When PTSD Gets Worse Before It Gets Better

March 3, 2020 Beth Avery

Posttraumatic stress disorder (PTSD) can get worse before it gets better when you start therapy. Find out why that's normal and how to handle it.

Have you ever heard the saying: It gets worse before it gets better? Any person that has sought out psychological help is likely to understand what this saying means, myself included. Therapy is designed to draw out uncomfortable emotions, thoughts, and memories. When things start getting tough in therapy for a person with PTSD, it's often a sign that therapeutic progress is being made.

Though it's very rewarding when walls start breaking down in therapy for a person with PTSD, it can also be difficult to handle. In trauma therapy, making progress often means confronting scary memories of past traumatic experiences. It can involve facing uncomfortable emotions that have been locked away. Though the psychological healing process is good, it can feel very bad for a person with PTSD. Keep in mind that PTSD often gets worse before it gets better, but it will get better.

What to Do When Therapy Makes PTSD Gets Worse, Not Better

First and foremost, it's important to remember that trauma therapy happens on your timeline. There's no time limit on healing. If it feels like your therapist is pushing you too fast, it's okay to take a step back and reevaluate. A break to focus on self-care and self-compassion is needed at times. 

Of course, that's not to say that we should run away from therapy when it starts to get tough because therapy often makes PTSD worse before it gets better. Sometimes it's necessary to go through those tough times in therapy, with the hope of healing and peace on the other end. And there are many different methods a person with PTSD can use to self-soothe while facing scary emotions and memories.

Self-Care Tips for People in PTSD Therapy

Because I have tough conversations about my past during trauma therapy, I like to feel as safe and comfortable as possible when I’m in my therapist's office. Sometimes that means dimming the lights in the room or bringing a weighted blanket to my session. Other times, I use fidget toys to help filter out some of my anxiety. And before every session, I buy an iced coffee as a little therapy day treat. 

Feeling safe with your therapist is a crucial part of trauma therapy, so it's important to keep your therapist in the loop about what you need to feel comfortable during therapy sessions. Divulging tough emotions and thoughts isn't going to happen if you don't feel safe, so remember to communicate these needs with your therapist. 

Therapy is not meant to be easy. It's not meant to be clean and straightforward. It can be messy. As you're going through trauma therapy, don't be afraid of the tough times. Sometimes PTSD really does get worse before it gets better. It's normal and natural to face ups and downs when healing from trauma. If you're going through a rough patch in therapy, hold on to the hope that there is healing at the other end. 

APA Reference
Avery, B. (2020, March 3). When PTSD Gets Worse Before It Gets Better, HealthyPlace. Retrieved on 2024, May 28 from

Author: Beth Avery

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Suzanne Humphreys-Hogg
January, 22 2023 at 11:59 pm

I hate to say it but most therapists do not understand PTSD from long term abuse. If this is the root of your PSTD i would suggest you look at Melanie Tonia Evans NARP program. Also if you are in a permanent freeze state Alprazolam will bring you out . Handle this drug with caution and get off when you think you understand what you have been through and are at peace. This can take a long time. Be kind to yourself. Your body and mind are doing exactly what nature intended, You are not crazy or diseased . It's trauma and it hurts.

October, 10 2022 at 9:01 am

Hey Beth
I recently changed therapist and all of my ‘parts’ are in outrage! They don’t trust me to make the right decisions or my therapist isn’t competent enough…’s so so tough, all my old coping mechanisms have come out, I am self medicating with alcohol again….I know this is very unhealthy but it’s better that the possible alternative……I’m pretty sure this is a reaction to new therapy and I just gotta roll with it…..#hardestthingsver x

Tom Richards
December, 5 2021 at 6:04 am

Thank u Beth. What u say makes sense. I've been working hard w NY therapist. It IS worse right now, even as I type this. Which is why I decided to take a bit of a break before I start again. Thank u again. Tom

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