What to Expect From PTSD Therapy

PTSD therapy in Ottawa usually starts with safety and sleep, not with retelling the worst moment of your life. The first sessions are about understanding what your symptoms are doing to daily life, steadying the nights, and building enough grounding that harder work becomes possible later.

If you have been putting off a first appointment because you dread being asked to relive everything, this is what the early sessions with me actually involve.

Before the First Session

You call (613) 859-8740 or send an inquiry through the contact page, and we talk briefly about what is going on and whether my practice is a good fit. You do not need a diagnosis or a referral to start.

Sessions are $250 an hour. Many extended health plans and employee assistance programs cover psychotherapy by a Registered Psychotherapist. I do not bill insurers directly, but you receive a receipt with my registration details to submit for reimbursement. Sessions are in person at 854 Wingate Dr or by secure video where clinically appropriate, in English or French.

The First Session: Safety and Sleep

The first session is a conversation, not an interrogation. I ask about nightmares, intrusive memories, triggers, what you avoid, how on guard you feel, and how you are sleeping. I also ask what has helped, even a little.

You decide how much of the traumatic event to share. A one-line headline is enough at first. We also check safety: thoughts of self-harm, drinking or other ways of numbing, and who is around to support you.

Why Sleep Comes First

A neatly made bed in a quiet bedroom at dawn, with pale light through sheer curtains and a clock and glass of water on the bedside table — Steadier nights make every other part of PTSD therapy more manageable.

Lost sleep makes every other PTSD symptom harder to manage. Nightmares break up the night, hypervigilance keeps the body braced, and exhaustion leaves less capacity to cope the next day. So the early work often focuses on the nights: what happens before bed, what wakes you, and what helps you settle again.

Grounding Before Memory Work

A person seated in an armchair with both hands resting on their knees and feet flat on a rug, face out of frame — Grounding skills come first, so you have a way back to the present before any memory work.

Before any work with the memories themselves, you learn ways to bring yourself back to the present when a flashback or a surge of panic hits: noticing your feet on the floor, slowing your breathing, naming what is around you. We practise these in session until they are familiar enough to use on your own.

When Exposure Work Begins

Exposure means gradually and deliberately approaching memories or situations you have been avoiding, in a planned way, so they lose their grip. It starts only when there is a reason, a plan, and enough grounding to do it responsibly, and you can slow down or stop.

Nothing is sprung on you: each step is agreed in advance, and we review how it went before taking the next one. Cognitive behavioural therapy (CBT) works alongside it, looking at the thoughts that keep the threat response switched on. For clients who want it, faith and meaning can be part of the conversation too.

How Progress Is Measured

An open weekly planner with a pencil and a cup of coffee on a wooden table by a window — Regular check-ins on sleep and symptoms show whether the work is helping.

Regular check-ins track your sleep, how intense the symptoms are, and how day-to-day life is going, so change is measured rather than assumed. If something is not helping, we adjust.

How long therapy takes varies from person to person. The Centre for Addiction and Mental Health (CAMH) puts it plainly: "People can recover from PTSD. Some recover in six months, while others take much longer. Everyone’s experience is different."

Therapy and Your Family Doctor

Therapy works alongside medical care, not instead of it. CAMH notes that "Psychiatrists and family doctors can prescribe medication for depression, nervousness and sleep problems, which are common in people with PTSD. Medication works best when a person is also in counselling." If you take medication or are considering it, keep your doctor in the loop.

If You Need Help Right Now

If you are having thoughts of suicide or feel unsafe, call or text 9-8-8, the Suicide Crisis Helpline, at any hour. In an emergency, call 9-1-1.

PTSD Counselling in Ottawa

I offer PTSD counselling in Ottawa for people living with nightmares, flashbacks, broken sleep and hypervigilance, in English or French. My PTSD counselling approach explains how the work is paced.

Veterans and serving members can also look at counselling for military personnel, and people in policing, paramedicine and firefighting at first responder counselling.

Call (613) 859-8740 or use the contact page to ask about a first session.

What to Expect From PTSD Therapy in Ottawa: The First Sessions