complex PTSD in which the trauma was repeated or prolonged, and in which the disturbance extends to affect regulation, self-concept, and relational capacity. Dissociative presentations along the full range of severity. Structural traumatic stress and the psychological injuries of migration and displacement, where the source is a condition that continues. Moral injury in veterans, first responders, and healthcare workers. Trauma that has been treated previously, sometimes repeatedly, without altering its effect in the present.
What We Pay Attention To
We pay attention to what keeps the trauma active in the present: what it protects, what it has foreclosed, and what the person had to become in order to survive it. We attend to pacing, since processing before a patient can tolerate it can be harmful. And we hold the distinction between a traumatic memory and a traumatic structure, since some patients require the former to be addressed and others require the arrangement built around it to be understood.
Why Doctoral Training Matters for Trauma: Complex PTSD involves disturbances in self-organization beyond the fear-based symptoms of PTSD and is associated with greater functional impairment. Judgment about readiness, about differential diagnosis, and about when dissociation or self-harm requires a change of frame is what doctoral training is for. Where trauma underlies depression, anxiety, or grief, the treatment addresses the whole presentation.
Our clinical director reads every inquiry and recommends a clinician within minutes on weekdays, hours on weekends.
Will I have to recount what happened in detail?
Not before you are able to, and in some approaches not at all in the way people anticipate. Some methods work with the memory directly; others work with what the memory has become. The pace is set with you.
Is EMDR available?
Yes, with clinicians trained in it, where it is appropriate to the presentation and to the person.
Do you treat complex PTSD and dissociation?
Yes. This is where doctoral-level work is most consequential, and where we exercise the greatest care with pacing and with the stability of the frame.
From Our Journal
A Hole That Doesn't Heal: What Trauma Actually Does to a Life.