Trauma changes the brain. It rewires the alarm systems that are supposed to keep you safe, leaving them stuck in the “on” position long after the danger has passed. If you’ve experienced trauma — whether a single event or a prolonged period of abuse, violence, or threat — you may find yourself hypervigilant, emotionally numb, plagued by flashbacks, or unable to sleep. These are not signs of weakness. They are symptoms of post-traumatic stress disorder, and they respond to treatment.
At Denver Catholic Counseling, we use prolonged exposure therapy to treat PTSD. It is one of the most rigorously studied and effective treatments available, recommended as a first-line treatment by the American Psychological Association, the VA/DoD Clinical Practice Guideline for PTSD, and the World Health Organization. And it works.
What Does PTSD Do to the Brain?
When you experience a traumatic event, your brain encodes the memory differently than it encodes ordinary experiences. Instead of being processed and filed away, the trauma memory remains “hot” — fragmented, emotionally charged, and easily triggered. The amygdala, your brain’s threat-detection center, becomes hyperactive. The prefrontal cortex, which normally provides perspective and rational assessment, struggles to exert control. The result is a nervous system that is perpetually braced for danger.
PTSD symptoms typically cluster into four categories: intrusive re-experiencing (flashbacks, nightmares, intrusive memories), avoidance (steering clear of anything associated with the trauma), negative changes in thinking and mood (guilt, shame, emotional numbness, loss of interest), and hyperarousal (difficulty sleeping, startling easily, being constantly on edge). These symptoms are the brain’s attempt to protect you from a threat that has already passed. They were adaptive at the time. Now, they’re keeping you trapped.
What Is Prolonged Exposure Therapy?
Prolonged exposure (PE) therapy was developed by Dr. Edna Foa at the University of Pennsylvania and has been studied in dozens of clinical trials over more than three decades. The evidence base is extensive and consistent: PE produces significant reductions in PTSD symptoms for the majority of people who complete the protocol.
PE is based on a straightforward principle: avoidance maintains PTSD. When you avoid reminders of the trauma — places, people, activities, even your own memories — you never give your brain the chance to learn that the threat has passed. The avoidance provides temporary relief but keeps the fear alive. PE breaks this cycle by systematically, gradually, and safely helping you confront what you’ve been avoiding.
The treatment involves two core components. Imaginal exposure involves revisiting the traumatic memory in a structured, therapeutic setting. With your therapist’s guidance, you recount the trauma aloud, repeatedly, in a safe environment. Over time, the memory loses its emotional charge. It becomes something you can think about without being overwhelmed. It moves from being a raw, present-tense emergency to being a past event that no longer controls you.
In vivo exposure involves gradually re-engaging with the real-world situations, places, and activities you’ve been avoiding because of the trauma. This is done incrementally, starting with less distressing situations and working up. The goal is not to eliminate all discomfort but to help your nervous system learn that these situations are safe — that the danger has passed.
What Does a Prolonged Exposure Session Look Like?
A typical PE protocol involves 8 to 15 weekly sessions, each lasting about 90 minutes. The first few sessions focus on psychoeducation — understanding PTSD, how PE works, and building the tools you’ll need. Breathing techniques are introduced to help manage acute anxiety. Then the exposure work begins.
Imaginal exposure sessions are recorded so you can listen to them between sessions as homework. This repeated processing is a key part of how PE works — the more you engage with the memory in a safe context, the more your brain updates its assessment of the threat. In vivo assignments are also given as homework, with specific activities tailored to your avoidance patterns.
It is important to be honest about something: PE is hard. The early sessions of imaginal exposure can be distressing. You are, after all, deliberately facing something you’ve been running from. But the distress is temporary and decreasing. Most clients report significant relief within the first several sessions, and by the end of the protocol, the majority show clinically significant improvement.
Faith and Trauma Recovery
Trauma often affects a person’s relationship with God. Some people feel abandoned by God — where was He when this happened? Others experience what theologians call a “spiritual wound,” a fracture in their capacity to trust in divine goodness. Still others find that their faith deepens through suffering, though this is not something that should be forced or expected.
At Denver Catholic Counseling, we hold space for all of these responses. We don’t use faith as a Band-Aid over trauma, and we don’t pressure you to “find the silver lining” in your suffering. What we do is provide clinically rigorous treatment within a context that understands the spiritual dimensions of trauma. If your faith is a resource in your recovery, we draw on it. If your faith has been damaged by your experience, we acknowledge that honestly. Both are common, and both deserve respect.
Finding Trauma Treatment in Denver
If you’re in the Denver metro area and living with PTSD, you deserve treatment that works. Our practice in Greenwood Village offers prolonged exposure therapy in person and via telehealth throughout Colorado. We work with survivors of all types of trauma — childhood abuse, sexual assault, combat, accidents, domestic violence, and more.
You do not have to live in survival mode forever. The brain that learned to fear can learn to be at peace. And with the right support, it will.
“He heals the brokenhearted and binds up their wounds.” — Psalm 147:3